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TRAINING BURSARY PROGRAMME

The programme will take place starting from September 2021. Should awarded applicants not be able to travel internationally at that time, their bursaries will be frozen and granted when possible.

This program pursues major goals of the SLEuro mission, aiming to help young physicians develop their clinical and/or research skills, expertise and network of scientific contacts in the SLE field.
For this purpose, SLEuro will award bursaries to applicants for an 8-week SLE-related training at a European Institution.

Below is the list of SLEuro Centers that host the Training Bursary Programme

Amsterdam Rheumatology and Immunology Center (ARC)

The Amsterdam Rheumatology and immunology Center (ARC) consists of the departments of rheumatology of both Amsterdam UMC (Amsterdam University Medical Center; locations De Boelelaan (former VU University Medical Center, VUmc) and Meibergdreef (former Academic Medical Center, AMC)) and Reade in Amsterdam, the Netherlands. The ARC / Amsterdam UMC has a dedicated SLE out-patient clinic, in which > 400 SLE patients are currently followed per year.Moreover, since 2001, basic, translational and clinical-epidemiological research on SLE is performed in our center using patient data and biosamples obtained from 260 SLE patients included in the SLE cohort Amsterdam with ongoing inclusion of patients. Both scientific research and wide clinical experience with the diagnosis and management of SLE have contributed to numerous publications of original articles and reviews in the area of SLE by members of our SLE center. The ISI Impact Factors of the publications related to SLE in the last 3 years of the leader of the SLE center (prof. Ronald van Vollenhoven) far exceeds 25. At your request, if necessary, I can provide an overview these publications.

Members of our SLE Center are currently:

Prof. dr. Ronald F. van Vollenhoven, MD PhD, rheumatologist (director of the ARC and head of the department of rheumatology of Amsterdam UMC);
Prof.dr. Alexandre E. Voskuyl, MD PhD, rheumatologist;
Dr. Irene E.M. Bultink, MD PhD, rheumatologist;
Dr. Liesbeth (A.E.) Hak, MD PhD, rheumatologist and clinical immunologist;
Dr. Marieke van Onna, MD PhD, rheumatologist;
Dr. Michel W.P. Tsang-A-Sjoe, MD, PhD, rheumatology trainee;
Agner Parra, MD, physicians researcher

Language requirements: English (proficient user)

Contact person responsible for the training and for answering queries from prospective candidates:

Dr. Irene E.M. Bultink, MD PhD, rheumatologist
Department of Rheumatology and Clinical Immunology
Amsterdam UMC
De Boelelaan 1117
1081 HV Amsterdam
Netherlands
iem.bultink@amsterdamumc.nl
+31 – 20 – 444 34 32

Cliniques Universitaires Saint-Luc, Department Of Rheumatology

Our Lupus Center is dedicated to clinical care of lupus patients and to translational and clinical research, with a strong cross-fertilization approach. Clinical care is provided by two full-time rheumatologists (Frédéric Houssiau and Farah Tamirou), a dedicated nurse coordinator (Séverine Nieuwland-Husson) and 4 rheumatology trainees. Every week, we run two Lupus Clinics, allowing us to see 40-50 lupus patients/week, half of them with lupus nephritis. We have access to our own in-patient beds for acute cases. Our Lupus Center is part of the European Reference Network ReCONNET (Connective tissue and Musculoskeletal Diseases). More than 600 lupus patients are registered in our electronic data base.

Lupus nephritis is our main clinical research topic, with more than 50 publications in this specific field dealing with the diagnosis, prognosis and treatment of renal involvement. Our group designed and run two European investigator-initiated trials which helped to define the optimal therapy of lupus nephritis. We recently defined the early proteinuria target which predicted long-term renal outcome. We have started an ambitious renal re-biopsy program Click Here

Selected recent publications

Per-protocol repeat kidney biopsy portends relapse and long-term outcome in incident cases of proliferative lupus nephritis. Parodis et al. Rheumatology (Oxford) 2020; 59: 3424-34.
Disease severity of proliferative lupus nephritis in Maghrebians. Tamirou et al. Lupus 2018 ; 27 : 1387-92.
A proteinuria cut-off level of 0.7 g/day after 12 months of treatment best predicts long-term renal outcome in lupus nephritis : data from the MAINTAIN Nephritis Trial. Tamirou et al. Lupus Sci Med 2015 ; 2 : e000123.
Prediction of prognosis and renal outcome in lupus nephritis. Parodis et al. Lupus Sci Med 2020 ; 7 : e000389.
Intrarenal activation of adaptive immune effectors is associated with tubular damage and impaired renal function in lupus nephritis. Pamfil C. et al. Ann Rheum Dis 2018. doi: 10.1136/annrheumdis-2018-213485.
Time to change the primary outcome of lupus trials. Houssiau FA. Ann Rheum Dis 2018. doi:10.1136/annrheumdis-2018-213788.
Ustekinumab: a promising drug for SLE? Costedoat-Chalumeau N and Houssiau FA. Lancet 2018. doi:10.1016/S0140-6736(18)32330-4.
Brief Report: The Euro-Lupus low-dose intravenous cyclophosphamide regimen does not impact the ovarian reserve, as measured by serum levels of anti-Müllerian hormone. Tamirou F et al. Arthritis Rheumatol 2017;69: 1267.
Long-term follow-up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis. Tamirou F et al. Ann Rheum Dis 2016; 75: 526-31.
Contacts
Cliniques universitaires Saint-Luc
10 Avenue Hippocrate 10, B 1200 Woluwe-Saint-Lambert, Bruxelles Belgium
Phone: 02 764 11 11
Fax: 02 764 37 03

Language issue
Knowledge of English is a prerequisite. Some basic knowledge of French is welcome.

CHUC Lupus Clinic (Coimbra)

The CHUC Lupus Clinic is located at the Rheumatology Department, Centro Hospitalar Universitário de Coimbra, in Coimbra, Portugal. It is an academic referral lupus center, founded in 2005, that specializes in the care of patients with Systemic lupus erythematosus (SLE) and related conditions.

The CHUC Lupus Clinic aims to provide excellent clinical care while seeking to improve knowledge on the disease and its treatment. We currently are the main providers of specialized clinical care to over 400 patients with SLE at our dedicated out-patient clinic. We are also strongly committed to postgraduate medical education in SLE, by providing a structured clinical educational program to visiting clinical fellows. We work in close clinical collaboration with clinicians with a special interest in SLE from other medical specialties and integrate a dedicated pregnancy clinic.

The CHUC Lupus Clinic is run by Prof. Luís Inês, MD, PhD, who is a senior attending rheumatologist and faculty member at the School of Health Sciences, University of Beira Interior. In addition to clinical care, we are actively involved in clinical research. Our main research areas are clinical outcomes research in SLE and developing new measures of SLE disease activity. The clinical research program is based in the CHUC Lupus Cohort, a prospective cohort of over 400 SLE patients and with more than 12 years of follow-up. We collaborate in national and international multicenter research in SLE and participate in SLE clinical trials. Prof. Luís Inês is a founding board member of the European Lupus Society (SLEuro) and the leading author of a chapter on SLE of the EULAR Textbook on Rheumatic Diseases, 2018 (3rd edition).

