Cracking the Case for OA

Janet L. Huebner, MS, has been involved in osteoarthritis research for close to 30 years, looking for early biomarkers of the disease, which could lead to early treatments and possibly prevention. As part of the Duke University research team, she currently is taking part in the  first Arthritis Foundation-directed clinical trial aimed at preventing post-traumatic osteoarthritis (PTOA), the PIKASO trial (Preventing Injured Knees from Osteoarthritis: Severity Outcomes). She is among the top researchers from Duke and eight other institutions across the country participating in PIKASO. The trial is examining the use of the drug metformin in people who are at high risk for developing PTOA after anterior cruciate ligament (ACL) reconstruction. Huebner is a senior lab research analyst in the Duke Molecular Physiology Institute. 

Q: Tell us about your background.

I was born on Long Island and grew up in East Northport, NY. My dad was an electrical engineer who worked for Grumman Aerospace and my mom stayed at home with my sister and me until we were teenagers, when she started working at our high school in the arts department. My town was a typical suburban community from which many people commuted daily into New York City for work. The proximity to the beaches and the beautiful summer weather provided the backdrop to some of my favorite memories from my childhood. All of my grandparents lived in NYC and fortunately, we were able to spend a lot of time with them.

I was always very interested in science, even as a young child, and was sure I was going to grow up to be a medical examiner like actor Jack Klugman in the television show Quincy, M.E. I was utterly fascinated by the clues discovered by his forensic investigations and how he used the information to discover reasons for suspicious deaths.

I attended the State University of New York at Geneseo, where I majored first in biology before switching to biochemistry. During my time at Geneseo, I was very fortunate to be a part of a relatively small and nurturing department. I had the opportunity to do an independent research project in organic chemistry, mentored by Dr. Richard F. Smith, PhD, who encouraged me to apply to graduate school to explore research as a career. 

I attended the University of North Carolina at Chapel Hill for my graduate studies in the Department of Biochemistry and Biophysics, where I worked in the laboratory of Dr. Howard Fried, PhD, studying the nuclear transport of RNA. After graduate school, I was fortunate to start my career in the laboratory of Dr. Virginia Byers Kraus, MD, PhD, a physician-scientist at Duke University Medical Center who is a practicing rheumatologist and an expert in biomarkers of osteoarthritis. Over the last 28 years, we have continued to explore biomarkers as indicators of disease and aging.

Q: What drew you to the field of science and research, and arthritis research in particular? 

I love the process of scientific discovery and piecing together various findings to shed light on complex processes related to health and disease. I was first exposed to arthritis research in graduate school at UNC-Chapel Hill, where I met Dr. Bruce Caterson, PhD, a biochemist who was using monoclonal antibodies for studying connective tissue proteoglycans, major components of cartilage, in the study of OA. I found his research to be exciting and loved the idea of being involved in research that had a direct effect on human disease.

Since I began my career at Duke, I have had the opportunity to work on different models of OA as well as human clinical trials identifying biological indicators of disease (biomarkers) and testing potential treatments. One of the many challenges of osteoarthritis research is the time it takes to develop the disease. The focus of my research has been to identify early biomarkers of disease and track how these biomarkers change throughout the disease process. With this information, it will be possible to identify patients best suited for potential interventions that can halt the progression of the disease and to monitor the effectiveness of future treatments. 

I hope that my research will impact clinical practice by aiding in the development of treatment options for patients that will improve their quality of life.

Q: Could you describe what you do with PIKASO?

For the PIKASO trial, I have been working with Dr. Kraus, Cale Jacobs, PhD, and Miguel Otero, PhD, to develop the protocols required for collecting and processing biospecimens (blood, urine, synovial fluid) at the nine participating clinical sites. In addition, I have been conducting virtual training meetings with the study personnel at each site in preparation for the start of enrollment. The goal is to standardize the biospecimen collections across all sites to ensure we obtain the highest quality of samples.

Once the trial has been completed, these biological samples will be available for analysis, the results of which will be critical for us to understand the impact of metformin on inflammation, pain and the development of osteoarthritis.

Q: Do you expect PIKASO to affect patients either directly or indirectly?

Both! The PIKASO trial will enroll patients who have suffered a knee injury, a population known to be at high risk for developing PTOA, to assess the ability of metformin to slow or prevent disease progression. The knowledge gained from this trial will impact the standard of care for patients suffering from an injury and provide critical information about the development of the disease that can be applied to patients living with OA.

Q: What are you excited about in OA, and what should patients be excited about?

I am excited about the possibility of developing early treatment options for OA that will delay and/or prevent the pain and suffering experienced by so many people around the world. Years of research and technological advances have allowed us to improve our understanding of the disease process, which is critical to identifying patients who are more at risk and require early intervention. Patients should stay informed about new advances and focus on making the necessary accommodations that will enable them to live their best lives.

Q: What else would you like to share about your involvement with arthritis research?

Throughout my career, my involvement with arthritis research has been humbling. The unique characteristics of patient populations and complexities of the biological processes involved in the development of osteoarthritis have proven to be quite challenging. I am proud of my contributions to the field and feel privileged to have worked with countless colleagues around the world who have dedicated their careers to understanding this complex disease. I am hopeful that breakthroughs are on the horizon and that more treatment options will be available for millions of patients to improve their quality of life.