February 2010 (historical)

Organization Chart

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Appropriation Language

NATIONAL INSTITUTES OF HEALTH

National Institute of Arthritis and Musculoskeletal and Skin Diseases
For carrying out section 301 and title IV of the Public Health Services Act with respect to arthritis and musculoskeletal and skin diseases [$539,082,000] $555,715,000 (Public Law 111-117, Consolidated Appropriations Act, 2010, )

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Amounts Available for Obligation

1/ Excludes the following amounts for reimbursable activities carried out by this account:
   FY 2009 - $1,207,000   FY 2010 - $1,200,000   FY 2011 - $1,238,000

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Budget Mechanism Table

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Budget Authority by Program

Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research

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Major Changes in the Fiscal Year 2011 Budget Request

Major changes by budget mechanism and/or budget activity detail are briefly described below. Note that there may be overlap between budget mechanism and activity detail and these highlights will not sum to the total change for the FY 2011 budget request for NIAMS, which is $16.861 million more than the FY 2010 Estimate, for a total of $555.715 million.

Research Project Grants (+$8.165 million; total $362.915 million): NIAMS will support a total of 1,021 Research Project Grant (RPG) awards in FY 2011. Noncompeting awards will increase by 51 awards and $20.833 million. Competing RPGs will decrease by 44 awards and $13.213 million. The NIH budget policy for RPGs in FY 2011 is to provide an inflationary increase of 2% in noncompeting awards and allow a 2% increase in the average cost of competing RPGs. NIAMS will continue to support new investigators and to maintain an adequate number of competing RPGs.

Research Training (+$.928 million; total $16.596 million): NIAMS will support 321 pre- and postdoctoral trainees in full-time training positions, the same number as in FY 2009. Stipend levels for NRSA trainees will increase by 6 percent over FY 2010 levels.

Intramural Research (+$1.758 million; total $56.702 million): NIAMS will continue to identify areas of potential savings within the Intramural Research Program which will allow us to achieve our program goals and accomplishments. As outlined in the Justification Narrative for the Intramural Research Program area, NIAMS will also pursue new opportunities in genome research.

Research Management and Support (+$1.289 million; total $27.073 million): Research Management and Support will receive an increase to help cover the costs of pay and other increases.

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Summary of Changes

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Fiscal Year 2011 Budget Graphs

History of Budget Authority and FTEs:

 

Distribution by Mechanism: 

Change by Selected Mechanisms:

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Justification of Budget Request

This document provides justification for the Fiscal Year (FY) 2011 activities of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), including HIV/AIDS activities. Details of the FY 2011 HIV/AIDS activities are in the “Office of AIDS Research (OAR)” Section of the Overview. Details on the Common Fund are located in the Overview, Volume One. Program funds are allocated as follows: Competitive Grants/Cooperative Agreements; Contracts; Direct Federal/Intramural and Other.

DIRECTOR'S OVERVIEW

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) supports a broad range of research, training, and information dissemination activities related to arthritis, musculoskeletal, and skin diseases. Some are rare disorders, but many are very common, and all have a major influence on the quality of people’s lives. Diseases addressed by NIAMS affect individuals of all ages, of all racial and ethnic backgrounds, and across all economic strata; many disproportionately affect women and minorities. Over the years, NIAMS-funded research teams have made significant progress in uncovering the causes of and developing new treatments for many disorders of the bones, muscles, joints, and skin.

The NIAMS constructed its FY 2011 budget to support the NIH Director’s five themes.

Recent Progress

Building on the success of FY 2008 and 2009 pilot initiatives to promote partnerships among fields that share interests, but historically do not interact, the NIAMS expanded its FY 2010 Building Interdisciplinary Research Teams (BIRT) initiative to researchers from all NIAMS areas. Integration of scientific groups holds the promise of opening avenues of inquiry and, in the process, may empower the biomedical research community to develop new disciplines and approaches with which to tackle increasingly complex questions.

