Institutes and Research Divisions
National Institute of Arthritis
and Musculoskeletal and Skin Diseases


The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) was established in 1986. It conducts and supports basic, clinical, and epidemiological research and research training, and disseminates information on many of the most debilitating diseases affecting the Nation's health. Many of these diseases are chronic. They afflict millions of Americans causing tremendous human suffering and costing the U.S. billions of dollars in health care and lost productivity. These diseases include the many forms of arthritis and numerous diseases of the musculoskeletal system and of the skin.

The institute also conducts and supports basic research on the normal structure and function of joints, muscles, bones, 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 addresses rheumatology, orthopedics, derma-tology, metabolic bone diseases, heritable disorders of bone and cartilage, inherited and inflammatory muscle diseases, and sports medicine.


Important Events in NIAMS History

November 20, 1985--The Health Research Extension Act of 1985 (P.L. 99-158) author-ized the establishment of the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

April 8, 1986--NIAMS was established.

February 18, 1987--The first meeting of the National Arthritis and Musculoskeletal and Skin Diseases Advisory Council was held.

April 15, 1996--NIAMS held a 10th anniversary symposium: "Progress and Promise in Chronic Disease."


NIAMS Legislative Chronology

August 1950--An arthritis program was established within the National Institute of Arthritis and Metabolic Diseases under P.L. 81-692.

May 1972--The institute was renamed the National Institute of Arthritis, Metabolism and Digestive Diseases, P.L. 92-305.

1973--Senator Alan Cranston introduced legislation which 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 in depth and to develop an arthritis plan. The act also 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--P.L. 94-562, the Arthritis, Diabetes, and Digestive Diseases Amendments of 1976 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--The Department conferred bureau status on the institute, resulting in 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 bring increased emphasis to research on these disorders. The legislation provided for the development of a plan for a national arthritis and musculoskeletal diseases program, establishment of two interagency coordinating committees, one on arthritis and musculoskeletal diseases and one on skin diseases, and expanded the activities of the National Arthritis Advisory Board to include musculoskeletal and skin diseases.

Director's of NIAMS

NameDate of Birth Dates of Office
Lawrence E. SchulmanJul. 25, 1919 April 1986October 1994
Michael D. LockshinDec. 9, 1937November 1994July 1995
Stephen I. KatzJan. 26, 1941August 1995

Biographical Sketch of NIAMS Director

Stephen I. Katz, M.D., Ph.D.

Dr. Katz was born in New York City in 1941 and grew up in the Washington, D.C., and Bethesda, Md., areas. He earned a B.A. degree cum laude in history from the University of Maryland, College Park; an M.D. degree cum laude from Tulane University Medical School, New Orleans; and a Ph.D. degree in immunology from the University of London, England. He com-pleted a medical internship at Los Angeles County Hospital, a residency in dermatology at the University of Miami School of Medicine, Florida, military service at Walter Reed General Hospital in Washington, D.C., and postdoctoral work at the Royal College of Surgeons of England.

In 1974 he joined NIH as a senior investi-gator in the Dermatology Branch of NCI, becoming acting chief in 1977 and chief in 1980. From 1989 to 1995, he also served a Marion B. Sulzberger professor of dermatology at the Uniformed Services University of the Health Sciences in Bethesda. On August 1, 1995, he was appointed director of NIAMS. He continues to serve as chief of the NCI Dermatology Branch.

Dr. Katz' stuides of Langerhans cells and epidermally derived cytokines have demonstrated that skin is a critical component of the immune system both in its normal function and as a target in immunologically mediated diseases. He has also made seminal discoveries in the field of inherited and acquired blistering skin diseases.

At NCI, he has led a program of investigations in fundamental biological and clinical problems in neoplastic and inflammatory diseases of the skin. He has trained a large number of immunodermatologists from the U.S. and abroad. These individuals are now leading thie own independent research programs.

