Kristen Demoruelle

Research Description

Dr. Kristen Demoruelle is a rheumatologist who studies the etiology of rheumatoid arthritis (RA). RA is a systemic inflammatory autoimmune disease that primarily affects the joints and can lead to decreased quality of life and disability. RA affects women 3 times more often than men, and it is unknown what causes this sex difference in RA. 

Dr. Demoruelle's research focuses on understanding what causes RA-related antibodies to initially develop and whether there are sex differences in that process. Her studies investigate the lung and female genital tract as potential mucosal sites where RA-related antibodies may be triggered as a response to local inflammation. With her studies, she hopes to identify specific factors or mechanisms that may explain the differential effect of RA on women. Such findings could ultimately lead to new targets for RA treatment or prevention that could be personalized to an individual based on their sex or other factors.

BIRCWH project title: Mucosal Autoimmunity and the Microbiome in the Pathogenesis of Rheumatoid Arthritis

Current research focus: My research focuses on understanding the earliest steps of rheumatoid arthritis (RA) development, specifically the development of RA-related autoimmunity prior to the onset of joint disease. My research investigates the central hypothesis that RA-related antibodies are initially generated at the mucosal surface as the result of a dysregulated immune response to inflammation and/or environmental factors. My work specifically focuses on the lung and female genital tract an the dysregulation of inflammatory responses, particularly  neutrophil extracellular trap (NET) formation, as a potential mechanism by which autoimmunity in RA may originate at these mucosal sites. My research investigating the female genital tract mucosa as a potential site where immune dysregulation in RA may begin in women provides a novel approach to address the long unanswered question of why women develop RA 3 times more often than men.

How Dr. Demoruelle became interested in this work: RA can lead to a disabling and deforming arthritis. In my clinical practice as a rheumatologist, I see the life-altering impact that RA has on my patients' daily lives. My interest in this research developed from a drive to improve the lives of my RA patients and their families.

Clinical significance of this research: There is currently no cure for RA. If my research can identify the earliest steps in the development of RA occurring before the onset of arthritis, they can be targeted to potentially prevent RA. Prevention of RA before the onset of arthritis would revolutionize the management of this disease and reduce the substantial pain, disability and healthcare costs associated with RA.

Relevance of this work to women's health or sex/gender differences: RA is 3 times more common in women compared to men. While the sex difference in RA prevalence has been well established for decades, the reason for this discrepancy remains largely unexplained. My work aims to better understand this sex difference in RA by investigating sex specific mucosal sites and sex specific environmental exposures, such as contraception, in the development of RA-related autoimmunity in women.