To accelerate translation of basic research in musculoskeletal and skin tissue engineering and regenerative medicine into treatments, the NIAMS is encouraging small businesses to propose pre-clinical tissue engineering and regenerative medicine studies that could lead immediately to phase I human clinical trials. As part of this FY 2010 effort, the NIAMS plans to support the development of pre-clinical animal models to assess safety and efficacy of potential commercial products in musculoskeletal and skin tissue engineering and regenerative medicine.

The NIAMS also is encouraging investigators to design experiments related to the NIAMS mission that use existing resources developed through the Nation’s considerable investment in large clinical trials. Specifically, the Institute is offering an accelerated process by which investigators can propose innovative, ground breaking projects that need to begin quickly if they are to make full use of the unique resources that an already approved study is establishing.

One element of improving the Nation’s health is to support clinical studies on which physicians can rely when discussing treatment options with patients. Before the Spine Patient Outcomes Research Trial (SPORT), many who had low back pain were conflicted about surgery. Thus far, SPORT has shown that surgery is superior to nonoperative treatments for intervertebral disk herniation (a common cause of debilitating low back pain in working-age adults) and lumbar spinal stenosis, which often afflicts older Americans. Moreover, SPORT’s results are reassuring to those patients who are reluctant to undergo an operation, as they show that people who have one of these conditions are not subjecting themselves to further damage if they adopt a "wait-and-see" approach before committing to surgery.

The NIAMS intramural research program (IRP) has recently completed two genome-wide association studies (GWAS). A study on Behçet’s disease—a complex disorder of inflammation affecting skin, joints, eyes, gastrointestinal tract, lungs, and vasculature—found two new genetic locations that confer susceptibility to this condition in specific populations. Recognition of one of these locations suggests a new therapy for it. The other GWAS, performed by a consortium of researchers from throughout the United States, focused on rheumatoid arthritis. These studies have led to the identification of several genetic locations that may provide new therapeutic targets.

Future Directions

NIAMS is actively encouraging its researchers to apply the unprecedented opportunities in genomics and other high-throughput technologies to explain fundamental biologic mechanisms in health and disease. In the NIAMS IRP, for example, sample collection is beginning for a GWAS of systemic onset juvenile idiopathic arthritis (SoJIA), a type of rheumatoid arthritis that affects children, is accompanied by fever, and can include rashes and enlargement of the lymph nodes, liver, spleen, heart, and lungs.

In FY 2009 and 2010, NIAMS solicited input about the process by which the Institute identifies new clinical research directions and gathers feedback on emerging needs and opportunities, existing gaps, and obstacles in clinical trials related to its mission. Plans for FY 2011 include implementing a strategy to ensure that its portfolio continues to address pressing questions that translate basic science discoveries into treatments, or could guide the decision making of health care providers and improve patient care.

The success of biomedical research depends on empowering the next generation of scientists by providing them with robust training experiences. To this end, the NIAMS has taken steps to address the structure and review criteria for the Ruth L. Kirschstein National Research Service Award Institutional Research Training Grants, or T32 grants, that it will award in FY 2011 and beyond.

Other plans for FY 2011 include the possibility of supporting awards under a trans-NIH solicitation that the NIAMS spearheaded in FY 2009, in partnership with the National Aeronautics and Space Administration (NASA). This initiative encourages biomedical researchers to develop projects that could be conducted in the microgravity environment of the International Space Station (ISS). When the ISS becomes fully operational in 2011, it will provide a unique setting where NIH-funded researchers can explore fundamental questions about human health issues, including how the body heals itself, fights infection, or develops diseases such as osteoporosis.

Overall Budget Policy: The 2011 request for NIAMS is $555.715 million or 3.1 percent over the FY 2010 Enacted level. Investigator-initiated research project grants and research conducted by new scientists continue to be the Institute’s highest priorities. In FY 2011, the NIAMS will strive to equalize success rates between new and experienced investigators submitting new R01 or equivalent applications. In FY 2011 NIAMS will continue its policy of not accepting unsolicited applications for new program project grants, and competing continuation applications for program project grants will only be considered for a second competing award for a total project period of up to 10 years. As in previous years, the NIAMS will reserve a portion of its budget to support high priority research or meritorious applications beyond the established payline. Areas of special emphasis include genome-wide association studies and translational research, particularly in the areas of tissue engineering and regenerative medicine. Funds are included in R&D contracts to support several trans-NIH initiatives, such as the Therapies for Rare and Neglected Diseases program (TRND), the Basic Behavioral and Social Sciences Opportunity Network (OppNet), and support for a new synchrotron at the Brookhaven National Laboratory, as well as increased support for other HHS agencies through the program evaluation set-aside.

