2025 Grant Focuses on a Hidden Arthritis Subtype 

By Vandana Suresh | Aug. 27, 2026 

Rheumatoid arthritis (RA) is not one disease. It begins at different ages, follows different courses and responds differently in different people to the same medications — and rheumatologists generally can't predict which patient will follow which path. 

“Individuals with rheumatoid arthritis don't always get a good response to all the treatments that we offer them, and some patients don't get much response at all,” says  Robert Corty, MD, PhD, an instructor in medicine in the division of rheumatology and immunology at Vanderbilt University Medical Center. “There's a need to find new and improved approaches to managing RA.” 

To better understand these different forms of RA, the Arthritis Foundation has given a 2025 RA Research Program award to Dr. Corty. His team will investigate whether certain genetic mutations in blood-forming stem cells — called clonal hematopoiesis of indeterminate potential, or CHIP — define a distinct subtype of RA. 

RA is a complex autoimmune disease that is influenced by both environmental and genetic factors. Smoking, hormones and prior infections increase the risk of developing RA. Further, differences in genes that code for immune surveillance proteins, like human leukocyte antigens, are a major risk factor for RA. An emerging genetic risk factor for RA is CHIP. 

“It’s well known that CHIP is common amongst older adults, and even though it's asymptomatic, it seems to influence their health a lot,” says Dr. Corty. “People with CHIP have an increased risk of leukemia, heart attacks and strokes. We recently found that they also have an increased risk of RA.” 

What is CHIP? Blood stem cells, found in the bone marrow, produce red blood cells, white blood cells and platelets. As we age, these blood stem cells acquire mutations, most of which have no effect. But some mutations cause the blood stem cells to multiply, leading to an expanding subpopulation of genetically identical cells, termed CHIP. CHIP is found in 10% to 20% of older adults, but it cannot be detected by routine clinical blood tests. 

The mechanisms by which CHIP alters gene activity and expression in RA-relevant cell types are not fully understood. This Arthritis Foundation-funded research will investigate if the way CHIP changes DNA methylation, the chemical process that turns genes on and off, contributes to a distinct RA subtype with unique onset patterns, disease progression and treatment responses.  

Dr. Corty will leverage Vanderbilt research institute’s BioVU biobank to molecularly characterize CHIP-positive RA patients versus CHIP-negative RA patients while keeping track of variables like age, smoking habits, disease progression and treatment response. Using statistical models, his team will test whether CHIP influences RA risk through DNA methylation changes or vice versa. 

“The Arthritis Foundation has done something great by picking a project that has the potential to help people with rheumatoid arthritis. I’m hopeful that this project can reveal insights that can help people get relief from RA,” says Dr. Corty.