Leslie J. Crofford, M.D.



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Faculty Appointments
Professor of Medicine Professor of Pathology, Microbiology and Immunology
M.D., University of Tennessee Center for Health Science, Memphis, TennesseeB.A., Chemistry , Vanderbilt University, Nashville, Tennessee
Office Address
T-3113 MCN
1161 21st Ave S.
Nashville, TN 37232-2681
Research Description
Inflammatory arthritis, including rheumatoid arthritis, is a systemic disease causing pain, fatigue, disability, and early mortality. Clinical expression of systemic autoimmune inflammatory arthritis is associated with activation of innate and acquired immune systems. In addition to the local effects of synovitis, systemic effects include skeletal muscle dysfunction likely mediated by pro-inflammatory cytokines.

Our research focuses on the role of prostaglandins and other lipid mediators in mediating innate immune functions and the transition from innate to acquired immunity.

We also are involved with the intersection of inflammation and pain in patients with rheumatic diseases.

Finally, we have focused on the systemic effects of inflammatory arthritis on skeletal muscle function.
Research Keywords
Innate and acquired immunity in inflammatory arthritis
Clinical Research Keywords
Arthritis, myositis, scleroderma, fibromyalgia, pain, inflammation
Dolan JM, Weinberg JB, O'Brien E, Abashian A, Procario MC, Aronoff DM, Crofford LJ, Peters-Golden M, Ward L, Mancuso P. Increased Lethality and Defective Pulmonary Clearance of Streptococcus Pneumoniae in Microsomal Prostaglandin E Synthase-1 Knockout Mice. Am. J. Physiol. Lung Cell Mol. Physiol [print-electronic]. 2016 Apr 4/8/2016; ajplung.00220.2015. PMID: 27059285, PII: ajplung.00220.2015, DOI: 10.1152/ajplung.00220.2015, ISSN: 1522-1504.

Leverenz D, Zaha O, Crofford LJ, Chung CP. Causes of creatine kinase levels greater than 1000 IU/L in patients referred to rheumatology. Clin. Rheumatol [print-electronic]. 2016 Apr 4/4/2016; PMID: 27041384, PII: 10.1007/s10067-016-3242-9, DOI: 10.1007/s10067-016-3242-9, ISSN: 1434-9949.

Crofford LJ, Nyhoff LE, Sheehan JH, Kendall PL. The role of Bruton's tyrosine kinase in autoimmunity and implications for therapy. Expert Rev Clin Immunol [print-electronic]. 2016 Mar 3/4/2016; 1-11. PMID: 26864273, DOI: 10.1586/1744666X.2016.1152888, ISSN: 1744-8409.

Nyhoff LE, Barron B, Johnson EM, Bonami RH, Maseda D, Fensterheim BA, Han W, Blackwell TS, Crofford LJ, Kendall PL. Bruton's tyrosine kinase deficiency inhibits autoimmune arthritis but fails to block immune complex-mediated inflammatory arthritis. Arthritis & rheumatology (Hoboken, N.J.) [print-electronic]. 2016 Mar 3/4/2016; PMID: 26945549, DOI: 10.1002/art.39657, ISSN: 2326-5205.

Salt E, Wiggins AT, Rayens MK, Huaman MA, Mannino D, Schwieterman P, Merkley SA, Jones AR, Crofford LJ. Risk Factors for Targeted Fungal and Mycobacterial Infections in Patients Taking Tumor Necrosis Factor Inhibitors. Arthritis & rheumatology (Hoboken, N.J.). 2016 Mar; 68(3): 597-603. PMID: 26474379, DOI: 10.1002/art.39468, ISSN: 2326-5205.

Barnado A, Crofford LJ, Oates JC. At the Bedside: Neutrophil extracellular traps (NETs) as targets for biomarkers and therapies in autoimmune diseases. J. Leukoc. Biol [print-electronic]. 2016 Feb; 99(2): 265-78. PMID: 26658004, PII: jlb.5BT0615-234R, DOI: 10.1189/jlb.5BT0615-234R, ISSN: 1938-3673.

Simmons LA, Yang NY, Wu Q, Bush HM, Crofford LJ. Public and Personal Depression Stigma in a Rural American Female Sample. Arch Psychiatr Nurs [print-electronic]. 2015 Dec; 29(6): 407-12. PMID: 26577555, PII: S0883-9417(15)00137-5, DOI: 10.1016/j.apnu.2015.06.015, ISSN: 1532-8228.

Hanaoka BY, Cleary LC, Long DE, Srinivas A, Jenkins KA, Bush HM, Starnes CP, Rutledge M, Duan J, Fan Q, Fraser N, Crofford LJ. Physical impairment in patients with idiopathic inflammatory myopathies is associated with the American College of Rheumatology functional status measure. Clin. Rheumatol [print-electronic]. 2015 Nov; 34(11): 1929-37. PMID: 25388646, PII: 10.1007/s10067-014-2821-x, DOI: 10.1007/s10067-014-2821-x, ISSN: 1434-9949.

Cleary LC, Crofford LJ, Long D, Charnigo R, Clasey J, Beaman F, Jenkins KA, Fraser N, Srinivas A, Dhaon N, Hanaoka BY. Does computed tomography-based muscle density predict muscle function and health-related quality of life in patients with idiopathic inflammatory myopathies?. Arthritis Care Res (Hoboken). 2015 Jul; 67(7): 1031-40. PMID: 25623494, DOI: 10.1002/acr.22557, ISSN: 2151-4658.