Selection of publications

Brites, L., Silva, S., Andreoli, L. Inês LS. Effectiveness of reproductive health counseling of women with systemic lupus erythematosus: observational cross-sectional study at an academic lupus clinic. Rheumatol Int 2020; doi: 10.1007/s00296-020-04671-9
Jesus D, Matos A, Henriques C, Zen M, Larosa M, Iaccarino L, Da Silva JAP, Doria A, Inês LS. Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity. Ann Rheum Dis 2019;78: 365-71.
Larosa M, Zen M, Gatto M, Jesus D, Zanatta E, Iaccarino L, Inês L, Doria A. IL-12 and IL-23/Th17 axis in systemic lupus erythematosus. Exp Biol Med (Maywood). 2019; 244: 42-51.
Jesus D, Matos A, Henriques C, Zen M, Doria A, Inês LS. Response to: ‘Performance of the systemic lupus erythematosus disease activity score (SLE-DAS) in a Latin American population’, by Rodríguez-González et al. Ann Rheum Dis 2019. doi: 10.1136/annrheumdis-2019-216110.
Jesus D, Matos A, Henriques C, Zen M, Doria A, Inês LS. Response to: ‘SLE-DAS: ready for routine use’ by Mathew et al. Ann Rheum Dis 2019. doi: 10.1136/annrheumdis-2019-215794.
Jesus D, Zen M, Doria A, Inês LS. Response to: ‘Assessment of responsiveness of the musculoskeletal component of SLE-DAS in an independent cohort’, by Hassan et al. Ann Rheum Dis 2019. doi: 10.1136/annrheumdis-2019-215430.
Jesus D, Rodrigues M, Matos A, Henriques C, Pereira da Silva JA, Inês LS. Performance of SLEDAI-2K to detect a clinically meaningful change in SLE disease activity: a 36-month prospective cohort study of 334 patients. Lupus 2019: 28(5):607-612.
Rodrigues M, Inês L, Gordon C. Systemic Lupus Erythematosus: Chapter 20: Pathogenesis and Clinical Features. In: EULAR Textbook on Rheumatic Diseases. 3rd edition. London: BMJ; 2018: 577-604.
Inês L, Rodrigues M, Jesus D, Fonseca FP, Silva JAP. Risk of damage and mortality in SLE patients fulfilling the ACR or only the SLICC classification criteria. A 10-year, inception cohort study. Lupus 2018; 27: 556-63.
Jesus D, Rodrigues M, Silva JAP, Inês L. Multitarget therapy of mycophenolate mofetil and cyclosporine A for induction treatment of refractory lupus nephritis. Lupus 2018; 27: 1358-62.
Rodrigues M, Galego O, Costa C, Jesus D, Carvalho P, Santiago M, Malcata A, Inês L. Central nervous system vasculitis in systemic lupus erythematosus: a case series report in a tertiary referral centre. Lupus 2017; 26: 1440-47.
Henriques, A., Silva I., Inês L., Souto-Carneiro MM., et al. CD38, CD81 and BAFFR combined expression by transitional B cells distinguishes active from inactive systemic lupus erythematosus. Clin Exp Med 2016; 16: 227-32.
Inês L, Silva C, Galindo M, López-Longo FJ, et al. Classification of Systemic lupus erythematosus: Systemic Lupus International Collaborating Clinics versus American College of Rheumatology criteria. A Comparative Study of 2,055 Patients from a Real-life, International Systemic Lupus Erythematosus Cohort. Arthritis Care Res 2015; 67:1180-5.
Contacts
For queries related to the training program, please contact:
Coordinator of the Lupus training program: Prof. Luís Inês, MD, PhD
Contact: luisines@gmail.com
Office telephone: +351 239 400 547
Mail address: Serviço de Reumatologia. Centro Hospitalar Universitário de Coimbra. Praceta Prof. Mota Pinto, 3000-075 Coimbra. Portugal

Language requirements for candidates:
Professional working proficiency in English is recommended.
Native and working language is Portuguese.
Spoken Spanish is well understood by most patients, many have at least elementary proficiency in English.

The Policlinic of Rheumatology & Hiller Research Unit, Heinrich-Heine-University Düsseldorf (UDUS) (Head: Prof. Dr. Matthias Schneider), is dedicated to routine patient care and basic and translational research on inflammatory rheumatic diseases. Approximately 2,500 in- and outpatients with various musculoskeletal and rheumatic diseases are seen per year; clinical focuses are early diagnosis strategies, systemic connective tissue diseases and a specialized outpatient clinic for pregnancy in rheumatic diseases; we contribute e.g. approximately 30% of the lupus patients documented in the National Database of the German Collaborative Arthritis Centres. For local collaboration in care, education and research we host the administrative office of the Collaborative Arthritis Centre Rhine Ruhr (RZRR) at the Department of Rheumatology at HHUD. Nineteen rheumatologic departments in different hospitals and 80 resident rheumatologists are partners in the RZRR. Approximately 12 million people live in this area.

We were one of the six leading competence centres of the “Competence Network Rheumatic Diseases” funded by the German Federal Ministry of Education and Science. Due to our role the information technology expertise has a longstanding tradition. Several information technology projects have been conducted or established in our clinic (e.g. evaluation of the use of an APP for self-management in rheumatoid arthritis outpatients – MiDEAR; Patients’ attitudes towards electronic health record; an online registry for pregnant patients with inflammatory rheumatic diseases – RHEKISS).

In collaboration with the German Lupus Self-Help Organisation we run since 2001 a nationwide SLE cohort study (LuLa-study), which is completely performed based on patients reported outcomes focusing on burden of illness, therapy adherence, care, coping and similar topics. Exceptional competencies exist on the subject co-morbidities and their prevention on account of established non-interventional cohorts and cross sectional studies (arteriosclerosis study, Lupus erythematodes Langzeit-Studie (LuLa) study, Lupus-prevention pass, gender study. Further research focuses on the issue that conceptualised psychoeducational support may produce a significant and sustained improvement in coping skills of SLE patients and hence in their quality of life.

We successfully applied for multiple funding at EU, the Deutsche Forschungsgemeinschaft (DFG), the German Federal Ministry of Education and Research (BMBF), Ministry of Innovation, Science, Research and Technology of North-Rhine-Westphalia, patient organisations (e.g. Deutsche Rheuma-Liga and German LE Self-Help Community), and the pharmaceutical industry. In addition we are continuously sponsored by the Hiller foundation, which founded in 2015 together with the UDUS the Hiller Research Unit for Rheumatology coordinated by professorship for Experimental Rheumatology. In addition, our work is supported by our own unit of biometrics and a specific research unit for imaging in Rheumatology. A dedicated biobank compliant with the German and international data-protection regulations and research in biomarkers supports the (health services) research in view of the developments in the field of individualised medicine.

We are members of the European Reference Network on connective tissue and musculoskeletal diseases (ERN ReCONNET) established in March 2017.

Contacts
Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225 Düsseldorf
+49 (0) 2 11-81 00

The Lupus Clinic at the Centre for Rheumatology, University College London has been running since 1979. Over that time we have treated over 600 patients with SLE and we are currently following over 400 patients.

We have extensive databases of clinical and serological information including activity measured by BILAG for each patient at each visit. Thus we have been able to write a large number of research papers looking at long-term clinical outcomes in SLE, for example cancer, damage, cardiovascular events, infection and neuropsychiatric lupus. We were one of the first centres to develop use of B cell depletion to treat patients with refractory SLE.

Our centre is affiliated to both the British Isles Lupus Assessment Group and the Systemic Lupus International Collaborative Clinics and we are therefore involved in multi-centre studies of lupus.

We also have a thriving programme of laboratory research in SLE and APS, including both mouse models and human studies. We have published work on T Cells, B cells, monocytes, autoantibodies and lipid profiles and the impact of these biological factors on clinical outcomes.

Many European fellows have spent time in our unit over the last 20 years, ranging from a few months to several years. Many of them published research based on projects that they did here.

Fellows would need to speak English to train here.

Contacts
Centre for Rheumatology, UCL Division of Medicine, Rayne Building, 4th Floor, 5 University Street, London WC1E 6JF
+44 (0)20 7679 2000

Contact person
Professor Anisur Rahman: Anisur.rahman@ucl.ac.uk

Centre de Référence Maladies Rares – Hôpital Cochin (Paris)

he area of expertise of Cochin’s Hospital Center includes systemic lupus erythematosus (SLE) especially for its rare or complex presentations, antiphospholipid syndrome (APS), but also systemic sclerosis (SSc), Sjogren’s syndrome, mixed connective tissue disease (MCTD) and undifferentiated connective tissue disease (UCTD), myositis (dermatomyositis, polymyositis, antisynthetase syndrome) and relapsing polychondritis. In addition, we have a specific national expertise on pregnancies and connective tissue diseases (CTD).

The Department of Internal Medicine is located in Cochin Hospital, University of Paris and it ensures a global management of these patients. Patients are referred based on the expertise of our center. As a healthcare Provider, we provide:

  • 15 weekly clinics dedicated to CTD: 4 SLE, 4 SSc and 7 with different CTD, including 2 clinics dedicated to pregnancy and CTD.
  • 2 hospitalization and 1 week hospitalization wards (20 and 14 beds respectively) dedicated to CTD (and vasculitis and other rare systemic autoimmune diseases). We perform in real time a number of instrumental examinations, including videocapillaroscopy, pulmonary function tests, computerized tomodensitometry scanning, echocardiography, articular ultrasound, renal biopsy and ophthalmological monitoring of hydroxychloroquine treatment (visual field testing, Optical Coherence Tomography spectral domain (OCT-SD), Fundus autofluorescence, electroretinogram). All these tests are performed and analysed by CTD specialized physicians, ensuring accurate evaluation. We also perform plasma exchanges and administrate infused therapies including intravenous immunoglobulin, cyclophosphamide and biologics.
  • 1 day hospitalization ward in obstetric where high risk pregnant patients with CTD are offered the best available care in a department with more than 6000 deliveries/year
  • Urgent care (24/7) and admission of patients with acute problems or requiring specific treatments in the traditional hospitalization wards, where an infectious mobile team is available for immuno-compromised patients.
  • An access to an intensive care unit with physicians trained to manage severe CTD.
  • A daily facility for the dressing of ulcers or skin lesions (on demand).
  • An access to high quality immunological lab
  • A transitioning circuit from pediatric to adult care in collaboration with the Necker hospital pediatric departments has been established for years.
  • A multidisciplinary team with physicians, nurses, physiotherapists, nutritionists, psychologists and social workers specialized in therapeutic education of patients
  • Numerous multidisciplinary regular expert reviews and joint meetings for difficult nephrological cases, muscular cases, ophthalmological cases, pediatric cases, obstetrical and rheumatological cases.