Program Descriptions and Accomplishments

Arthritis and Rheumatic Diseases:

The goals of this program are to advance high-quality basic, translational, and clinical biomedical and biopsychosocial research to treat and prevent arthritis and rheumatic diseases. The program uses new insights in the fields of genetics, genomics, and biomarkers as important indicators of disease occurrence, disease progression, and response to treatment, which may also identify potential therapeutic targets. NIAMS pursues new opportunities that identify risk factors for these disorders, to enhance disease prediction, and advance prevention strategies. In FY 2009, the Institute organized a session at its annual scientific retreat to explore novel approaches in clinical trials that target immune dysfunction in rheumatic diseases. NIAMS will collaborate with the extramural community to broaden the discussion of immune system targets, as well as potential personalized medicine approaches through pharmacogenomics. NIAMS continues to support research on the causes of rheumatoid arthritis and juvenile idiopathic arthritis which could lead to therapeutic interventions that would inhibit the irreversible effects of these diseases.

Budget Policy: The FY 2011 budget estimate for this program is $131.896 million, an increase of $3.860 million or 3.02 percent over the FY 2010 Enacted level.

NIAMS plans for FY 2011 include continued support for the replication of genome-wide association study (GWAS) results and fine-mapping of identified gene associations, which will inform further research in disease susceptibility and therapeutic development. The NIAMS will support testing and validation of tools to measure patient-reported outcomes—created by the NIH Roadmap’s Patient-Reported Outcomes Measurement Information System (PROMIS) initiative—in the diverse populations represented by the NIAMS portfolio, including arthritis and rheumatic diseases. The Institute also will encourage interactions in the research community to address the effectiveness of rheumatoid arthritis treatments in relation to genetic differences across patient populations.

Musculoskeletal Biology and Diseases:

The program focuses on both understanding the fundamental biology of tissues that constitute the musculoskeletal system, and applying this knowledge to a variety of diseases and conditions including osteoarthritis. It studies the causes and treatment of acute and chronic injuries, such as carpal tunnel syndrome, repetitive stress injury, and low back pain. The program supports the development of new technologies, including methods of imaging bone and cartilage to improve the diagnosis and treatment of skeletal disorders, and to facilitate repair of damage caused by trauma to otherwise healthy musculoskeletal tissue. In FY 2009, NIAMS and other NIH components extended the Osteoarthritis Initiative (OAI) through FY 2014. Continuation of this public-private partnership allows investigators to supplement the data, which they collected annually from approximately 4,800 people over four years, with an additional four years worth of information. The entire research community has access to the OAI data for exploring the natural progression of osteoarthritis and gathering information on its risk factors.

Budget Policy: The FY 2011 budget estimate for this program is $121.718 million, an increase of $3.563 million or 3.02 percent over the FY 2010 Enacted level. Program plans for FY 2011 include collaborating with professional organizations to examine clinical research needs related to acute and chronic neck and back disorders. Other efforts include exploring a framework for subsequent studies of people who are at risk of post-traumatic knee osteoarthritis. The NIAMS also will continue to promote the use of the Osteoarthritis Initiative data and images by fostering collaborations between the broader scientific community and Osteoarthritis Initiative researchers.

Bone Biology and Diseases:

The program covers a broad spectrum of research designed to better understand genetic and cellular mechanisms involved in the build-up and break-down of bone. It addresses regulation of bone remodeling; bone formation, bone resorption, and mineralization; and effects of hormones, growth factors, and cytokines on bone cells. Through the program, NIAMS supports prospective cohort studies including the Framingham Osteoporosis Study, the osteoporosis component of the Rochester Epidemiology Project, and Mr. OS, an investigation into osteoporosis and other age-related diseases in men. These longstanding efforts (begun in 1986 and 2000, respectively) continue to provide data about osteoporosis diagnosis, treatment, and prevention. Mr. OS investigators, for example, published information in FY 2009 that is relevant to the U.S. Preventive Services Task Force’s efforts to provide guidance on using bone mineral density to assess fracture risk in men.

