The first half of the decade saw extraordinary discoveries and advances related to diseases within the NIAMS mission, some of which are featured in Appendix 1. Likewise, the NIAMS research community is poised to make considerable progress over the next five years in many areas. The examples below provide a sense of progress that may be possible across the NIAMS portfolio. They are not intended to be comprehensive nor exhaustive; many unanticipated advances are likely to occur. Likewise, some of these stated aspirations may take more than five years to be realized. They are included to highlight areas in which the state of the science suggests a clear path forward and convey our excitement and vision for ultimately improving health and quality of life.
- Interdisciplinary research into the mechanisms of tissue or organ crosstalk, including interactions with the microbiota, will lead to treatments that address the whole patient.
- Researchers will discover and explore all human gene variants that cause or exacerbate diseases of interest to NIAMS.
- A deeper understanding of the contributions of sex differences to autoimmune diseases will allow for more timely diagnosis and the development of personalized treatments.
- Characterization of all cell types in the epidermis and dermis at single-cell resolution will explain how crosstalk between cell types contributes to disease.
- Researchers will characterize molecules and signaling pathways that control cell activities essential for development and maintenance of musculoskeletal and tissue interfaces.
- New induced pluripotent stem cell (iPSC)-based therapies and iPSC-derived organoids will generate cutting-edge regeneration platforms.
- Researchers will apply data science tools to large datasets to discover common mechanisms linking various subtypes of diseases.
- Health care providers will understand and implement the best protocols to recognize that a fracture in an older person may indicate underlying osteoporosis that needs treatment to avoid future fractures, morbidity, and mortality, and provide treatments to avoid adverse effects such as atypical femoral fractures.
- Researchers will shift the current focus of treatments aimed at restoring lost musculoskeletal function toward identifying and implementing new early diagnostic and monitoring tools that enable proactive, personalized interventions for maintaining function.
- Researchers will advance digital endpoints and digital health technologies that provide real-time data to patients and clinicians.
- Treatments that specifically target disease-associated genetic variants will be made available for many immune-mediated diseases, reducing the need for systemic therapies.
- Treatments will target common disease pathways shared among rare diseases.
- Research teams will utilize organoid, three-dimensional bioprinting, computational, and machine learning (ML) approaches to develop multifactorial models in the study of diseases.
- Cross-disease research teams will develop targeted treatments for muscle diseases and disorders by sharing best practices and lessons learned.
- Researchers will identify social determinants of health that place people at risk for poor musculoskeletal outcomes.
- Institutional networks will enable research collaborations to develop and share databases of acute and chronic conditions to improve diversity of the data within the databases to inform artificial intelligence (AI)/ML algorithms and other clinical decision-making tools.
- Researchers will go beyond documenting health disparities and identify the sources and mechanisms responsible for health disparities and develop and test strategies to eliminate them.