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next five years of the NEBR. This was felt to be the best way to assure sufficient patients to make this type of research possible. The Skin Diseases research community, with whom we have consulted on several occasions, prefers core research centers, rather than specialized centers for research, as the most appropriate center mechanism at the present time for EB-related research.

It is, therefore, our objective that the Skin Diseases Core Centers Program be expanded by the addition of four centers to a total of six centers, as originally planned with the advice of national scientific leaders in the field, with the intent that one or two of the new centers would be on the subject of EB, blistering diseases, and the biology of the basement membrane zone of skin. The establishment of these Core Centers will provide for basic research on EB and the basement membrane zone that would complement support for large scale clinical research within the new NEBR. clinical research supported through the NEBR will be of a larger and more significant scale than could be supported through a SCOR at a single institution. It allows the combining of the patient material from all of the clinical sites.

This combination of approaches and awards will provide more overall basic and clinical research on EB, as well as providing a wider geographic distribution of research locations facilitating the participation of greater numbers of EB patients than could be achieved by awarding a single SCOR.


Question. The Committee has expressed interest in the use of antibiotics to treat rheumatoid arthritis. Doctor, can you please describe the status and progress of the clinical trials involving oral and intravenous antibiotics?

Answer. The contract to support the coordinating center for the clinical trial of minocycline treatment of rheumatoid arthritis will be awarded on or about March 1, 1991. Contracts for clinical centers to participate in the trial are expected to be awarded about the same time. Proposals for additional clinical centers needed to assure an adequate sample of patients are under review. The current design calls for a planning phase during which the protocol will be finalized, the procedures and data forms will be developed, and the staff at the clinical centers will be trained and certified to begin recruitment for the volunteers to participate in this trial.


Question. Doctor, there has been much publicity concerning sports related injuries. What are your plans for research in the study of sports medicine?

Answer. The Program Announcement on Musculoskeletal Fitness and Sports Medicine has been highly successful in generating applications and obtaining new funding related to this field. A book on inflammation and healing from sports injuries was published in 1990. The NIAMS is sponsoring two forthcoming workshops on sports related injury and has a current program announcement on this topic. The NIAMS will issue a new program announcement following the workshops.


Question. There are now two core centers focused on skin disease research. In the past the Committee has heard about the need for a total of six of these centers. In your professional judgment are additional centers needed?

Answer. Yes. In 1988, the NIAMS established two Skin Diseases Core Centers to coordinate and foster interdisciplinary cooperation among Investigators. The original plan, developed through consultation with our external advisors and the academic dermatology community, called for a total of six Skin Diseases Centers.

The NIAMS surveyed responsible members of the dermatology community and together with them decided that at least six centers would meet current needs at a minimal level. Funding was available to begin only two of these. Our opinion continues that six are needed.


Question. I am also interested in the status of two other programs dealing with bone disease research.

First, has the Institute been successful in providing fellowships to attract and train postdoctoral fellows in the area of bone research?

Answer. The NIAMS is issuing a program announcement for new research career awards in bone biology and bone diseases. This will request applications for clinical investigator awards, research career development awards, and physician scientist awards. This follows prior NIAMS announcements requesting additional research grants focusing on osteoporosis.

Question. Also, I wonder if you could update us on the genetic cause of osteoarthritis and describe what further work has been done on the relationship between this "faulty" gene and the production of collagen?


Answer. In the fall of 1990, for the first time, a gene has been found that causes a form of osteoarthritis. Researchers led by NIAMS grantees Dr. Darwin J. Prockop at Thomas Jefferson University in Philadelphia, Pennsylvania, and Dr. Roland W. Moskowitz at Case Western Reserve University in Cleveland, Ohio, studied three generations of a family affected with a form of primary osteoarthritis. They pinpointed a gene defect in collagen II, structural protein that strengthens cartilage. The researchers found a single gene mutation that directs the substitution of one amino acid, cysteine, for another, arginine, at one position in the chain of more than 1,000 amino acids that make up collagen II. This finding strongly supports the idea that a single genetic flaw can cause at least one form of osteoarthritis, and maybe others. Work is now in progress to determine whether this abnormality or similar ones are present in large numbers of patients with osteoarthritis.


Question. Your intramural research program has grown to 7.5 percent of your overall budget, but this is still below the average for NIH as a whole. What plans to you have for your laboratory programs? Have you been given adequate space? What difficulties have you experienced in recruiting scientists for areas of your program that you would like to expand?