Our center is part of a national network on rare diseases since 2004. As a referral center for rare autoimmune and systemic diseases, we are organised to fulfill 6 major missions:

  • coordinating the research effort and participating in the epidemiological surveillance, in connection with the French National Institute of Health Monitoring; to that end, databases have been established for SLE and APS (n>500), SSc (n=2500 patients), and CTD pregnancies (n>1500). Our center has been leading several projects and contributing to many others. It could be highlighted that we contributed to the 2013 reclassification criteria for SSc and to the new ACR/EULAR classification criteria for SLE.
  • participating in training and information initiatives for the healthcare providers, as well as for sick people and their families; communication and dissemination are pillars of our activities, our center being an academic centers hosting medical students (n=144 per year), residents (n=30 per year) and PhD (n=5) in training. We also deliver lectures at the nurse school of Cochin hospital and to nurses in our departments We organize at the local (hospital), regional (Ile de France), national and international levels meeting to share projects and ideas and improve the management of patients.
  • facilitating the diagnosis and defining a strategy of treatment including psychological care and social support; as above described, patients’ management has been organised to reach this goal and is fully included in our routine care with the participation of specialised nurses and psychologists.
  • setting up and making available for other centers therapeutic protocols and recommendations of care, in connection with the French National Health Authorities and the French National Health Insurance Funds, the so-colled PNDS have been supervised by our center in 2006 for SSc and is publicly available on the “Haute Autorité de Santé website” Click Here
  • leading and coordinating the networks of physicians, paramedics and social correspondents involved in the care of patients; We organize weekly medical meetings with CTD correspondents to review patient’s charts.

Our center is implicated in the clinical and translational research in CTDs:

  • 3 international clinical trials and numerous national clinical trials initiated by the members of the healthcare Provider.
  • 23 international and 13 national trials in which members of the healthcare Provider currently participate.
  • Six international and two national consensus conferences in which members of the healthcare Provider participate.
  • More than ten national or international courses on CTD including the university diploma on systemic autoimmune diseases at University of Paris (director Luc Mouthon and Nathalie Costedoat-Chalumeau), EULAR course in SLE, EUSTAR course and EUSTAR master class in SSc, in which members of the healthcare Provider participate.
  • International congresses including the international Lupus congress (co-organiser), the world congress on scleroderma and the international Workshop on scleroderma for which the members of the healthcare Provider participate in the organizing committee.
  • A member of our center is head of one basic research unit located at the Cochin institute, Inserm U1016, UMR 1804, Paris Descartes University, Paris: “neutrophils and vasculitis”: Head Pr luc Mouthon and Dr Véronique Witko-Sarsat. We are affiliated to other basic research unit including epidemiology (Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France)

Requirement:
to speak at least partially French.

Contacts
Nathalie Costedoat-Chalumeau
nathalie.costedoat@gmail.com

Clinical Immunology Unit (UIC) was formally created in 1996 in the Internal Medicine Department with internists directly involved in the field of Immunology. UIC has developed its activities in diagnosis and follow-up of patients with diseases resulting from altered immune mechanisms, mainly autoimmune diseases and immunodeficiencies.

In collaboration with the Immunology Service of our hospital and with the Immuno-Genetic department of ICBAS – Instituto Ciências Biomédicas Abel Salazar, Universidade do Porto, there are regular and proficuous contact with the laboratory techniques, their indications, methods, limitations and pitfalls. In addition to the theoretical approach in basic and laboratory immunology, residents will participate in the practical discussions associated with the use of the tests in real clinical cases.

Main areas of intervention:

  1. Clinical practice:
    Every day outpatient clinic of Autoimmune Diseases, Immunodeficiencies and Raynaud / Capillaroscopy is our main working area.
  2. Multidisciplinary group consultation
    It is held every Friday from 11 am to 2 pm, with the collaboration of different medical specialists, like nefrology, neurology, lab. immunology, pediatrics, dermatology, and others.
    It is a unique meeting of its kind in Portugal – where doctors from inside and other hospitals are also regularly involved. Several clinical cases with problems regarding diagnosis or therapy decision, such as those proposed for biological therapy, are discussed on a weekly basis. It is an extraordinary learning forum for the different levels of knowledge involved.
  3. In-patient counseling
    We support  hospitalized patients with pathologies in the area of ​​Clinical Immunology.
  4. Formation
    UIC has regularly scheduled, seminars to discuss topics such as SLE, Behçet, Sjogren, RA, Scleroderma, Myositis, Uveitis, Spondyloarthropathies, Undifferentiated connectivites, Antiphospholipid syndrome, Imaging in rheumatic diseases, Infiltration techniques in simulators, Clinical trials, Physiotherapy, Basic immunology, Primary and secondary Immunodeficiencies and Autoinflamatory syndromes. We also have Journal Club sessions.
  5. Research
    There is no good clinical care without associated research. Research lead clinician to raise questions, stimulate new sights that translate, in the short / medium term, into better care to the patient and his illness.
    UIC participate in several research projects at both national and international level and also participates in several Phase II, III and IV Clinical Trials.
  6. Conference organization
    UIC provide conditions for meetings between national and international experts, with an active role in the discussion and sharing of ideas, based on clinical evidence and personal experience, sharing experiences among centers of high level of differentiation in the area of autoimmunology and immunodeficiencies
    UIC organize every year an International meeting, PAM – Porto’s Autoimmunity Meeting and was responsible for the organization of the 11th European Lupus Meeting (Porto, chair Prof. Carlos Vasconcelos)

Selection of publications
ISI factor for Lupus – Carlos Vasconcelos PhD from 2015-2018: 70.7861

1: van Vollenhoven R, Voskuyl A, Bertsias G, Aranow C, Aringer M, Arnaud L, Askanase A, Balážová P, Bonfa E, Bootsma H, Boumpas D, Bruce I, Cervera R, Clarke A, Coney C, Costedoat-Chalumeau N, Czirják L, Derksen R, Doria A, Dörner T, Fischer-Betz R, Fritsch-Stork R, Gordon C, Graninger W, Györi N, Houssiau F, Isenberg D, Jacobsen S, Jayne D, Kuhn A, Le Guern V, Lerstrøm K, Levy R, Machado-Ribeiro F, Mariette X, Missaykeh J, Morand E, Mosca M, Inanc M, Navarra S, Neumann I, Olesinska M, Petri M, Rahman A, Rekvig OP, Rovensky J, Shoenfeld Y, Smolen J, Tincani A, Urowitz M, van Leeuw B, Vasconcelos C, Voss A, Werth VP, Zakharova H, Zoma A, Schneider M, Ward M. A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). Ann Rheum Dis. 2017 Mar;76(3):554-561. doi: 10.1136/annrheumdis-2016-209519. Epub 2016 Nov 24. Review. PubMed PMID: 27884822.
Impact Factor 2017/2018: 12.35

2: Tamirou F, D’Cruz D, Sangle S, Remy P, Vasconcelos C, Fiehn C, Ayala GuttierezMdel M, Gilboe IM, Tektonidou M, Blockmans D, Ravelingien I, le Guern V, Depresseux G, Guillevin L, Cervera R, Houssiau FA; MAINTAIN Nephritis Trial Group. Long-term follow-up of the MAINTAIN Nephritis Trial, comparing azathioprine and mycophenolate mofetil as maintenance therapy of lupus nephritis. Ann Rheum Dis. 2016 Mar;75(3):526-31. doi:10.1136/annrheumdis-2014-206897. Epub 2015 Mar 10. PubMed PMID: 25757867; PubMed Central PMCID: PMC4789692.
Impact Factor 2016: 12.811

