Robert H. “Hal” Scofield, M.D.
Member
Arthritis & Clinical Immunology Research Program
Adjunct Associate Professor, Department of Pathology and Department of Medicine, University of Oklahoma Health Sciences Center
My 101
Autoimmune diseases are especially frustrating, because they involve the immune system. Normally, the immune system protects the body from harmful bacteria and infections. But in autoimmune diseases, the immune system turns against the body, causing weakness and pain and sometimes leads to premature death.
In my laboratory, we’re working on three major projects. The biggest is trying to develop a new animal model of Sjögren’s syndrome. Why create an animal model of a disease? So we can learn more about the disease and find new and better treatments for patients. Sjögren’s syndrome is an autoimmune disease that targets glands that produce saliva and tears. Patients with the disease can live very painful lives, because saliva and tears play important roles in keeping our eyes and mouths clean and disease-free.
We’re also looking at the genetics of systemic lupus erythematosus, more often called just lupus, and how it affects black families. African Americans are more likely to have lupus and to have more severe cases of the disease. We’re hoping to figure out which genes play a role in the disease and how to predict and prevent the disease from occurring.
Our last focus is the correlation between lupus in men and the rare disease Klinefelter’s syndrome. Men are 10 times less likely to have lupus than women and Klinefelter’s (in which the man has an extra X chromosome) happens to only one in 17,000 men – but male lupus patients are much more likely to also have Klinefelter’s syndrome. We think this could play a role in why lupus affects women so much more frequently than men.
Research
My laboratory concentrates on three major projects. First, we have developed a new animal model of Sjögren’s syndrome. This is a common autoimmune rheumatic illness in which there is autoimmune targeting of the salivary and lacrimal glands. Most people with the illness have antibodies in their sera binding the Ro and La proteins. When BALB/c mice are immunized with short peptides (15-18 amino acids in length) from the 60 kD Ro sequence, the mice first develop antibodies and T cell responses recognizing the peptide of immunization. Shortly thereafter there is intra- and intermolecular spreading such that these animals develop autoantibodies binding other epitopes of 60 kD Ro as well as anti-La and and anti-Ro52. We find lymphocytic infiltrates in the salivary glands of immunized animals whose structure and composition are similar to those found in the salivary glands of humans with Sjögren’s syndrome. Also, mice have a decrease in stimulated salivary flow. Thus, these mice recapitulate human Sjögren’s syndrome. Disease can be adoptively transferred by either cells or sera. Experiments are ongoing to determine the specificities of the cell type required for adoptive transfer as well as the specificity of immunoglobulin required for transfer of disease.
In regard to the genetics of SLE, my lab is pursuing the established and confirmed genetic linkage at 11q13 found in Black American SLE families. Black Americans have SLE more frequently and more severely than do White Americans. The strongest linkage is among families with severe disease. The linkage interval has been narrowed by typing of microsatellites within the region. In addition, typing of a large number of single nucleotide polymorphisms has been carried out. Several possible genetic associations are being pursued, including the catalase gene promoter region. We are also interested in the role of prolidase deficiency in autoimmunity.
Finally, we are investigating the association of SLE in men with the presence of Klinefelter’s syndrome (47,XXY). Klinefelter’s syndrome is present in 1 in 17,000 live male births, but our data indicate that 5 of 207 men with SLE have 47,XXY. Meanwhile, Turner’s syndrome (45,XO females) is not commonly found among women with SLE. Thus, we hypothesize that the female-to-male predilection of SLE is due to a gene dose effect on the X chromosome.
Brief CV
Education
B.A., Texas A&M University, 1980
M.D., University of Texas Southwestern Medical School, Dallas, 1984
Honors and Awards
Distinguished Student, Texas A&M University
1987 Stewart Wolf Award
Outstanding Medicine Resident
1988-1989 W.W. Rucks Fellowship
1989-1991 Presbyterian Health Foundation Fellowship
1989 Visiting Professor’s Award
1989 Outstanding Paper, OUHSC Housestaff Scientific Session
1990 Best Paper in Internal Medicine, OUHSC Housestaff, Scientific Session
1990 Lloyd Rader Scholarship, Outstanding Postgraduate Trainee, OUHSC
1992-1997 Physician Scientist Award, NIH, Institute of Musculoskeletal and Skin Diseases
1992 The Merrick Award for Outstanding Research, OMRF
1995 Internal Medicine Faculty Teaching Award, Department of Medicine, OUHSC
1996 OUHSC Provost Award for research by an Assistant Professor
1994 Henry Christian Award, American Federation of Medical Research (national meeting)
1998 Fellow, American College of Physicians
2001 James A. Shannon Director’s Award (NIAMS and the Office for Research on Women’s Diseases)
2002 OUHSC Provost Award for research by a senior faculty member
2003-present Oklahoma Health Research Committee (appointed by Governor Brad Henry)
2004 Ethel Baxter Award for Outstanding Sjogren’s Syndrome Abstract, American College of Rheumatology National Meeting
Other Activities
Serves on the Medical Records Committee for University Hospital; representative to the American Federation of Clinical Research; Vice-Chairman, Research and Development Committee, Department of Veteran’s Affairs Medical Center; member of the Medical Residency Education Review Committee, Department of Medicine, OUHSC; Chairman, Institutional Review Board, OMRF; member, Research Committee, Department of Medicine, OUHSC; volunteer physician, Little Flower Clinic.
