Peter Grayson, M.D., M.Sc.

Summary

Peter Grayson, M.D., M.Sc., is a senior investigator at the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). He completed his undergraduate degree from Brown University in 1999, his medical degree from the Medical University of South Carolina in 2004, and his master's in science from Boston University in 2008. He served as a chief resident in Internal Medicine at Boston Medical Center and completed an additional two-year vasculitis fellowship within the Vasculitis Clinical Research Consortium. 

Dr. Grayson is firmly committed to mentoring young investigators in rare disease research. He serves as the acting program director for the NIAMS Rheumatology Fellowship Program and is the recipient of numerous teaching awards. He received the American College of Rheumatology's Distinguished Fellow Award in 2011 and was elected into the American Society for Clinical Investigation in 2024.

Research Statement

Dr. Grayson's research focuses on understanding the molecular mechanisms that drive systemic inflammatory diseases, with particular emphasis on clonal mechanisms of hematoinflammation and systemic vasculitis. His work integrates clinical investigation with genetics and genomics, biomarker discovery, advanced molecular imaging, molecular classification of disease, and clinical trials to identify disease mechanisms and translate these discoveries into improved diagnosis and treatment.

A major focus of his research is deciphering how somatic mutations and clonal hematopoiesis give rise to inflammatory disease. His group co-discovered VEXAS syndrome in 2020, establishing somatic mutations in UBA1 in myeloid cells as a cause of severe adult-onset systemic inflammation and providing a paradigm for genetically defined hematoinflammatory disease. Building on this work, his group investigates how acquired mutations in hematopoietic cells alter inflammatory pathways, shape clinical phenotypes, and contribute to diseases that intersect rheumatology, hematology, and immunology. Extending these concepts beyond the myeloid compartment, his group has also identified previously unrecognized clonal populations of T lymphocytes associated with aneurysmal vasculitis.

Complementary work from the group has defined novel pathways of neutrophil-mediated inflammation in monogenic and drug-induced vasculitis and identified biomarkers of disease activity across multiple forms of vasculitis that suggest new therapeutic targets. His group has also helped establish advanced molecular imaging as a surrogate marker of vascular inflammation in large-vessel vasculitis. Collectively, this research aims to move beyond phenotype-based classification of inflammatory diseases toward a molecular understanding of disease rooted in causal genetic, clonal, and immune mechanisms.

Scientific Publications

Somatic Mutations in UBA1 and Severe Adult-Onset Autoinflammatory Disease.

Beck DB, Ferrada MA, Sikora KA, Ombrello AK, Collins JC, Pei W, Balanda N, Ross DL, Ospina Cardona D, Wu Z, Patel B, Manthiram K, Groarke EM, Gutierrez-Rodrigues F, Hoffmann P, Rosenzweig S, Nakabo S, Dillon LW, Hourigan CS, Tsai WL, Gupta S, Carmona-Rivera C, Asmar AJ, Xu L, Oda H, Goodspeed W, Barron KS, Nehrebecky M, Jones A, Laird RS, Deuitch N, Rowczenio D, Rominger E, Wells KV, Lee CR, Wang W, Trick M, Mullikin J, Wigerblad G, Brooks S, Dell'Orso S, Deng Z, Chae JJ, Dulau-Florea A, Malicdan MCV, Novacic D, Colbert RA, Kaplan MJ, Gadina M, Savic S, Lachmann HJ, Abu-Asab M, Solomon BD, Retterer K, Gahl WA, Burgess SM, Aksentijevich I, Young NS, Calvo KR, Werner A, Kastner DL, Grayson PC
N Engl J Med.
2020 Dec 31;
383(27).
doi: 10.1056/NEJMoa2026834
PMID: 33108101

(18) F-Fluorodeoxyglucose-Positron Emission Tomography As an Imaging Biomarker in a Prospective, Longitudinal Cohort of Patients With Large Vessel Vasculitis.

Grayson PC, Alehashemi S, Bagheri AA, Civelek AC, Cupps TR, Kaplan MJ, Malayeri AA, Merkel PA, Novakovich E, Bluemke DA, Ahlman MA
Arthritis Rheumatol.
2018 Mar;
70(3).
doi: 10.1002/art.40379
PMID: 29145713

A role for muscarinic receptors in neutrophil extracellular trap formation and levamisole-induced autoimmunity.

Carmona-Rivera C, Purmalek MM, Moore E, Waldman M, Walter PJ, Garraffo HM, Phillips KA, Preston KL, Graf J, Kaplan MJ, Grayson PC
JCI Insight.
2017 Feb 9;
2(3).
doi: 10.1172/jci.insight.89780
PMID: 28194438

Deficiency of adenosine deaminase 2 triggers adenosine-mediated NETosis and TNF production in patients with DADA2.

Carmona-Rivera C, Khaznadar SS, Shwin KW, Irizarry-Caro JA, O'Neil LJ, Liu Y, Jacobson KA, Ombrello AK, Stone DL, Tsai WL, Kastner DL, Aksentijevich I, Kaplan MJ, Grayson PC
Blood.
2019 Jul 25;
134(4).
doi: 10.1182/blood.2018892752
PMID: 31015188

Translation of cytoplasmic UBA1 contributes to VEXAS syndrome pathogenesis.

Ferrada MA, Savic S, Cardona DO, Collins JC, Alessi H, Gutierrez-Rodrigues F, Kumar DBU, Wilson L, Goodspeed W, Topilow JS, Paik JJ, Poulter JA, Kermani TA, Koster MJ, Warrington KJ, Cargo C, Tattersall RS, Duncan CJA, Cantor A, Hoffmann P, Payne EM, Bonnekoh H, Krause K, Cowen EW, Calvo KR, Patel BA, Ombrello AK, Kastner DL, Young NS, Werner A, Grayson PC, Beck DB
Blood.
2022 Sep 29;
140(13).
doi: 10.1182/blood.2022016985
PMID: 35793467
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