3: Oparina NY, Delgado-Vega AM, Martinez-Bueno M, Magro-Checa C, Fernández C, Castro RO, Pons-Estel BA, D’Alfonso S, Sebastiani GD, Witte T, Lauwerys BR, Endreffy E, Kovács L, Escudero A, López-Pedrera C, Vasconcelos C, da Silva BM, Frostegård J, Truedsson L, Martin J, Raya E, Ortego-Centeno N, de Los Angeles Aguirre M, de Ramón Garrido E, Palma MJ, Alarcon-Riquelme ME, Kozyrev SV. PXK locus in systemic lupus erythematosus: fine mapping and functional analysis reveals novel susceptibility gene ABHD6. Ann Rheum Dis. 2015 Mar;74(3):e14. doi:10.1136/annrheumdis-2013-204909. Epub 2014 Feb 17. PubMed PMID: 24534757.
Impact Factor 2015: 12.384

4: Cervera R, Serrano R, Pons-Estel GJ, Ceberio-Hualde L, Shoenfeld Y, de Ramón E, Buonaiuto V, Jacobsen S, Zeher MM, Tarr T, Tincani A, Taglietti M, Theodossiades G, Nomikou E, Galeazzi M, Bellisai F, Meroni PL, Derksen RH, de Groot PG, Baleva M, Mosca M, Bombardieri S, Houssiau F, Gris JC, Quéré I, Hachulla E, Vasconcelos C, Fernández-Nebro A, Haro M, Amoura Z, Miyara M, Tektonidou M, Espinosa G, Bertolaccini ML, Khamashta MA; Euro-Phospholipid Project Group (European Forum on Antiphospholipid Antibodies). Morbidity and mortality in the antiphospholipid syndrome during a 10-year period: a multicenter prospective study of 1000 patients. Ann Rheum Dis. 2015 Jun;74(6):1011-8. doi:10.1136/annrheumdis-2013-204838. Epub 2014 Jan 24. PubMed PMID: 24464962.
Impact Factor 2015: 12.384

5: Marinho A, Carvalho C, Boleixa D, Bettencourt A, Leal B, Guimarães J, Neves E, Oliveira JC, Almeida I, Farinha F, Costa PP, Vasconcelos C, Silva BM. Vitamin D supplementation effects on FoxP3 expression in T cells and FoxP3(+)/IL-17A ratio and clinical course in systemic lupus erythematosus patients: a study in a Portuguese cohort. Immunol Res. 2017 Feb;65(1):197-206. doi:10.1007/s12026-016-8829-3. PubMed PMID: 27423437.
Impact Factor 2017/2018: 2.487

6: Marinho A, Taveira M, Vasconcelos C. Topics on vitamin D in systemic lupus erythematosus: analysis of evidence and critical literature review. Immunol Res. 2017 Apr;65(2):495-511. doi: 10.1007/s12026-017-8903-5. Review. PubMed PMID:28229285.
Impact Factor 2017/2018: 2.487

7: Bettencourt A, Carvalho C, Leal B, Brás S, Lopes D, Martins da Silva A, Santos E, Torres T, Almeida I, Farinha F, Barbosa P, Marinho A, Selores M, Correia J, Vasconcelos C, Costa PP, da Silva BM. The Protective Role of HLA-DRB1(∗)13 in Autoimmune Diseases. J Immunol Res. 2015;2015:948723. doi: 10.1155/2015/948723. Epub 2015 Oct 29. PubMed PMID: 26605347; PubMed Central PMCID: PMC4641944.
Impact Factor 2015: 3.53

8: Tamirou F, Lauwerys BR, Dall’Era M, Mackay M, Rovin B, Cervera R, Houssiau FA;MAINTAIN Nephritis Trial Investigators. A proteinuria cut-off level of 0.7 g/day after 12 months of treatment best predicts long-term renal outcome in lupus nephritis: data from the MAINTAIN Nephritis Trial. Lupus Sci Med. 2015 Nov 12;2(1):e000123. doi: 10.1136/lupus-2015-000123. eCollection 2015. PubMed PMID:26629352; PubMed Central PMCID: PMC4654096.
Impact Factor not available

Scopus CiteScore 2.88 (2017)

9: Langefeld CD, Ainsworth HC, Cunninghame Graham DS, Kelly JA, Comeau ME, Marion MC, Howard TD, Ramos PS, Croker JA, Morris DL, Sandling JK, Almlöf JC, Acevedo-Vásquez EM, Alarcón GS, Babini AM, Baca V, Bengtsson AA, Berbotto GA, Bijl M, Brown EE, Brunner HI, Cardiel MH, Catoggio L, Cervera R, Cucho-Venegas JM, Dahlqvist SR, D’Alfonso S, Da Silva BM, de la Rúa Figueroa I, Doria A, Edberg JC, Endreffy E, Esquivel-Valerio JA, Fortin PR, Freedman BI, Frostegård J, García MA, de la Torre IG, Gilkeson GS, Gladman DD, Gunnarsson I, Guthridge JM, Huggins  JL, James JA, Kallenberg CGM, Kamen DL, Karp DR, Kaufman KM, Kottyan LC, Kovács L, Laustrup H, Lauwerys BR, Li QZ, Maradiaga-Ceceña MA, Martín J, McCune JM, McWilliams DR, Merrill JT, Miranda P, Moctezuma JF, Nath SK, Niewold TB, Orozco L, Ortego-Centeno N, Petri M, Pineau CA, Pons-Estel BA, Pope J, Raj P, Ramsey-Goldman R, Reveille JD, Russell LP, Sabio JM, Aguilar-Salinas CA, Scherbarth HR, Scorza R, Seldin MF, Sjöwall C, Svenungsson E, Thompson SD, Toloza SMA, Truedsson L, Tusié-Luna T, Vasconcelos C, Vilá LM, Wallace DJ, Weisman MH, Wither JE, Bhangale T, Oksenberg JR, Rioux JD, Gregersen PK, Syvänen AC, Rönnblom L, Criswell LA, Jacob CO, Sivils KL, Tsao BP, Schanberg LE, Behrens TW, Silverman ED, Alarcón-Riquelme ME, Kimberly RP, Harley JB, Wakeland EK, Graham RR, Gaffney PM, Vyse TJ. Transancestral mapping and genetic load in systemic lupus erythematosus. Nat Commun. 2017 Jul 17;8:16021. doi: 10.1038/ncomms16021. PubMed PMID: 28714469; PubMed Central PMCID: PMC5520018.
Impact Factor 2015: 12.353

Contacts
Carlos Vasconcelos
Centro Hospitalar do Porto, Largo do Prof. Abel Salazar, 4099-001 Porto, Portugal

Karolinska University Hospital (Stockholm)

Presently the Karolinska university hospital is localized in two sites Karolinska Solna and Karolinska Huddinge. We have weekly lupus clinics at both sites where we perform inclusion visits to enter or follow up patients in our studies. Our center has performed studies with regard to SLE since 1995, when we started to collect the Karolinska lupus cohort. It has now been followed for > 20 years and contains information on more than 700 SLE patients (including deceased patients).

The study design build on very detailed and structured inclusion of the patients approximately every 10 years. Large cross-sectional studies of all SLE patients at Rheumatology Karolinska were initially performed 1995-98, with an extended now completed follow-up 2004-14. Since 2015, a novel third follow up of prevalent and new cases is ongoing. Very detailed clinical characterization, life style questionnaires, fasting plasma, urine and DNA samples together with results from carotid ultrasound and bone mineral density measures have been collected. General disease activity, patient reported measures as well as lupus nephritis (affecting 40%) activity and detailed autoantibody profiles are recorded at inclusion. Data are stored in a common database. The total number of SLE patients recorded on our databases is today >700. Population based controls identified in the national population registry, individually matched for age, sex, and residency have been investigated in person according to the same structured protocol (n=320). Originating in the collected data we have conducted studies on selected topics. Previous studies have focused on cardiovascular disease, renal manifestations, biomarkers, microparticles, autoantibodies, fatigue, patient reposted outcomes and sub-phenotypes of lupus.

Professor Iva Gunnarsson is PI for another line of research based on renal biopsies (N=400), including paired biopsies performed before and after treatment (N=100). The biopsies have been collected over many years together with a corresponding database/biobank with stored serum, plasma and urine sampled. Renal tissue is available for research purposes. We also perform structured longitudinal follow up studies including blood samples and PBMC from SLE patients on biological treatments such as rituximab and belimumab.

