national institute of arthritis and musculoskeletal and skin diseases national institute of arthritis and musculoskeletal and skin diseases the national institute of arthritis and musculoskeletal and skin diseases (niams) is one of the institutes and centers that make up the national institutes of health, an agency of the united states department of health and human services (hhs). national institute of arthritis and musculoskeletal and skin diseases (niams)agency overviewformedaugust 4, 1986 (1986-08-04)jurisdictionfederal government of the united statesagency executivelindsey a. criswell, directorparent departmentdepartment of health and human servicesparent agencynational institutes of healthwebsitewww.niams.nih.gov nih is the primary federal agency that conducts and supports basic, clinical and translational medical research. the institute investigates the prevention, diagnosis, causes, treatments and cures for both common and rare diseases. mission niams' mission is to support the research of arthritis, musculoskeletal and skin diseases. the institute also disseminates information on research progress in these diseases. niams supports and conducts basic, clinical, translational and epidemiologic research and research training at universities and medical centers. the institute also conducts and supports basic research on the normal structure and function of bones, joints, muscles, and skin. basic research involves a wide variety of scientific disciplines, including immunology, genetics, molecular biology, structural biology, biochemistry, physiology, virology, and pharmacology. clinical research includes rheumatology, orthopedics, dermatology, metabolic bone diseases, heritable disorders of bone and cartilage, inherited and inflammatory muscle diseases, and sports and rehabilitation medicine. legislative chronology august 1950—an arthritis program was established within the national institute of arthritis and metabolic diseases under public law 81-692. may 1972—p.l. 92-305 renamed the institute the national institute of arthritis, metabolism, and digestive diseases. 1973—senator alan cranston introduced legislation that would eventually lead to the national arthritis act. companion legislation was introduced in the house by congressman paul rogers. january 1975—the national arthritis act (p.l. 93-640) established the national commission on arthritis and related musculoskeletal diseases to study the problem of arthritis and to develop an arthritis plan. the act established the position of associate director for arthritis and related musculoskeletal diseases and authorized an interagency arthritis coordinating committee; community demonstration project grants; an arthritis data bank; an information clearinghouse; and comprehensive centers for research, diagnosis, treatment, rehabilitation and education. april 1976—after a year of study and public hearings, the commission issued a comprehensive plan aimed at diminishing the physical, economic and psychosocial effects of arthritis and musculoskeletal diseases. it laid the groundwork for a national program encompassing research, research training, education and patient care. october 1976—the arthritis, diabetes, and digestive diseases amendments of 1976 (p.l. 94-562) established the national arthritis advisory board to review and evaluate the implementation of the arthritis plan, prepared in response to the national arthritis act (p.l. 93-640). december 1980—p.l. 96-538 changed the name of the institute to the national institute of arthritis, diabetes, and digestive and kidney diseases. 1982—hhs conferred bureau status on the institute, resulting in the creation of the division of arthritis, musculoskeletal and skin diseases and the appointment of a division director. november 1985—the health research extension act of 1985, p.l. 99-158, established the national institute of arthritis and musculoskeletal and skin diseases to increase research emphasis. the legislation provided for the development of a plan for a national arthritis and musculoskeletal diseases program and established two interagency coordinating committees, one on arthritis and musculoskeletal diseases and one on skin diseases. it also expanded the activities of the national arthritis advisory board to include these diseases. september 1993—the nih revitalization act of 1993 (p.l. 103-43) directed niams to establish "an information clearinghouse on osteoporosis and related bone disorders to facilitate and enhance knowledge and understanding on the part of health professionals, patients, and the public through the effective dissemination of information." october 2000—the children's health act of 2000 (p.l. 106-310) directed niams to expand and intensify research programs on juvenile arthritis and related conditions, in coordination with other nih institutes and the arthritis and musculoskeletal diseases interagency coordinating committee. the institute directed to include resources on juvenile arthritis and associated conditions in its clearinghouse. november 2000—the