Memberships
American College of Physicians
American College of Rheumatology
American Federation of Clinical Research
The Endocrine Society
American Association for the Advancement of Science
American Diabetes Association
Oklahoma Rheumatism Association
The Society of General Internal Medicine
The New York Academy of Sciences
American Association of Immunologists
Joined OMRF Scientific Staff in 1991.
Publications
Recent Publications
Sharma R, Harris VM, Cavett J, …, Lessard CJ, Harley JB, Ng WF, Rasmussen A, Sivils KL, Scofield RH. Rare X Chromosome Abnormalities in Systemic Lupus Erythematosus and Sjögren's Syndrome. Arthritis Rheumatol. 2017 Nov;69(11):2187-92. PMID:28692793
Leehan KM, Pezant NP, Rasmussen A, Grundahl K, Moore JS, Radfar L, Lewis DM, Stone DU, Lessard CJ, Rhodus NL, Segal BM, Scofield RH, Sivils KL, Montgomery C, Farris AD. Minor salivary gland fibrosis in Sjögren's syndrome is elevated, associated with focus score and not solely a consequence of aging. Clin Exp Rheumatol. 2017 Oct 23. PMID:29148407
Leehan KM, Pezant NP, Rasmussen A, Grundahl K, Moore JS, Radfar L, Lewis DM, Stone DU, Lessard CJ, Rhodus NL, Segal BM, Kaufman CE, Scofield RH, Sivils KL, Montgomery C, Farris AD. Fatty infiltration of the minor salivary glands is a selective feature of aging but not Sjögren's syndrome. Autoimmunity. 2017 Oct 8:1-7. PMID:28988489
Selected Publications
Harris VM, Sharma R, Cavett J, Kurien BT, Liu K, Koelsch KA, Rasmussen A, …, Lessard CJ, Harley JB, Sivils KL, Scofield HR. Corrigendum to "Klinefelter's syndrome (47,XXY) is in excess among men with Sjögren's syndrome." Clin Immunol. 2017 Nov 28. pii: S1521-6616(17)30854-9. PMID:29195081
Schell J, Betts NM, Foster M, Scofield RH, Basu A. Cranberries improve postprandial glucose excursions in type 2 diabetes. Food Funct. 2017 Jul 27. [Epub ahead of print] PMID: 28748974
Li H, Reksten TR, Ice JA, ..., Scofield RH, Kovats S, Mariette X, Rönnblom L, Witte T, Rischmueller M, Wahren-Herlenius M, Omdal R, Jonsson R, Ng WF; for UK Primary Sjögren's Syndrome Registry, Nordmark G, Lessard CJ, Sivils KL. Identification of a Sjögren's syndrome susceptibility locus at OAS1 that influences isoform switching, protein expression, and responsiveness to type I interferons. PLoS Genet. 2017 Jun 22;13(6):e1006820. [Epub ahead of print] PMID: 28640813
Kurien BT, Matsumoto H, Scofield RH. Nutraceutical Value of Pure Curcumin. Pharmacogn Mag. 2017 Jan;13(Suppl 1):S161-3. PMCID:PMC5407110
Vivino FB, Carsons SE, Foulks G, Daniels TE, Parke A, Brennan MT, Forstot SL, Scofield RH, Hammitt KM. New Treatment Guidelines for Sjögren's Disease. Rheum Dis Clin North Am. 2016 Aug;42(3):531-51. Review. [Abstract]
Scofield RH. Sjögren Syndrome in the Twenty-First Century. Rheum Dis Clin North Am. 2016 Aug;42(3):xiii-xiv. [Abstract]
Contact
Arthritis & Clinical Immunology Research Program, MS 38
Oklahoma Medical Research Foundation
825 N.E. 13th Street
Oklahoma City, OK 73104
Phone: (405) 271-7144
Fax: (405) 271-7063
E-mail: Hal-Scofield@omrf.org