Our collaborators in the lab are located at Center for Molecular Medicine at the Karolinska Solna site. Autoantibodies, B-cells and microparticles are the focus of several ongoing studies in the lab. Within the Swedish SLE network (>1500 patients) we have also performed, and been part of, larger genetic studies.

Requirement: Fluent English, Swedish or Scandinavian languages will facilitate patient contacts

Some recent publications:

  1. Parodis I, Arnaud L, Gerhardsson J, Zickert A, Sundelin B, Malmstrom V, et al. Antiphospholipid Antibodies in Lupus Nephritis. PLoS One. 2016;11(6):e0158076.
  2. Mobarrez F, Vikerfors A, Gustafsson JT, Gunnarsson I, Zickert A, Larsson A, et al. Microparticles in the blood of patients with systemic lupus erythematosus (SLE): phenotypic characterization and clinical associations. Sci Rep.2016;6:36025.
  3. Zickert A, Oke V, Parodis I, Svenungsson E, Sundstrom Y, Gunnarsson I. Interferon (IFN)-lambda is a potential mediator in lupus nephritis. Lupus Sci Med. 2016;3(1):e000170.
  4. Gustafsson JT, Herlitz Lindberg M, Gunnarsson I, Pettersson S, Elvin K, Ohrvik J, et al. Excess atherosclerosis in systemic lupus erythematosus,-A matter of renal involvement: Case control study of 281 SLE patients and 281 individually matched population controls. PLoS One. 2017;12(4):e0174572.
  5. Arkema EV, Svenungsson E, Von Euler M, Sjowall C, Simard JF. Stroke in systemic lupus erythematosus: a Swedish population-based cohort study. Ann Rheum Dis. 2017.
  6. Oke V, Brauner S, Larsson A, Gustafsson J, Zickert A, Gunnarsson I, et al. IFN-lambda1 with Th17 axis cytokines and IFN-alpha define different subsets in systemic lupus erythematosus (SLE). Arthritis Res Ther. 2017;19(1):139.
  7. Mobarrez F, Gunnarsson I, Svenungsson E. Altered beta2 -glycoprotein I expression on microparticles in the presence of antiphospholipid antibodies. J Thromb Haemost. 2017;15(9):1799-806.
  8. Grosso G, Vikerfors A, Woodhams B, Adam M, Bremme K, Holmstrom M, et al. Thrombin activatable fibrinolysis inhibitor (TAFI) – A possible link between coagulation and complement activation in the antiphospholipid syndrome (APS). Thromb Res. 2017;158:168-73.
  9. Gronwall C, Hardt U, Gustafsson JT, Elvin K, Jensen-Urstad K, Kvarnstrom M, et al. Depressed serum IgM levels in SLE are restricted to defined subgroups. Clin Immunol. 2017;183:304-15.
  10. Idborg H, Eketjall S, Pettersson S, Gustafsson JT, Zickert A, Kvarnstrom M, et al. TNF-alpha and plasma albumin as biomarkers of disease activity in systemic lupus erythematosus. Lupus Sci Med. 2018;5(1):e000260.
  11. Gerhardsson J, Sundelin B, Zickert A, Padyukov L, Svenungsson E, Gunnarsson I. Histological antiphospholipidassociated nephropathy versus lupus nephritis in patients with systemic lupus erythematosus: an observational cross-sectional study with longitudinal follow-up. Arthritis Res Ther. 2015;17:109.
  12. Parodis I, Lopez Benavides AH, Zickert A, Pettersson S, Moller S, Welin Henriksson E, et al. The impact of belimumab and rituximab on health-related quality of life in patients with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2018.
  13. Parodis I, Sjowall C, Jonsen A, Ramskold D, Zickert A, Frodlund M, et al. Smoking and pre-existing organ damage reduce the efficacy of belimumab in systemic lupus erythematosus. Autoimmun Rev. 2017;16(4):343-51.
  14. Parodis I, Soder F, Faustini F, Kasza Z, Samuelsson I, Zickert A, et al. Rituximab-mediated late-onset neutropenia in systemic lupus erythematosus – distinct roles of BAFF and APRIL. Lupus. 2018;27(9):1470-8.
  15. Pettersson S, Bostrom C, Eriksson K, Svenungsson E, Gunnarsson I, Henriksson EW. Lifestyle habits and fatigue among people with systemic lupus erythematosus and matched population controls. Lupus. 2015.
  16. Pettersson S, Svenungsson E, Gustafsson J, Moller S, Gunnarsson I, Welin Henriksson E. A comparison of patients’ and physicians’ assessments of disease activity using the Swedish version of the Systemic Lupus Activity Questionnaire. Scand J Rheumatol. 2017:1-10.

Contact persons
Professor Elisabet Svenungsson Elisabet.svenungsson@ki.se
Professor Iva Gunnarsson iva.gunnarsson@sll.se

Service de Rhumatologie, Hôpital de Hautepierre, Strasbourg, France

The department of Rheumatology of Hôpitaux Universitaires de Strasbourg is located in the beautiful city of Strasbourg in the North-East of France. This center acts as the French National Reference Center for Rare Auto-immune diseases and is a major actor within the European Centers of Excellence for auto-immune diseases, being a member of two major European Networks of Reference (ERN) for rare diseases, namely the ERN ReCONNET and the ERN RITA. The center follows very large cohorts of patients with inflammatory rheumatic diseases, including Systemic Lupus Erythematosus and is interfaced with the INSERM (National Institute of Health) immune-molecular rheumatology unit UMR-S 1109. More than 15 industry-sponsored phase 2/3 SLE trials are ongoing in the center. Participants to our training program will gain extensive clinical experience and practical knowledge of SLE and will be offered the possibility to perform research at the highest international level. Applicants should be able to speak French to fully benefit from the experience.

Contacts
Pr Laurent ARNAUD
Service de Rhumatologie
Hôpital de Hautepierre
1 Av Moliere – 67098 Strasbourg Cedex
Laurent.arnaud@chru-strasbourg.fr

Rheumatology Unit, University of Padua, Italy

The Rheumatology Unit, University of Padua, is a tertiary referral rheumatology center, within Italy, for the diagnosis and management of patients affected with different rheumatologic conditions including patients with systemic lupus erythematosus, other systemic connective tissue diseases, vasculitis, and autoinflammatory syndromes. 

Padua is a welcoming and charming city, ensuring one of the finest experiences of Italian arts, culture and lifestyle. The University of Padua is one of Europe’s oldest and most renowned universities with a very famous school of Medicine which hosted, among others, William Harvey, Gabriele Falloppio, Girolamo Fabrici ab Acquapendente, Giovanni Battista Morgagni.

Rheumatology Unit

Hospital Admissions: The Unit has 10 beds for the hospitalization of patients with acute and severe rheumatological conditions and/or complications.

Day Hospital: The Unit has some offices for the administration of intravenous treatments. In this area we also perform emergency visits requested by emergency service of the Hospital.

Outpatient Clinics: we have many out-patient clinical activities dedicated to patients affected with specific diseases: lupus clinic, scleroderma clinic, myositis clinic, Sjögren syndrome clinic, antiphospholipid syndrome clinic, vasculitis clinic, autoinflammatory diseases clinic and arthritis clinic. In addition, pregnant patients with systemic rheumatologic diseases are regularly followed-up in a dedicated out-patients clinic.

Diagnostic Tools: we regularly perform video-capillaroscopy, joint, salivary-glands and vessel Doppler ultrasonography, and synovial fluid examination.

We are members of the European Reference Network on connective tissue and musculoskeletal diseases (ERN ReCONNET), European Myositis Network (EUMyoNET), and members of Immunodeficiency, autoinflammatory and autoimmune diseases (ERN RITA)

Research programs: we perform translational, clinical and epidemiological research focused on systemic lupus erythematosus, other connective tissue diseases, vasculitis, autoinflammatory disorders and arthritis.

We also have a research laboratory where we perform studies on both mouse models and humans. Our research is mainly focused on connective tissue diseases and especially systemic lupus. In this regard, we carry on in vivo research on murine models of lupus nephritis, aimed at unraveling peculiar abnormalities in the pathogenic pathways which can be eventually targeted for treatment. Besides, we adopt a bed-to-bench approach starting from observations on patient samples which have been paving the way to study of novel biomarkers in lupus and lupus nephritis in the last decades. The main facilities used include flow-cytometry, confocal microscopy and use of immunoenzymatic assays; in addition, specific strategies are developed in close collaborations with other researchers of Padova University, thereby allowing a wider experimental approach.