lupus research and care amendments of 2000, which passed as part of the public health improvement act (p.l. 106-505), required niams to expand and intensify research and related activities regarding lupus. among other provisions, the bill called for information and education programs. december 2001—the muscular dystrophy community assistance, research, and education amendments of 2001, or the md-care act (p.l. 107-84), called on several components of the nih, including the niams, to enhance research on muscular dystrophy, including establishing centers of excellence. february 2003—the omnibus appropriations act for fy 2003 (p.l. 108-7) directed office of the secretary, hhs, to establish a federal working group on lupus for the purpose of exchanging information and coordinating federal efforts regarding lupus research and education initiatives. niams led this federal working group. the group has representatives from all relevant hhs agencies and other federal departments. october 2008—the paul d. wellstone muscular dystrophy community assistance, research, and education (md-care) amendments of 2008 (p.l. 110-361) officially named the related centers of excellence after the senator. in addition, the muscular dystrophy coordinating committee was authorized to give special consideration to enhance the clinical research infrastructure to test emerging therapies. september 2014—the paul d. wellstone muscular dystrophy community assistance, research and education (md-care) amendments of 2014 (p.l. 113-166) made several changes to the program’s authorization, including expanding the types of muscular dystrophy for which nih must conduct research, expanding the membership of the mdcc and requiring it to meet two times each year, and expanding the items to be covered in the action plan for the muscular dystrophies. directors directors from 1986 - present portraitnamein office fromto lawrence e. shulman, m.d., ph.d.april 1986october 1994 michael d. lockshin, m.d. (acting)november 1994july 1995 stephen i. katz, m.d., ph.d.august 1995december 2018 robert h. carter, m.d. (acting)january 2019february 2021 lindsey a. criswell, m.d., m.p.h., d.sc.february 2021present programs the niams supports a multidisciplinary program of basic, clinical, and translational investigations; epidemiologic research; research centers; and research training for scientists within its own facilities as well as grantees at universities and medical schools nationwide. it also supports the dissemination of research results and information through the national institute of arthritis and musculoskeletal and skin diseases information clearinghouse and through the nih osteoporosis and related bone diseases national resource center. the niams extramural program supports research supports research via grants and contracts in the division of extramural research. researchers pursue a wide array of basic, translational, and clinical research and research training in the fields of rheumatology, muscle biology, orthopedics, bone and mineral metabolism, and dermatology through these programs. the intramural research program of the niams conducts innovative basic, translational, and clinical research relevant to the health concerns of the institute and provides training for investigators interested in careers in these areas. the ultimate goals are: 1) to provide new insights into the normal function of immune cells, bones, muscles, and skin, and diseases that affect them, especially immune and inflammatory diseases; and 2) to generate a cadre of well-trained investigators to continue toward a complete understanding of these structures and the disease conditions that affect them adversely. division of extramural research the niams division of extramural research (der) supports scientific research via grants and contracts in the niams mission areas. most funding from the niams supports investigators involved in a variety of basic, clinical, epidemiologic, training, and other programs in universities, medical schools, academic health centers, and small business concerns, all of which comprise the extramural research community. spanning the fields of rheumatology, muscle biology, orthopedics, bone and mineral metabolism, and dermatology, the der is divided into five distinct research areas, each of which encompasses several individual scientific programs. as well, the der includes an office of extramural operations (oeo), which is responsible for assuring compliance with nih and niams policies and procedures with regard to scientific review, grants management, and clinical research administration. systemic rheumatic and autoimmune diseases. the overall goals of the programs comprising systemic rheumatic and autoimmune diseases are to advance high-quality basic, translational, and clinical research in autoimmune and arthritis-related chronic disorders. these disorders include the adult diseases of rheumatoid arthritis, systemic lupus erythematosus (lupus), scleroderma, vasculitis, the spondyloarthropathies (e.g., ankylosing spondylitis, psoriatic