Investigating a new method to treat sarcoidosis

A disease that has no cause or cure, sarcoidosis affects people of all ages throughout the world. Once considered a rare disease, the inflammatory condition now affects about 40 in every 100,000 African Americans in the U.S. and about five in every 100,000 Caucasians. It occurs in all races and in men and women but is most common among African American females ages 20 to 40.

The disease most commonly affects the lungs but can involve almost any organ system, including the skin, eyes, joints and heart. Cardiac involvement, which occurs in up to 25% of patients with sarcoidosis in other organs, can lead to life-threatening heart rhythm problems and heart failure.

Dr. Jennifer Jordan (left) and Dr. Jordana Kron

“The field of cardiac sarcoidosis, and sarcoidosis in general, really needs new mechanistically driven therapies,” said Jordana Kron, M.D., an associate professor in the VCU School of Medicine and a cardiologist at Pauley.

In 2019, Kron was awarded a $50,000 Pauley Pilot Research Grant to investigate a new treatment protocol for cardiac sarcoidosis. The 15-month philanthropic grant is being used to evaluate the efficacy and safety of using an interleukin-1 blockade to treat patients who present with cardiac sarcoidosis. The study is the first of its kind to explore the new treatment paradigm.

“A new, safe and effective treatment could be life-altering for patients with cardiac sarcoidosis. It may also open the door for new therapies for cardiac sarcoidosis and other inflammatory heart diseases in the future,” said Kron, a translational science scholar at the VCU C. Kenneth and Dianne Wright Center for Clinical and Translational Research.

Interleukin-1 is a protein whose presence indicates inflammation in the body. Kron’s research aims to evaluate if using medication to block the protein will help treat cardiac sarcoidosis. “Corticosteroids are the most commonly used treatment for sarcoidosis, but there is little data showing their efficacy, and they have significant side effects,” Kron said. “Interleukin-1 is the prototypical cytokine that plays a role in most inflammatory processes. Blockade of the protein has been shown to be effective in many types of heart disease.”

While cardiac sarcoidosis is the focus of Kron’s research, she is optimistic that, if shown to be effective, the blockade could be used to treat other forms of heart disease.

VCU has led clinical and translational research of cardiac sarcoidosis for nearly a decade, and VCU Health is home to the Multidisciplinary Sarcoidosis Clinic, the only center of its kind in Virginia. At the clinic, patients are able to meet with specialists in pulmonology, cardiology, electrophysiology and rheumatology.

In December 2019, VCU was recognized as a Sarcoidosis Center of Excellence. This two-year designation provides formal recognition of our team’s commitment to meet the needs of sarcoidosis patients and efforts to keep abreast of the ongoing advances and findings in the space.

“A new, safe and effective treatment could be life-altering for patients with cardiac sarcoidosis.”

Kron, who was awarded an endowment fund through the Wright Center to further support her research, is joined in the study by co-principal investigator Jennifer Jordan, Ph.D., an assistant professor in the VCU College of Engineering Department of Biomedical Engineering and director of the Cardiovascular MRI Core Lab at Pauley. Jordan’s research focuses on translational and clinical cardiovascular MRI techniques and cardiac magnetic resonance tissue characterization in patients who have received chemotherapy for breast cancer. For this study, she is using her expertise in cardiac magnetic resonance to help assess inflammation in cardiac sarcoidosis and evaluate responses to treatment.

The Pauley Pilot Grant enabled Kron to successfully apply for and receive external funding. A $275,000 R21 grant from the NIH will be used to explore the feasibility and safety of interleukin-1 blockade as a novel therapeutic agent to treat clinically active cardiac sarcoidosis. A $750,000 AHA Collaborative Sciences Award will support evaluating cardiac inflammation using novel cardiac magnetic resonance techniques to determine whether this method has clinical utility to assess disease activity, and to provide pilot data on whether cardiac and systemic inflammation are modulated by a targeted IL-1 blocker, anakinra.

Kron also received a Johnson Center grant to participate in a trial looking at steroids versus steroids plus methotrexate, and another Wright Center grant to look at optimizing cardiac MRI in cardiac sarcoidosis patients with defibrillators.

Learn more about VCU Health’s sarcoidosis comprehensive treatment and care: https://www.vcuhealth.org/services/pulmonary-disease-and-critical-care-medicine/sarcoidosis