European and non-European fellows: in the last 10 years, we host many fellows, mostly residents during their rotation period.

Updates in Rheumatology: Padova Rheumatology Unit organizes yearly meetings on the timeliest topics in Rheumatology, discussing updates and difficult cases with domestic and foreign experts


Language requirements: English


Contacts

Prof. Andrea Doria

Division of Rheumatology,

Department of Medicine,

University of Padova, Italy.

Via Giustiniani, 2, 35128 Padova, Italy.

Tel.: +39 049 8212190

fax: +39 049 8212191

e-mail: adoria@unipd.it


Members of Padua Lupus Clinic:

Prof. Luca Iaccarino

Dr. Margherita Zen

Dr Mariele Gatto


Members of Lab

Dr. Anna Ghirardello

Dr. Marta Tonello

Dr. Roberto Luisetto


Selected recent publications on SLE

1. Zen M, Loredo Martinez M, Benvenuti F, Gatto M, Saccon F, Larosa M, Iaccarino L, Doria A. Prevalence, outcome and management of patients with SLE and secondary antiphospholipid antibody syndrome after aPL seroconversion. Rheumatology (Oxford). 2020 Sep 17:keaa463. doi: 10.1093/rheumatology/keaa463. Epub ahead of print. PMID: 32940703.

2. Moroni G, Gatto M, Tamborini F, Quaglini S, Radice F, Saccon F, Frontini G, Alberici F, Sacchi L, Binda V, Trezzi B, Vaglio A, Messa P, Sinico RA, Doria A. Lack of EULAR/ERA-EDTA response at 1 year predicts poor long-term renal outcome in patients with lupus nephritis. Ann Rheum Dis. 2020; 79(8):1077-1083.

3. Saccon F, Zen M, Gatto M, Margiotta DPE, Afeltra A, Ceccarelli F, Conti F, Bortoluzzi A, Govoni M, Frontini G, Moroni G, Dall’Ara F, Tincani A, Signorini V, Mosca M, Frigo AC, Iaccarino L, Doria A. Remission in systemic lupus erythematosus: testing different definitions in a large multicentre cohort. Ann Rheum Dis. 2020 Jul;79(7):943-950. 

4. Zen M, Saccon F, Gatto M, Montesso G, Larosa M, Benvenuti F, Iaccarino L, Doria A. Prevalence and predictors of flare after immunosuppressant discontinuation in patients with systemic lupus erythematosus in remission. Rheumatology (Oxford). 2020 Jul 1;59(7):1591-1598. 

5. Jesus D, Matos A, Henriques C, Zen M, Larosa M, Iaccarino L, Da Silva JAP, Doria A, Inês LS. Derivation and validation of the SLE Disease Activity Score (SLE-DAS): a new SLE continuous measure with high sensitivity for changes in disease activity. Ann Rheum Dis. 2019; 78(3):365-371..

6. Gatto M, Zen M, Iaccarino L, Doria A. New therapeutic strategies in systemic lupus erythematosus management. Nat Rev Rheumatol. 2019 Jan;15(1):30-48. 

7. Moroni G, Vercelloni PG, Quaglini S, Gatto M, Gianfreda D, Sacchi L, Raffiotta F, Zen M, Costantini G, Urban ML, Pieruzzi F, Messa P, Vaglio A, Sinico RA, Doria A. Changing patterns in clinical-histological presentation and renal outcome over the last five decades in a cohort of 499 patients with lupus nephritis. Ann Rheum Dis. 2018; 77(9):1318-1325.

8. Gatto M, Saccon F, Zen M, Regola F, Fredi M, Andreoli L, Tincani A, Urban ML, Emmi G, Ceccarelli F, Conti F, Bortoluzzi A, Govoni M, Tani C, Mosca M, Ubiali T, Gerosa M, Bozzolo E, Canti V, Cardinaletti P, Gabrielli A, Tanti G, Gremese E, De Marchi G, De Vita S, Fasano S, Ciccia F, Pazzola G, Salvarani C, Negrini S, Puppo F, Di Matteo A, De Angelis R, Orsolini G, Rossini M, Faggioli P, Laria A, Piga M, Mathieu A, Scarpato S, Rossi FW, de Paulis A, Brunetta E, Ceribelli A, Selmi C, Prete M, Racanelli V, Vacca A, Bartoloni E, Gerli R, Larosa M, Iaccarino L, Doria A. Early Disease and Low Baseline Damage as Predictors of Response to Belimumab in Patients With Systemic Lupus Erythematosus in a Real- Life Setting. Arthritis Rheumatol. 2020;72(8):1314-1324.

9. Doria A, Stohl W, Schwarting A, Okada M, Scheinberg M, van Vollenhoven R, Hammer AE, Groark J, Bass D, Fox NL, Roth D, Gordon D. Efficacy and Safety of Subcutaneous Belimumab in Anti-Double-Stranded DNA-Positive, Hypocomplementemic Patients With Systemic Lupus Erythematosus. Arthritis Rheumatol. 2018;70(8):1256-1264. 

10. Zen M, Iaccarino L, Gatto M, Saccon F, Larosa M, Ghirardello A, Punzi L, Doria A. Lupus low disease activity state is associated with a decrease in damage progression in Caucasian patients with SLE, but overlaps with remission. Ann Rheum Dis. 2018; 77(1):104-110.

Department of Autoimmune Diseases of the Hospital Clínic de Barcelona

The Department of Autoimmune Diseases of the Hospital Clínic de Barcelona devotes its clinical activity to the diagnosis, treatment and follow-up of patients with systemic autoimmune diseases. It is a reference center for these diseases at European level (member of ERN-ReCONNET and ERN-RITA) and Spanish level (CSUR Enfermedades Autoinmunes Sistémicas).

Outpatient Clinics: Every day, 30-50 patients (5-10 first consultations and 20-30 successive consultations) are visited in 2 offices. More than 10,000 new patients have been visited over the 25 years.

Hospital Admissions: The Department has 6 beds for conventional hospitalisation.

Day Hospital: The Department has two offices and several sites for the administration of intravenous treatments located at the Day Hospital. This area also allows access to unscheduled and emergency visits without a prior appointment (Monday to Friday, from 9:00 to 21:00).

Diagnostic Tools: The following exams are carried out by members of the Department: Capillaroscopy, temporal artery biopsy, muscle and nerve biopsy, minor gland biopsy and temporal artery ultrasonography.

Current clinical and research programs: It takes care and perform clinical and epidemiological studies of patients with systemic lupus erythematosus, antiphospholipid syndrome, Sjögren’s syndrome, systemic sclerosis, systemic vasculitis, inflammatory myopathies, sarcoidosis, Behçet’s disease, autoimmune uveitis, autoinflammatory diseases and primary immunodeficiencies. Our Department organises the Master in Autoimmune Diseases of the Universitat de Barcelona. This is a master’s degree adapted to the European Higher Education Area, made up of by 60 ECTS credits. This is the first University Master in Europe that presents autoimmune diseases comprehensively, bringing together the basic concepts of autoimmunity with clinical aspects of the autoimmune diseases. For more information.

Contact:
Ricard Cervera

Requirements:
Currently the way to perform this fellowship at our center is by performing the Master in Autoimmune Diseases of the Universitat de Barcelona that we coordinate. It includes 60 ECTS credits (one academic year), but it is not necessary to stay in Barcelona the whole year:
– Module 1 is performed completely on-line and, therefore, it can be performed anywhere.
– Module 2 includes lectures performed every Friday from October to February (plus complementary activities, readings, portfolios…). This is the suggested period to stay in Barcelona.
– Module 3 is the clinical rotation that can be performed during the stay in Barcelona (i.e., from October to February).
– Module 4 is the research project.

Our Lupus Center offers the unique opportunity to work closely with rheumatologists, dermatologists, nephrologists and internists, experts in systemic lupus. We have recently been labelled French National Reference Center for Rare Auto-immune diseases in close collaboration with Strasbourg. We are also part of the Euskampus consortium in collaboration with Bilbao (Spain, Prof Ruiz-Irastorza)

The center follows very large cohorts of patients with systemic lupus and is interfaced with an Immunology Lab, ImmunoConcept CNRS UMR 5164.

Our current research mainly focuses on:
– The role of different immunological actors (OX40L, soluble FasL and selectins) in lupus pathogenesis
– Immune mediators and metabolites involved in cardiovascular risk of SLE patients

Participants to our training program will gain extensive clinical experience and practical knowledge of SLE and will be offered the possibility to perform research at the highest international level.

