History

The Allergy, Immunology and Rheumatology (AIR) Division at the University of Rochester began in the late 1950’s as two separate units, a Clinical Rheumatology Division founded by Dr. Ralph Jacox and a Clinical Immunology Division founded by Dr. John Vaughn. The Clinical Immunology Division focused on translational research across a broad range of immunological diseases including systemic rheumatologic diseases such as rheumatoid arthritis and lupus as well as allergic diseases. The Rheumatology Division was noted for its outstanding clinician-teachers who were instrumental developing the diagnostic criteria for rheumatoid arthritis (Dr. Jacox) and classification criteria for Juvenile Inflammatory Arthritis (Dr. Baum). These two divisions became a combined AIR Division in the 1984.

Under Dr. John Leddy, Division Chief from 1970 to 1996, the AIR Division had tremendous success as a research intensive division. Some of the notable research contributions during this period include: 1) the first description and functional characterization of human C5 and C6 deficiencies (Drs. Rosenfeld and Leddy); 2) characterization of defective complement regulation by PNH erythrocytes (Drs. Rosenfeld and Leddy); and 3) initial description of human FcγRI and Fcγ RII including production of the first monoclonal antibodies and characterization of the cellular distribute on and function of these molecules (Drs. Anderson, Looney, Rosenfeld, Leddy and Abraham).

Under Dr. Ignacio Sãnz, Division Chief from 1996 to 2014, the AIR Division became a leading center of expertise on human B lymphocytes. Drs. Sanz developed multiparameter flow cytometry allowing detailed characterization of human B cells. These advances allowed characterization of B cells abnormalities in patients with lupus, RA and Sjogren’s (Drs. Sanz and Anolik). In addition, the AIR division had one of the very first clinical trials of rituximab in an autoimmune disease, a single center, dose escalation trial of rituximab in SLE (Drs. Looney and Anolik). This trial also characterized the effects of rituximab on B cell subsets and the importance of how B cells reconstitute on clinical outcomes (Dr. Anolik, Looney, Sanz). In a large part, because of this expertise in human B cells, Rochester became one of the NIH Autoimmunity Centers of Excellence (2002-2014). During this period, Dr. Ritchlin was developing a human research program on osteoimmunology. Discovery in this area included description of the dramatic expansion of osteoclast precursors in psoriatic arthritis and a subset of patients with psoriasis and the production of the first monoclonal antibody against human DC-STAMP, a critical regulator of osteoclast development (Drs. Ritchlin and Schwarz). Another contribution to osteoimmunology was the very first trial of a biologic (etanercept) for prosthetic hip loosening and the development of 3D-CT scan technology to quantify peri-prosthetic osteolysis (Drs. Looney, Schwarz, O’Keefe, Totterman). A final advance during this period was the development of musculoskeletal ultrasound as a clinical and research technique within the AIR division. MSK-US in the AIR was developed by Dr. Thiele who has been a national leader in this movement. The AIR Division now has 3 MSK-US certified Rheumatologists (Drs. Thiele, Tebachian, Marston) and an ultrasound technician.

From 2014-2021, under the direction of Dr. Christopher Ritchlin as AIR Division Chief, the longstanding clinical and laboratory programs including studies on human B cell biology and osteoimmunology continued. The AIR Division’s close research and clinical ties with Orthopedics were strengthened, with three faculty member, Drs. Ritchlin, Looney, and Anolik becoming members of the Center for Musculoskeletal Research (CMSR). Under Dr. Anolik the AIR Division became a member of the NIH Accelerated Medicines Partnership. This program made excellent use of the Division’s expertise in MSK-US including needle biopsies of synovial tissue for research purposes. Under John Looney, Kirsi Jarvinen-Seppo, and colleagues, URMC was awarded a World Allergy Organization Center of Excellence to intensify and accelerate multi-disciplinary scientific and clinical research, education, and training in allergy, asthma and clinical immunology.

In 2021, Dr. Jenifer Anolik was named Interim Chief. Under Dr. Anolik, the longstanding clinical and basic science research as well as clinical endeavors have continued to expand. Dr. Anolik was named the principal lead for the RA team under URMC’s recent funding from the NIH AMP Autoimmune and Immune-Mediated Diseases program. In addition, Dr. Ritchlin was named the lead for the psoriasis/ psoriatic arthritis team under this grant.

The AIR Division faculty currently includes Rheumatologists, (one with a joint appointment in Medicine and Pediatrics), Allergists/Clinical Immunologists (several with joint appointments in Pediatrics), and research scientists as well as clinical fellows in Rheumatology, Allergy/immunology and adult/pediatric Rheumatology. In addition, the division has clinical coordinators who oversee clinical research projects as well as post-doctoral fellows, graduate students and technicians who conduct cutting edge studies of the newest treatments for autoimmune, rheumatic and allergic diseases. The AIR Division has multiple outpatient clinics as well as two infusion centers. Musculoskeletal ultrasound and immunotherapy are also available.