Leading the charge to develop new blood and urine tests that will help physicians diagnose osteoarthritis (OA) early, Dr. Virginia Kraus hopes her research will one day help prevent the pain and restrictions that inhibit the lives of the 27 million Americans with OA.
Dr. Kraus — a 2012 Arthritis Foundation Innovative Research Grant recipient – and her team of researchers at Duke University — have developed a method of identifying changes in specific proteins that occur naturally with age, allowing them to monitor joint degradation. Preliminary data from this research indicates that their blood test, which measures changes in a specific cartilage protein known as Cartilage Oligomeric Matrix Protein (COMP), is a specific indicator of hip OA. The research, according to Kraus,
“has also provided amazing new insights into the ability of cartilage to repair itself, and has suggested that knee OA
cartilage is much more readily able to repair itself than hip OA cartilage.”
Using a cohort of more than 3,000 individuals — whose blood, as well as knee and hip X-rays, have been collected and banked for research — she hopes to validate initial findings that the biomarker test is indeed specific for hip OA. The research might also determine if we can predict an individual’s OA risk and measure progression of the disease over time.
Additionally, Kraus and her team are working to develop a second biomarker test measuring aggrecan, the second most common protein in cartilage. Responsible for the compressibility of cartilage, aggrecan is lost very early in the progression of OA.
Dr. Kraus hopes that by developing tests to measure aggrecan degradation, doctors can identify OA at its earliest onset, when it can still be effectively halted or reversed with the right combination of prevention and treatment. “We also hope these tests will help determine whether an individual is responding to treatment based on urine and blood tests that could give an indication of response much sooner than an X-ray and for much less cost than an MRI,” says Dr. Kraus.
Dr. Kraus has firsthand knowledge of the personal and financial costs of OA, and an understanding of the relationship between joint injury and the later development of the disease. “My father had one of his hips replaced three times,”
Dr. Kraus says. “He fell in a foxhole in Vietnam and needed the injured hip replaced 15 years later, a perfect timeline
to suggest the injury was the cause of the OA. After 10 years it had to be replaced a second time. The stem of this
prosthesis fractured two years later, which led to a third replacement. Even the longest stem was not long enough
to fill the drilled-out space of bone in his thigh that would have allowed his leg to be of normal length.
“I would like to spare others the terrible consequences of such a disabling condition, having so closely observed the
pain and life-altering consequences of OA,” she says. To that end, Kraus credits the Arthritis Foundation with launching her research career when she was awarded her first research grant, and calls the organization the “lifeblood of arthritis research.”
“OA is by far the most common of all arthritis,” she asserts. “The Foundation recognizes the importance of this problem and is partnering with investigators and OARSI (Osteoarthritis Research Society International) to do everything it can to develop definitive treatments for OA.” When she’s not in the lab working to find new ways of diagnosing and treating OA, Dr. Kraus serves as Soprano II section leader in the Women’s Voices Chorus. She also enjoys drawing, painting watercolors, reading about art
and artists, and says that had she not pursued a career in medicine, she could see herself as either a science teacher
or painter. “I think that the creative process of both art and science are similar, and they can stimulate each other,” she says.