Budget Policy: The FY 2011 budget estimate for this program is $72.585 million, an increase of $2.125 million or 3.02 percent over the FY 2010 Enacted level. Program plans for FY 2011 include continued support of several epidemiologic studies of fracture risk in women and men, as noted above. The NIAMS plans to build upon the findings of these and other large population study samples by encouraging researchers to connect information regarding the genetic makeup of study participants and their risks of fracture through genome-wide association studies of bone mass and fracture risk. It also will partner with the National Institute on Aging to promote research on how bone health influences, and is affected by, other conditions including diabetes, obesity, anorexia nervosa, and depression.

Muscle Biology and Diseases:

The program supports a wide range of basic, translational, and clinical research projects in skeletal muscle biology and diseases. It focuses on fundamental biology of muscle development, physiology, and muscle imaging. Its overarching objective is to advance the understanding of, and, ultimately, to prevent and treat muscular dystrophies, inflammatory myopathies, muscle ion channel diseases, and muscle disorders, such as disuse atrophy and age-related loss of muscle mass. Program activities in FY 2010 will include funding a new Senator Paul D. Wellstone Muscular Dystrophy Cooperative Research Center. NIAMS also will maintain a pipeline of basic and pre-clinical discoveries that researchers can develop into treatments, and will continue to collaborate with the National Institute of Neurological Disorders and Stroke on efforts to encourage investigator-initiated proposals for translational research on muscular dystrophies.

Budget Policy: The FY 2011 budget estimate for this program is $76.390 million, an increase of $2.236 million or 3.02 percent over the FY 2010 Enacted level. For FY 2011, the program will continue to participate in the Senator Paul D. Wellstone Muscular Dystrophy Research Center program. It also will continue to support training and career development in muscular dystrophies including, but not limited to, Duchenne, myotonic, facioscapulohumeral, and congenital disease. Other FY 2011 activities will continue to promote research on the mechanisms of muscular dystrophies, characterization of disease phenotypes, management of disease complications, and development of new therapies. The NIAMS also is fostering preclinical development and testing of potential treatments against the muscular dystrophies and inflammatory myopathies. It remains committed to supporting research on non-dystrophic skeletal muscle diseases such as channelopathies and inflammatory and mitochondrial myopathies, and on muscle wasting resulting from disuse or systemic diseases.

Skin Biology and Diseases:

This program supports a broad portfolio of basic, translational, and clinical research in skin, including work on the developmental and molecular biology of skin; the study of skin as an immune organ; and the genetics of skin diseases. The Institute is pursuing opportunities in developing artificial skin, and imaging technologies for diagnosing and tracking progression of skin diseases. In FY 2009, a NIAMS-facilitated consortium of leading researchers in psoriasis genetics discovered genes for disease risk, which may provide insights into novel therapeutic approaches. The Institute also organized a session on stem cells at its annual scientific retreat, to explore opportunities to use easily-accessible skin cells as a source of pluripotent stem cells. These cells, which have the potential to become any type of cell in the body, could guide studies in disease pathogenesis, regenerative medicine, tissue engineering, and cell-based therapies for a wide range of disorders. NIAMS continues to support several projects that study connective tissue disorders, including Marfan syndrome—a heritable disease characterized by highly flexible skin, and severe skeletal and cardiovascular complications—and pediatric hemangiomas, which are benign, blood vessel tumors in the skin that can occasionally result in permanent, significant abnormalities when facial structures are involved.