Members of our SLE Center are currently:

  • Prof. Christophe Richez, MD PhD, rheumatologist (director of center of reference);
  • Prof. Estibaliz Lazaro, MD PhD, internist (co-director of center of reference);
  • Prof. Patrick Blanco, MD PhD, immunologist (head of autoimmunity department of the Immunology lab);
  • Prof. Lionel Couzi, MD PhD, nephrologist;
  • Prof. Julien Seneschal, MD PhD, dermatologist.

Selected recent publications

  1. Rituximab in moderate to severe non-renal systemic lupus erythematosus: a reanalysis of the EXPLORER study. Ann Rheum Dis. 2019. doi: 10.1136/annrheumdis-2018-214833
  2. OX40L/OX40 axis impairs follicular and natural Treg function in human SLE. JCI Insight. 2018. doi: 10.1172/jci.insight.122167
  3. Disrupting the CD95-PLCγ1 interaction prevents Th17-driven inflammation. Nat Chem Biol. 2018. doi: 10.1038/s41589-018-0162-9.
  4. Systemic lupus erythematosus and systemic sclerosis: All roads lead to platelets. Autoimmun Rev. 2018 Jun;17(6):625-635.
  5. IgE Inhibits Toll-like Receptor 7- and Toll-like Receptor 9-Mediated Expression of Interferon- α by Plasmacytoid Dendritic Cells in Patients With Systemic Lupus Erythematosus. Arthritis Rheumatol. 2016 Sep;68(9):2221-31.

Contacts
Place Amélie Raba Léon, 33000 Bordeaux, France
Christophere Richez
reference.autoimmunite@chu-bordeaux.fr

Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Iraklio and University of Crete Medical School

Website: Department of Rheumatology
The Rheumatology Department at the University Hospital of Iraklio-Crete, is the reference center for systemic autoimmune diseases in the island of Crete and South Aegean. Our goal is to: a offer high quality health care to patients with rheumatic diseases; b promote the research in the field of autoimmune and chronic inflammatory diseases; c train young physicians in the field systemic autoimmune diseases.

It is the first autonomous University Rheumatology Clinic in Greece. It has a capacity of 12 beds, served by two faculty members, three consultant rheumatologists and four fellows. In order to meet the clinical and research needs, we have trained 4 research nurses in the care of chronic rheumatic patients.

The number of patients in the Clinic has markedly increased in the last 10 years. In 2014, we served 13.200 patients compared to 2.937 total visits in 2003. In order to offer medical services of high standards, the Clinic has developed innovative activities such as:
– Day-care unit for providing immunosuppressive and biological therapies (cytokine inhibitors, co-stimulation inhibitors (CTLA4lg), B-lymphocyte depletion).
– Early arthritis clinic
– Dedicated clinics for SLE and undifferentiated connective tissue diseases/pre-lupus
– Systemic sclerosis / capillaroscopy clinic
– Musculoskeletal ultrasound
Finally, one of the main goals of the Clinic is to promote education and training. We participate in the medical training of pre-graduate medical students, rheumatology fellows and in the continuing medical education of rheumatologists and other specialties.

Current clinical and research programs

One of our main interests is the clinical research. For that purpose, we participate in clinical trials for innovative drugs (phase II-IV trials) and we collaborate with other centres in Greece and abroad in epidemiological and pharmaco-economics studies and in the Hellenic Registry for Biologics in Inflammatory Arthritides. Moreover, we have established the Cretan Lupus Registry through which, we seek to define the optimal therapeutic target in SLE and the impact of comorbidities on patient outcomes. Moreover, we are actively involved in the formulation of guidelines for the diagnosis and treatment of systemic autoimmune diseases.

Our Clinic is also engaged in studies of basic-translational research. We are affiliated with the laboratory of Rheumatology, Autoimmune and Inflammation in the Faculty of Medicine, University of Crete. Our aim is to study the role of function of innate and adaptive cell types and pathways in the pathogenesis of chronic inflammatory diseases, the impact of new biological therapies on the biology of the organism (hematopoiesis, atherosclerosis). Therefore, we have become partners of National and European research projects (FP6, FP7, NSRF) and we are in close collaboration with the Foundation for Research and Technology (FoRTH) in Crete, such as the Institute of Molecular Biology and Biotechnology (IMBB) and the Institute of Computer Science (ICS).

Requirements for the participants:
Good command of English language

Name and contact of the person
George Bertsias gbertsias@uoc.gr
Mary Adamaki nadamaki@uoc.gr

Center for Genomics and Oncological Research (GENyO) – Complex Diseases Group led by Prof. Marta E. Alarcón-Riquelme (Granada)

Brief description of the Center
GENyO is located in Granada, Spain and was founded 10 years ago in a collaborative framework between the pharmaceutical Pfizer, the University of Granada and the Andalusian Government, in particular the Health Council and the Knowledge and Universities Council. The center has two main areas, medical genomics and oncology. The center counts with 12 independent researchers. Dr. Alarcón-Riquelme is the head of the medical genomics department. Each area has specialized lines of work. The center is located in the Parque Tecnológico de la Salud (Health Technology Park) and very close to the University Clinical Hospital of San Cecilio. The center has high-level technology platforms and performs Next Generation Sequencing, Mass cytometry and flow cytometry, microscopy, and has two important unit of genomics and bioinformatics.

Research Areas to select
Studies on the molecular stratification of systemic autoimmune diseases (PRECISESADS):
this study aims at the use of integrated gene expression and methylation data from blood and specific cell populations to define the molecular pathways for each patient´s disease. This will lead us to a new molecular diagnosis and to personalized medicine possibilities. The aim is also to identify classifiers that can be used to determine if a patient may become active or fall into remission, whether long-term or short term. Here the candidate will be involved in the analysis of longitudinal transcriptome data to determine the best molecular pattern to define the evolution of the disease. In addition we are investigating major functional differences between the clusters identified.
Molecular Phenotyping of Disease States and the genetics behind each disease state:
During period of flare, not all lupus patients fall within the same molecular pattern of disease. We have identified 3 possible molecular patterns: inflammatory, lymphoid and interferon. Each disease state may have a different genetic basis. We have identified a new locus strongly associated in the inflammatory cluster and analyzing the genes involved, while attempting to dissect their function and role in the pathogenesis of the disease. Here the person will be involved in the analysis of single-cell transcriptome data from blood and tissues, according to the patient´s disease state, or exome sequencing of the individuals of interest.
Studies on mouse models of SLE:
Mouse models of SLE help us understand the mechanisms of disease. We have been working on the role of the BANK1 gene and the appearance of various subsets of B cells, including pro-inflammatory B cells and regulatory B cells. In addition, the role of the microbiome in the development and differentiation of B cell subsets in the spleen but also kidney and intestine.
Relevant publication
Kozyrev, S.V*., Abelson, A.K*., Wojcik, J., Zaghlool, A., Linga Reddy, P.M.V., Sanchez, E., Yin, H., Gunnarsson, I., Svenungsson, E., Sturfelt, G., Jönsen, A., Truedsson, L., Pons-Estel, B., Witte, T., D’Alfonso, S., Momigliano-Richiardi, P., Danieli, M.G., Gutierrez, C., Suárez, A., Junker, P., Laustrup, H., González-Escribano, M.F., Martin, J., Abderrahim, H., and Alarcón-Riquelme, M.E. The B Cell Gene BANK1 is Associated with Systemic Lupus Erythematosus Through the Effect of Several Functional Variants Nat Genet 40(2):211-6, 2008

Bentham, J., Morris, D.L., Cunninghame-Graham, D.S., Pinder, C.L., Tombleson, P., Behrens, T.W., Criswell, L.A., Gaffney, P., Martin, J., Fairfax, B., Knight, J., Syvannen, AC., Ronnblom, L., Graham, R.R., Wither, J.E., Rioux, J.D., Alarcón-Riquelme, M.E. , and Vyse, T.J. Genetic Association Analyses Implicate aberrant gene regulation of the innate and adaptive immunity genes in the pathogenesis of SLE implicated by genetics. Nat Genet 47: 1457–1464, 2015.

Wu, Y.Y., Kumar, R., Iida, R., Bagavant, H., and Alarcón-Riquelme, M.E. BANK1 Regulates IgG Production in a Lupus Model by Controlling STAT1 Activation. PLoS One. 11(5):e0156302, 2016.

Toro, D., Martorell-Marugán, J., Goldman, D., Petri, M., Carmona-Sáez, P., and Alarcón-Riquelme, M.E. Longitudinal Stratification of Gene Expression Reveals Three SLE Groups of Disease Activity Progression Arthritis Rheum 70(12):2025-2035, 2018.