Dr. Katz has received many government and private sector honors and awards, including the Presidential Executive Meritorious Rank Award, the PHS Superior Service Award, the NIH Director's Award, the Sulzberger Lecture Award, the D. Martin Carter Mentor Award from the American Skin Association, the Outstanding Alumnus Award of Tulane University Medical School, honorary membership in many international dermatologic societies, and 1992 election into the National Academy of Sciences Institute of Medicine.

He has served many scientific organizations in leadership positions such as president of the Society for Investigative Dermatology (SID), membership on the board of directors of SID and of the Association of Professors of Dermatology, secretary-general of the 18th World Congress of Dermatology in New York in 1992, and secretary-treasurer of the Clinical Immunology Society. He has also served on the editorial boards of most clinical and investigative dermatology journals and many immunology journals. He has authored or coauthored more than 180 scientific articles and 50 book chapters and edited several conference proceedings.


NIAMS Programs The NIAMS supports a multidisciplinary program of basic and clinical investigations, epidemiologic research, research centers, and research training for scientists within its own facilities as well as supporting grantees at universities and medical schools nationwide. It also supports the dissemination of research results and information through the National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse and through the Osteoporosis and Related Bone Diseases National Resource Center.

The NIAMS Intramural Research Program conducts basic research in structural biology, biology of the immune system, biology of the skin, muscle biophysics, and development of bone and cartilage. It does clinical research on lupus, rheumatoid arthritis, genetic skin diseases, and inflammatory muscle diseases.

The Extramural Program supports research via grants and contracts in four branches: Arthritis; Musculoskeletal Diseases; Skin Diseases; and Muscle Biology. Support also is provided for the Epidemiology/Data Systems Program and the Centers Program. A wide array of basic and clinical research and research training in the fields of rheuma-tology, muscle biology, orthopedics, bone and mineral metabolism, and dermatology are being pursued through these programs.

Arthritis Branch

This program supports basic and clinical research on the normal function and components of connective tissue and the immune system and their dysregulation in rheumatic, genetic, and inherited diseases of connective tissue. The goals are increased understanding of the mechanisms involved in the initiation and development of rheumatic and degenerative diseases of the joints and the translation of these basic research findings to prevention, diagnosis, and treatment of disease.

The research supported by the program uses approaches emanating from immunology, pathology, physiology, behavioral medicine, and epidemiology. Some of the specific diseases being studied include rhematoid arthritis, osteoarthritis, systemic lupus erythmatosus, scleroderma, fibromyalgia, juvenile rheumatic diseases, gout, ankylosing spondylitis and other spondyloarthropathies, and many other inherited and acquired connective tissue disorders.

Specific areas under investigation include:

Epidemiology and Data Systems Programs

The epidemiology program provides an administrative core for efforts to encourage epidemiologic research in the fields of rheumatic, musculoskeletal and skin diseases. Epidemiologic studies of these diseases contribute knowledge related to the prevalence and economic and social burdens from these diseases, studying their natural history, identifying risk factors, and investigating disease etiologies.

The data systems program fosters system-atic acquisition, storage, retrieval, and analysis of information concerning arthritis and skin diseases. Program effort is focused on assuring validity and comparability of data collected in separate institutions and integrating data resources with data needs.

Musculoskeletal Diseases Branch

This program supports studies of the skeleton and associated connective tissues. Broad areas of interest include skeletal development, metabolism, mechanical properties, and responses to injury. Research on osteoporosis, a disease afflicting many of the Nation's growing population of older people, is a major area of emphasis. Some other diseases and skeletal disorders under investigation are osteogenesis imperfecta, a genetic disorder that leads to fragile, easily fractured bones; Paget's disease of bone, which results in irregular bone formation and subsequent deformity; genetic disorders of bone growth and development, such as osteomalacia.

Other studies focus on the causes and treatment of acute and chronic injuries, including carpal tunnel syndrome, repetitive stress injury, and low back pain. The program supports development of technologies with the potential to improve treatment of skeletal disorders and facilitate the repair of trauma in the normal skeleton. These include drugs and nutritional interventions, joint replacement, bone and cartilage trans-plantation, and gene therapy. Sports medicine and musculoskeletal fitness are also areas of special research emphasis.