Answer. In 1990, the NIAMS established two new laboratories in its intramural research program: the Laboratory of Skin Biology and the Laboratory of Structural Biology Research. We are currently recruiting an individual to lead a Section on Genetics within the Laboratory on Skin Biology to study the genetic basis for a variety of heritable skin diseases. The Laboratory of Structural Biology Research is expanding its work with the Division of Computer Research and Technology in the area of image processing and analysis of macromolecules; it is also recruiting for a senior scientist to pursue x-ray diffraction analysis of proteins.

Establishment of a Laboratory of Bone and Connective Tissue Biology is the next step in expanding the Institute's Intramural program in accordance with the plan submitted to Congress in 1988. The first director of the Orthopaedics Research Unit has recently accepted a position outside the NIH. A new director is being vigorously recruited with the advice of leaders in academic orthopaedics. We also have plans to recruit for a director of the Laboratory of Bone and Connective Tissue Biology.

Expansion of the Intramural Program depends upon space being vacated by other NIH Institutes that are moving to new quarters. We expect that some additional space will be available by the end of this fiscal year.



Question. Dr. Shulman, much of the Nation's attention will be focused on sports this weekend as the NCAA Basketball Tournament gets underway. Let me note, for the record Mr. Chairman, that five Pennsylvania teams are participating in the tournament. There has been much publicity in recent years regarding sports related injuries. What are the Institute's plans for research in the study of sports injuries?

Answer. The NIAMS has organized and supported a Workshop on Sports Injuries in Youth: Surveillance Strategies to be held at the NIH on April 8-9, 1991. Speakers will discuss the background of existing surveillance systems and the scope of the problem, identify important data elements, and explore the resources needed to develop surveillance systems for sports injuries. Invited participants include orthopaedic surgeons, coaches, trainers, representatives from state health departments, epidemiologists, and other interested parties. The workshop and its written summary will encourage additional research applications in this field.

In the broader field of sports medicine research, the NIAMS has successfully increased the support for research grants in the past five years.

To date there have been 70' grant applications received in response to the Program Announcement on Musculoskeletal Fitness and Sports Medicine, of which 28 were funded. Both basic and clinical science projects cover a wide range of topics from tendon injury healing to clinical studies comparing reconstruction surgery for anterior cruciate ligaments. The most recent special effort of the NIAMS in the sports area was support of a workshop and book on sports-induced inflammation.

Question. Particular concerns have been raised of late regarding the use by athletes of anabolic steroids. Has the Institute supported any studies examining the effects of these steriods by young athletes?

Answer. The NIAMS has not supported research projects on anabolic steriods. We have had very few meritorious applications to consider. Clinical studies of anabolic steroid use are hindered by the reluctance of users to reveal their use and participate in well designed investigations. We would welcome meritorious applications for research in this important field.

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BUDGET REQUEST Senator HARKIN. Again my apologies for the delay due to a vote.

Dr. Whitney, we have your budget request for $320 million. I notice you have the distinction of being the only center or institute that is requesting a cut below your 1991 appropriations. In spite of this cut, I notice that your clinical research, research technology, and animal sciences programs all would grow at rates above inflation.

Dr. Whitney, welcome again. Please proceed with your statement.

Dr. WHITNEY. Thank you, Mr. Chairman. I am pleased to present the President's request for the fiscal year 1992 appropriation for the National Center for Research Resources.

Our three largest research centers programs, the General Clinical Research Centers, the Biomedical Research Technology Centers, and the Regional Primate Research Centers, as a group, comprise the largest national contribution of resources specifically identified for use in biomedical research. This request includes funding to continue support for these centers.

Like all of the programs in NCRR, these three resource centers programs provide effective mechanisms for containing research costs because they offer economies of scale and sharing of resources not otherwise available. The resources which the NCRR has developed and now supports are too expensive to be provided within a single research project or even by a cluster of individual projects.

In addition to supporting the major resource centers for NIH and PHS-funded investigators, the NCRR continually develops new resources hastening the progress of research. For example, developing a wide spectrum of new models of human disease processes is a principal focus of the NCRR's new research project grant activity.

Much of the 1991 increase in the biological models and materials research program was in support of research project grants. The 1992 request would continue that program and also continue the development of mammalian models in the Regional Primate Research Centers and Laboratory Animal Sciences Centers and computer-based models in the Biomedical Research Technology Centers.

The research capabilities of institutions with predominantly minority enrollment will be developed further through the research centers in minority institutions program and construction of new research facilities at historically black colleges and universities and similar minority institutions through the $15 million requested in 1992 for research facilities improvement.

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