Barturen, G., Beretta, L., Cervera, R., Van Vollenhoven, R., and Alarcón-Riquelme, M.E.. Moving Towards a Molecular Taxonomy of Autoimmune Rheumatic Diseases. Nat Rev Rheumatol 14(2):75-93, 2018.

Toro-Domínguez, D., Domínguez-López, R., García Moreno, A., Villatoro-García, J.A., Martorell-Marugán, J., Goldman, D., Petri, M., Wojdyla, D., Pons-Estel, B.A., Isenberg, D., Morales-Montes de Oca, G., Trejo-Zambrano, M.I., García González, B., Gómez-Martín, D., Romero-Díaz, J., Carmona-Saez, P., and Alarcón-Riquelme, M.E. Differential Treatments and Risk for Severe Nephritis Based on a Longitudinal Systemic Lupus Erythematosus Stratification. Sci Rep 9(1): 15502, 2019.

Technology platforms
The NExtSeq 500: Next-Generation Sequencing from Illumina
The iScan System from Illumina
Mass cytometry (Cytof/Helios) from Fluidigm
Flow cytometry: sorting, flow and imaging
Confocal microscopy
Animal models of SLE
Funding
European Science Foundation financiada por fondos de FMR (Austria), FNRS (Bélgica), FWO (Bélgica), RPF (Chipre), Danish Medical Research Council, DFG (Alemania), FCT (Portugal), CSIC (España, MICINN (España), Swedish Research Council, SNF (Suecia), MRC (Reino Unido). (2009-2014)
Instituto de Salud Carlos III (FIS, Miguel Servet, Rio Hortega and Sara Borrell programs) (2009-2015)
Ministerio de Economía y Competitividad, Plan Estatal de fomento de la Investigación Científica de Excelencia 2016 (2017-2020)
Swedish Research Council (2009-2013 and 2017-2020)
Fundación Ramón Areces (2011-2015)
Innovative Medicines Initiative Program of the European Unión (2014-2018): special funding of the project PRECISESADS
Innovative Medicines Initiative Program of the European Union (2019-2026): special funding of the project 3TR
Additional information
International Collaborations: Dr Alarcón-Riquelme heads the Managing Entity of the IMI funded project PRECISESADS, on the “Molecular Re-classification of Systemic Autoimmune Diseases” which joins 21 European academic groups, 2 SMEs and 5 Big Pharma. She is also the coordinator of 3TR: Taxonomy, Treatment, Targets, and Remission: Identification of the Molecular Mechanisms of non-response to Treatments, Relapses and Remission in Autoimmune, Inflammatory, and Allergic Conditions. The project joins 58 European academic groups, 3 biotechnology companies and 8 pharmaceutical companies. Dr. Alarcón-Riquelme is also a member of the Spanish Society of Rheumatology, The Spanish Society of Immunology, part of the Executive Board of SLEuro, Associate Editor of Arthritis & Rheumatology, member of the Board of Rheumatology, J of Rheumatology and Genes & Immunity.

Links
www.precisesads.eu
3tr-imi.eu

Whom to contact:
Prof Marta E. Alarcón-Riquelme at marta.alarcon@genyo.es

 

Rheumatology and Clinical Immunology Unit ASST-Spedali Civili and University of Brescia

The Rheumatology Unit is part of the University Department of Clinical and Experimental Science of UniBs; patients care, clinical research and education are the three main objectives of the Unit. The Unit is one of the partecipating centers of the ERN-RECONNET, the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases approved by the European Commission in 15th December 2016.

The clinical activity of the Unit is focused on systemic autoimmune diseases, including Systemic lupus erythematosus (SLE), Systemic Sclerosis (SSc), undifferentiated connective tissue disease, antiphospholipid syndrome, inflammatory myopathies and Systemic Vasculitides.

The clinical activity of the Unit is structured in outpatients visits and day-hospital for daily drug infusions. The outpatients clinic provides more than 50 daily visits for first rheumatologic assessment and follow-up evaluations; disease-specific second/third-level visits for SLE, Systemic sclerosis, Sjogren’s Syndrome, rheumatoid arthritis, Inflammatory myopathies, systemic vasculitis. In particular, the Unit hosts a formal Lupus Clinic since January 2015, including, in addition to the above described activities, a dedicated mail and phone number active for sudden needs or lupus related emergency problems.

All the dedicated clinics share common characteristics including the multidisciplinary approach to the patients as several health professionals other than rheumatologists are involved in the clinics: nurses, obstetrics and gynaecologists, cardiologists, nephrologists, ophthalmologists, psychiatrist, and orthopaedics. Moreover, all these clinics are characterized by a strong effort toward quality of care and a patient-centered approach. Overall, 400 SLE, 400 UCTD, 350 SSc, 400 SS, 200 antiphospholipid syndromes, 5000 RA, 100 myositides patients are regularly followed at the dedicated clinics of the Rheumatology Unit.

The day hospital/MAC section of the Rheumatology Unit includes 12 seats and 2 beds for daily intravenous drug-infusion; three rheumatologists and four nurses are assigned to this section of the Unit.

The Unit is also the venue of the Specialization School in Rheumatology of Brescia University. The research activity of the Unit is focused on pathogenesis and complications of the different autoimmune diseases:
– associations between autoantibodies’ and particular organ involvement of systemic autoimmune diseases
– setting up and validation of new laboratory methods for the determination of autoantibodies;
– analysis of prognostic factors for recurrent miscarriages and thromboses in antiphspholipid syndrome;
– subpopulation lymphocytes modifications during different autoimmune diseases.
The research activity is documented by published scientific articles over 30 years of activity, several participations to national and international congresses and a worldwide esteem of the research activity. The Rheumatology Unit takes part and leads of several collaborative research studies with Italian and European centers. The educational mission of the Rheumatology Unit is achieved by several initiatives addresses to medical students, internal and external rheumatologists in training (since 2015, also 6 trainees from abroad), rheumatologists, nurses, general practitioners.

Name and contact of the of the persons responsible for the training and for answering queries from prospective candidates:
Dr Micaela Fredi fredi.micaela@gmail.com and Dr Cecilia Nalli cecilianalli2@gmail.com that are devoted to the management of our Lupus Clinic

Languages that the candidates are required to speak to train there: Italian (better in order to be able to communicate with patients) and /or English (minimum).

Uppsala University Hospital, Rheumatology Clinic, SLE-center

Uppsala University Hospital is one of the largest hospitals in Sweden, with more than 900 beds for patients and more than 300.000 out-patient visits. The Department of Medical Sciences, with staff and research laboratories, is located at the University Hospital, and both patient care and research at the Hospital has an excellent reputation. The Section of Rheumatology has a specialized SLE clinic with more than 150 SLE patients supervised and treated. The clinic, as well as the patients, has long experience of both basic research projects and clinical studies. Our well-known, high quality research makes it very easy to recruit patients to ongoing projects. Main focus of our research is the type interferon system and its role in the etiopathogenesis of SLE, and the genetic background to SLE as well as functional consequences of identified risk genes. Professor Lars Rönnblom is head of the center and also coordinator of the Swedish SLE network, which encompass clinicians and basic research scientist from all university clinics in Sweden. More than 40 colleagues is involved in the Swedish SLE network and we have an annual meeting where we share and discuss our most recent research data. Our present research focus is on the genetic background to SLE and the molecular and clinical consequences of identified risk genes. In the Swedish SLE network we have clinical and genetic data on more that 1000 patients with SLE and control individuals. Beside identifying risk gene variants and their cellular functions, we also try to identify the connection between the risk gene variants and involved molecular pathways in each patient in order to develop tools for more targeted therapies. We have developed a polygenetic risk score for patients with SLE and this work continues. In our laboratory at the Rudbeck laboratory we perform a number of cellular experiments and at the moment we are looking for drug compounds that can down-regulate, or modulate, the cytokine response in immune cells involved in the SLE disease process. We have mainly worked with plasmacytoid Dendritic Cells (pDC) and their interferon response to nucleic acid containing immune complexes. We are also investigating the interaction between pDC and other cells in the cytokine response. In the research lab we speak both English and Swedish, but at the out-patient clinic at the hospital Swedish in the natural language with patients and the staff.

Contact persons
Professor Lars Rönnblom Lars.Ronnblom@medsci.uu.se
MD, PhD Dag Leonard Dag.Leonard@medsci.uu.se

Contact persons
We welcome PhD students and colleagues with some basic training in genetics or laboratory work.

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