Research areas support through this branch include:

Muscle Biology Branch

This program supports researchs on skeletal muscle, its diseases and disorders, and its central role in human physiology and exercise. Topics include the molecular structure of muscle and the molecular mechanisms that produce force and motion. An aim is understanding the alterations in muscle resulting from increased exercise and, conversely, the atrophy that follows immobilization during injury or illness. Specific aims include understanding the molecular structure and assembly of muscle components, including those respons-ible for contraction and regulation of muscle action; the molecular basis of genetic muscle diseases, such as Duchenne/Becker muscular dystrophy, myotonic dystrophy, myotonias, and malignant hyperthermia; genetic pro-cesses of muscle development and assembly; musculoskeletal fitness, metabolism, and adaptive mechanisms; the role of growth factors and hormones; altered metabolism during aging; the effects of therapeutic drugs and abused substances on basic muscle processes; the cellular basis for impaired muscle function in disease; inflammatory muscle diseases and inflammation resulting from exercise or injury; molecular mechanisms of muscle repair and regeneration; and development of more satisfactory methods of treatment and recovery.

Specific research covered by the branch include:


NIAID Appropriations -- Grants and Direct Operations
[Amounts in thousands of dollars]

Total Grants1
Direct Operations
1987125,175 14,482140,417
1988130,542 17,001147,543
1989141,564 18,322159,886
1990145,701 22,837168,538
1991166,918 26,531193,449
1992173,817 29,699203,516
1Comparable amount. Appropriations for arthritis and musculoskeletal and skin diseases are included in the NIDDK appropriation for FY 1986.

Skin Diseases Branch

Research studies supported by this program are increasing understanding of the mechanisms underlying normal and abnormal skin function and development. Research investigations are conducted on the molecular structures of various skin cells, the immunologic functions of the skin in normal and disease conditions, and the development of diagnostic tests and effective therapies for an array of skin diseases that can cause discomfort, disfigurement, and/or chronic disability. The range of skin diseases include keratinizing disorders such as psoriasis and ichthyosis atopic dermatitis and other chronic inflammatory skin disorders blistering diseases such as epidermolysis bullosa and pemphigus and disorders of pigmentation such as vitiligo and disorders of the hair and nails.

Basic science and disease areas in skin research include:

  • Metabolic studies of skin
  • Immunologically mediated skin disorders
  • Disorders or keratinization, pigmentation, and hair growth
  • Photobiology, photoallery, and phototoxic reactions
  • Bullous diseases and the basement membrane of skin
  • Acne and physiologic activity of sebaceous glands
  • Skin manifestations of diffuse connective tissue disorders
  • Heritable connective tissue diseases
  • Skin manifestations of HIV infection and AIDS.

Centers Program

The NIAMS currently supports three types of research centers programs: Multipurpose Arthritis and Musculoskeletal Diseases Centers, Specialized Centers of Research, and Skin Diseases Research Centers.

The Multipurpose Arthritis and Musculoskeletal Diseases Centers were established in the National Arthritis Act of 1974. The purpose of these centers, located at 14 medical institutions and hospitals around the country, is to foster a multidisciplinary approach to the many problems or arthritis and musculoskeletal diseases and to develop capabilities for research in these areas. To this end, centers develop and carry out basic and/or clinical research studies, research in professional and patient education, and epidemiology and health services research.

Existing Specialized Centers of Research (SCORs) are targeted for rheumatoid arthritis, systemic lupus erythematosus, osteo-arthritis, and osteoporosis. These centers aim to accelerate the pace of basic research on the causes of disease and to expedite transfer of advances in basic science into clinical applications and improved patient care.

NIAMS has six Skin Diseases Research Centers (SDRC), which promote collaborative efforts among scientists engaged in high-quality research related to a common theme. By providing funding for core facilities, pilot and feasibilty studies, and program enrichment activities at the SDRC, the institute reinforces and amplifies investigations already ongoing.