arthritis), gout, fibromyalgia, and sjögren's syndrome. pediatric diseases, such as juvenile idiopathic arthritis, periodic fever syndromes, and juvenile lupus are also included. additionally, the programs support studies focused on the natural history of these disorders, as well as molecular mechanisms of autoimmunity and inflammation, with the goal of finding ways to disrupt them and improve patient outcomes. the niams is committed to pursuing new opportunities in genetics and genomics research, clinical trial design, pain, and biopsychosocial aspects of diseases in this portfolio. it is also committed to identification of risk factors for these disorders, enhancement of disease prediction, and advancement of prevention strategies. the niams systemic rheumatic and autoimmune diseases research area encompasses the following individual scientific programs: arthritis biology program rheumatic diseases integrative biology research program scleroderma, fibrosis, and autoinflammatory disease program systemic autoimmune disease biology program bone biology and diseases. the programs comprising bone biology and diseases cover the development of common and rare bone diseases; their prevention, diagnosis, and treatment; and approaches to understanding the genetic, molecular, and cellular mechanisms involved in bone biology. research areas include the mechanisms of bone formation, resorption, and mineralization; the effects of hormones, growth factors, and other signaling molecules on these processes; genetics, genomics, and epigenetics of bone; bone fracture repair; bone imaging, and determinants of bone quality; and the interaction and communication of bone with other tissues and organs. the programs emphasize the application of fundamental knowledge of bone biology to the development of strategies to prevent bone diseases and bone fractures, as well as therapies for their treatment, while also supporting the characterization of the natural history of osteoporosis and rare bone diseases and disorders, with the ultimate goal of developing better prevention strategies, diagnostic tools, and treatment options for bone diseases. the bone biology and diseases research area encompasses the following individual scientific programs: bone biology, metabolic bone disorders, and osteoporosis program clinical, integrative physiology, and rare diseases of bone program muscle biology and diseases. the programs comprising muscle biology and diseases support a wide range of basic, translational, and clinical research projects in skeletal muscle biology and diseases, with a focus on the fundamental biology of muscle development, physiology, and muscle imaging. particular interests include the basic biology of satellite and muscle stem cells, excitation-contraction coupling, muscle metabolism, and adaptation of muscle to exercise. the programs address a need for translational research to develop discoveries that enhance treatment and improve management of muscle and musculoskeletal diseases and disorders with a focus on the interaction of muscle with other organs and tissues. the overarching objective is to advance the understanding of—and ultimately 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. the muscle biology and diseases research area encompasses the following individual scientific programs: muscle development and physiology program muscle disorders and therapies program joint biology, diseases, and orthopedics. the programs comprising joint biology, diseases, and orthopedics focus on understanding the fundamental biology of joints and their component tissues, and on translating this knowledge to a variety of diseases and conditions. research includes the study of the causes and treatments of acute and chronic injuries—including fractures, tendon and ligament injury and repair, and low back pain—as well as clinical and epidemiological studies of osteoarthritis. the program supports developmental and functional investigations of articular cartilage, growth plate, tendons, ligaments, menisci, infrapatellar fat pad, and intervertebral discs, with emphasis on contrasting normal and pathogenic phenotypes. the technology development component includes methods for imaging bone and cartilage to improve the diagnosis and treatment of skeletal disorders, or to facilitate the repair of damage caused by trauma to otherwise healthy musculoskeletal tissues including bone, cartilage, tendon, ligament, intervertebral disc, and meniscus. therapeutic approaches include drugs, nutritional interventions, joint replacement, bone and cartilage transplantation, and gene therapy. tissue engineering, regenerative medicine, sports medicine, and musculoskeletal fitness are areas of special emphasis. the joint biology, diseases and orthopedics research area encompasses the following individual scientific programs: cartilage and connective tissue program clinical osteoarthritis and diagnostic imaging program musculoskeletal tissue engineering and regenerative medicine program orthopaedic implant science program