Budget Policy: The FY 2011 budget estimate for this program is $69.351 million, an increase of $2.030 million or 3.02 percent over the FY 2010 Enacted level. NIAMS plans for FY 2011 include continued support for studies on the interactions between the skin and other parts of the body (such as the immune system, the cardiovascular system and the nervous system) under normal, healthy conditions, as well as a consequence of certain illnesses (e.g., eczema, psoriasis). In addition, the Institute will enhance the transfer of laboratory findings related to skin tissue engineering and regenerative medicine to the clinic, by funding research with animal models that mimic human biology.

Intramural Research Program:

The two-fold mission of this program is to conduct innovative basic, translational, and clinical research relevant to the health concerns of the Institute; and, to provide training for investigators who are interested in related research careers. The program conducts clinical studies on the genetics, etiology, pathogenesis, and treatment of a variety of rheumatic, autoimmune, inflammatory, joint, skin, and muscle diseases. Over the past year, the program has added clinical staff with expertise in orthopaedic surgery, an area that remains a high priority for the Institute. In addition, NIAMS continues to play a leadership role in the new, multidisciplinary, trans-NIH Center for Human Immunology, Autoimmunity, and Inflammation (CHI), which is bringing together scientists from several NIH institutes who are using common approaches to study multiple disease systems. In FY 2009, the CHI hosted a conference entitled, —Meeting the Human Immunology Challenge,— in which many NIAMS intramural researchers participated.

Budget Policy: The FY 2011 budget estimate for this program is $56.702 million, an increase of $1.758 million or 3.20 percent over the FY 2010 Enacted level. NIAMS plans for FY 2011 include a continued focus on translational research, in order to facilitate patient-oriented studies in the areas of arthritis, musculoskeletal, and skin diseases, including their genetic, inflammatory, and immune mechanisms. NIAMS will also continue its commitment to multidisciplinary training of rheumatology research fellows, including interactions with other NIH intramural training programs with common scientific interests, to strengthen the pipeline of highly qualified physician-scientists in this field. The Institute's intramural research program also anticipates building upon its recent ground-breaking, collaborative studies, to uncover more information on the genetic underpinnings of those diseases of interest to NIAMS. Utilizing new technologies that are able to read millions of DNA base pairs in just a few hours, intramural scientists will investigate how the genome is regulated, particularly as it relates to the maturation and differentiation of cells found in the skin and immune system.

RMS:

NIAMS' RMS funds the scientific, administrative management, and information technology expenses associated with day-to-day operations. It finances long-term investments in the research enterprise, including the review and financial management of applications for grants and contracts, and dissemination of research results to the American public. In FY 2009, the Institute managed more than 1,254 research grants and centers, as well as 55 research and development contracts and 321 individual and institutional full-time research training positions. NIAMS supports 528 clinical research studies, including 72 clinical trials. In FY 2010, NIAMS will release a new Long-Range Plan for FY 2010-2014. The plan will serve as a broad scientific outline for NIAMS by identifying compelling research opportunities and needs that will inform NIAMS’ priority-setting process, while enabling the Institute to adapt to the rapidly changing biomedical and behavioral science landscapes. Over time, it will help propel research progress related to NIAMS mission areas.

Budget Policy: The FY 2011 budget estimate for this program is $27.073 million, an increase of $1.289 million or 5.00 percent over the FY 2010 Enacted level. In FY 2011, the NIAMS will continue to implement its new Multicultural Outreach Initiative which has been designed to improve access to and availability of meaningful health information for racial and ethnic minority populations. Additional goals include raising awareness of the importance of research as the foundation for progress in achieving better bone, joint, muscle, and skin health, and enhancing involvement of community, voluntary, and professional organizations, and other governmental agencies in multicultural outreach efforts. The Institute also will continue to sponsor roundtable discussions and a scientific retreat with extramural investigators and lay representatives to inform the research priority-setting and strategic planning process.

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Budget Authority by Object

Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research

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Salaries and Expenses

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Authorizing Legislation

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Appropriations History

1/ Reflects enacted supplementals, rescissions, and reappropriations.
2/ Excludes funds for HIV/AIDS research activities consolidated in the NIH Office of AIDS Research.

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Details of Full-Time Equivalent Employment (FTEs)

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Detail of Positions

Includes FTEs which are reimbursed from the NIH Roadmap for Medical Research.

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New Positions Requested

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