Information and Education Efforts

The focus of most NIAMS information and education efforts is in the Office of Scientific and Health Communications. The efforts include the National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse, which helps lay and professional audiences locate materials and information, and a campaign entitled "What Black Women Should Know About Lupus." A National Resource Center on Osteoporosis and Related Bone Diseases provides public information and develops educational efforts on prevention, diagnosis, and treatment.


Intramural Research Program The NIAMS intramural program has six main components--the Arthritis and Rheumatism Branch, Laboratory of Physical Biology, Laboratory of Skin Biology, Laboratory of Structural Biology, Protein Expression Laboratory, and craniofacial development section--the first section within a planned Bone and Connective Tissue Biology Branch.

The Arthritis and Rheumatism Branch (ARB) conducts a variety of investigations--basic and clinical. The historical focus of the ARB has been the study of the autoimmune rheumatic diseases--particularly rheumatoid arthritis, systemic lupus erythematosus, and myositis. At present, studies in the laboratories and clinics also focus on genetic diseases affecting inflammation and the musculoskeletal system, the basic mechanisms of signal-ing in the cells of inflammation, animal models of disease, genetic-epidemiologic studies, the role of neuroendocrine-immune system interactions in disease, and a variety of novel approaches to the interruption of inflammation.

In the Laboratory of Physical Biology leading-edge physical and biological techniques are used to study biological systems. Efforts are devoted to studying the structure of muscle cells, the molecular structure and function of various muscle components, and the mechanism of muscle contraction. Significant effort also is directed at the study of target sizes of macromolecules by radiation inactivation. The mechanism of cell membrane assembly is being investigated by means of calorimetry.

The Laboratory of Skin Biology conducts basic and clinical research on the skin and skin diseases, with particular emphasis on the epidermis--the outermost layer of skin. Basic research includes study of the various structural proteins and enzymes, and their genes, that are specifically expressed in the epidermis; the processes by which these molecules are assembled to form a normal epidermis; and the processes of abnormal cornification (keratinization) that occur in a variety of genetic skin diseases. One section within the lab uses direct and indirect genetic approaches to identify the molecular bases of disorders of cornification and malignant skin diseases. This section also assists in genetic analysis of a variety of hereditary diseases under study by other NIH investigators, including complex hereditary disorders such as arthritis.

The Laboratory of Structural Biology conducts research into the structural basis of the assembly and functioning of macromolecules (large biological molecules) and their complexes such as viruses, cell membrane and cytoskeletal proteins, and proteins in the skin. There is particular interest in the mechanisms that control these processes. These investigations make extensive use of cryoelectron microscopy and three-dimensional image processing. The newest group in this laboratory, established in 1991, is devoted to x-ray crystallographic study of the high-resolution structure and function of biolgical macromolecules and multienzyme complexes, including the replication complex of bacteriophage T4, retroviral proteins, and host factors involved in HIV expression.

The Protein Expression Laboratory, form-erly under the NIH Office of the Director, joined the NIAMS in 1996. This lab plans and conducts research on the expression, purification, and structural characterization of HIV and HIV-related proteins. Laboratory scientists also collaborate with NIH intramural researchers studying the structure and function of HIV and HIV-related proteins. The lab serves as a support and resource group for the expression and purification of these proteins.

The craniofacial development section, established in 1996, conducts basic investigations at the molecular and cellular levels on the mechanisms of bone and cartilage formation as they relate to human genetic diseases such as achondroplasia, craniosyno-stosis, craniofacial dysostosis, and various other forms of skeletal dysplasias. Signal transduction pathways that determine and maintain cartilage and bone formation are of particular interest. Members of the lab will use relevant animal models combined with the power of molecular genetics to address fundamental questions in bone and cartilage development and extrapolate their findings to shed light on the cause and development of human skeletal diseases.

* Until May 19, 1972, the National Institute of Arthritis and Metabolic Diseases until June 23, 1981, the National Institute of Arthritis, Metabolism, and Digestive Diseases until April 8, 1986, the National Institute of Arthritis, Diabetes, and Digestive Kidney Diseases.