Division of Rheumatology Toronto Western Hospital
Dr. Chandran has become an independent internationally known researcher in the field of psoriatic arthritis with 50 published papers and over 160 scientific abstracts. He has been an active member of the international Group for Research and Assessment of Psoriasis and Psoriatic Arthritis since 2006 and has been a frequent invited lecturer locally, nationally and internationally. Research Focus "My research laboratory focuses on translational research in psoriatic arthritis(PsA), one of the spondyloarthritides (SpA). PsA is a lifelong chronic disease that strikes patients in their young productive years, and affects up to a third of patients with psoriasis – an inflammatory skin disease that afflicts 3.3% of Canadians. The disease is currently incurable and leads to progressive joint damage, functional limitation, poor quality of life, and mortality. My expertise is in the genetic and molecular epidemiology of PsA, having trained in internal medicine, immunology, rheumatology, and genetic epidemiology. I have established a translational research program at the Krembil Research Institute in Toronto. My program brings together experts in genomics, transcriptomics, proteomics, metabolomics, bioinformatics and clinical assay development as well as clinicians, patients and industry partners. My goal is to develop biomarker-based strategies to improve early diagnosis and prognosis of PsA. The immediate objectives of my program for the next 5 years are: 1. Identify biomarkers for PsA diagnosis: Early diagnosis of PsA leads to better long-term outcomes. To this end, in my laboratory I am conducting studies to identify soluble biomarkers, primarily using a proteomic approach. I now aim to develop high quality assays for biomarkers that identify PsA by integrating results from proteomic and metabolomics experiments and mining the data from genomic and transcriptomic studies. 2. Identify markers for disease activity in PsA: PsA patients with active disease are at high risk of developing severe joint damage and disability. However, reliably assessing disease activity in PsA is a difficult task due to its heterogeneous nature. I aim to integrate the results of the transcriptomic, proteomic and metabolomics experiments conducted on well curated samples on patients with varying levels of activity obtained from the rich clinical database and linked biorepository of PsA patients at my program to identify biomarkers for PsA activity. 3. Identify marker for therapeutic response to intra-articular (IA) injections: To identify markers that predict response to IA injections, I aim to build on my ongoing work on proteolytic enzymes in synovial fluid (SF) in PsA and measure the activity of specific proteolytic enzymes in SF as localized biomarkers for prediction of therapeutic response to IA injections. 4. Expand the current longitudinal BioRepository, which stores prospectively collected tissues/biofluids and matching serum samples from psoriatic disease patients. The discoveries made will be validated in the longitudinal cohort of patients at his centre, as well as at collaborating member sites of the International Psoriasis and Arthritis Research Team. I envision that over the next 5 years my research program will identify biomarkers for PsA, leading to objective methods for PsA screening and stratification. Subsequent studies will establish clinical utility and cost-effectiveness of biomarker-based methods. With support from my patients and the agencies supporting my research, I intend to develop and maintain an outstanding translational research program that delivers results impacting PsA patient care."