Salt E, Rayens MK, Kerr AM, Alikhan M, Crofford LJ. Examining rheumatoid arthritis patients' trust in their provider over time: the effects of demographic factors and accessing sources of information. Orthop Nurs. 2015 May; 34(3): 159-65. PMID: 25989126, PII: 00006416-201505000-00010, DOI: 10.1097/NOR.0000000000000145, ISSN: 1542-538X.

Crofford LJ. Psychological aspects of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol [print-electronic]. 2015 Feb; 29(1): 147-55. PMID: 26267008, PII: S1521-6942(15)00034-0, DOI: 10.1016/j.berh.2015.04.027, ISSN: 1532-1770.

Noehren B, Dailey DL, Rakel BA, Vance CG, Zimmerman MB, Crofford LJ, Sluka KA. Effect of transcutaneous electrical nerve stimulation on pain, function, and quality of life in fibromyalgia: a double-blind randomized clinical trial. Phys Ther [print-electronic]. 2015 Jan; 95(1): 129-40. PMID: 25212518, PMCID: PMC4295083, PII: ptj.20140218, DOI: 10.2522/ptj.20140218, ISSN: 1538-6724.

Dailey DL, Frey Law LA, Vance CG, Rakel BA, Merriwether EN, Darghosian L, Golchha M, Geasland KM, Spitz R, Crofford LJ, Sluka KA. Perceived function and physical performance are associated with pain and fatigue in women with fibromyalgia. Arthritis Res. Ther. 2015; 18(1): 68. PMID: 26979999, PMCID: PMC4793621, PII: 10.1186/s13075-016-0954-9, DOI: 10.1186/s13075-016-0954-9, ISSN: 1478-6362.

Maseda D, Bonami RH, Crofford LJ. Regulation of B lymphocytes and plasma cells by innate immune mechanisms and stromal cells in rheumatoid arthritis. Expert Rev Clin Immunol [print-electronic]. 2014 Jun; 10(6): 747-62. PMID: 24734886, DOI: 10.1586/1744666X.2014.907744, ISSN: 1744-8409.

Maseda D, Bonami RH, Crofford LJ. Regulation of B lymphocytes and plasma cells by innate immune mechanisms and stromal cells in rheumatoid arthritis. Expert Rev Clin Immunol [print-electronic]. 2014 Jun; 10(6): 747-62. PMID: 24734886, DOI: 10.1586/1744666X.2014.907744, ISSN: 1744-8409.

Brogden NK, Banks SL, Crofford LJ, Stinchcomb AL. Diclofenac enables unprecedented week-long microneedle-enhanced delivery of a skin impermeable medication in humans. Pharm. Res [print-electronic]. 2013 Aug; 30(8): 1947-55. PMID: 23761054, PMCID: PMC3773937, DOI: 10.1007/s11095-013-1036-1, ISSN: 1573-904X.

Brogden NK, Ghosh P, Hardi L, Crofford LJ, Stinchcomb AL. Development of in vivo impedance spectroscopy techniques for measurement of micropore formation following microneedle insertion. J Pharm Sci [print-electronic]. 2013 Jun; 102(6): 1948-56. PMID: 23589356, PMCID: PMC3678392, DOI: 10.1002/jps.23544, ISSN: 1520-6017.

Salt E, Crofford LJ, Studts JL, Lightfoot R, Hall LA. Development of a quality of patient-health care provider communication scale from the perspective of patients with rheumatoid arthritis. Chronic Illn [print-electronic]. 2013 Jun; 9(2): 103-15. PMID: 22822176, PII: 1742395312455440, DOI: 10.1177/1742395312455440, ISSN: 1745-9206.

Hung EW, Mayes MD, Sharif R, Assassi S, Machicao VI, Hosing C, St Clair EW, Furst DE, Khanna D, Forman S, Mineishi S, Phillips K, Seibold JR, Bredeson C, Csuka ME, Nash RA, Wener MH, Simms R, Ballen K, Leclercq S, Storek J, Goldmuntz E, Welch B, Keyes-Elstein L, Castina S, Crofford LJ, Mcsweeney P, Sullivan KM. Gastric antral vascular ectasia and its clinical correlates in patients with early diffuse systemic sclerosis in the SCOT trial. J. Rheumatol [print-electronic]. 2013 Apr; 40(4): 455-60. PMID: 23418384, PMCID: PMC3652008, PII: jrheum.121087, DOI: 10.3899/jrheum.121087, ISSN: 0315-162X.

Painter JT, Crofford LJ, Talbert J. Geographic variation of chronic opioid use in fibromyalgia. Clin Ther [print-electronic]. 2013 Mar; 35(3): 303-11. PMID: 23485077, PMCID: PMC4346177, PII: S0149-2918(13)00059-3, DOI: 10.1016/j.clinthera.2013.02.003, ISSN: 1879-114X.

Painter JT, Crofford LJ. Chronic opioid use in fibromyalgia syndrome: a clinical review. J Clin Rheumatol. 2013 Mar; 19(2): 72-7. PMID: 23364665, DOI: 10.1097/RHU.0b013e3182863447, ISSN: 1536-7355.

Oddis CV, Reed AM, Aggarwal R, Rider LG, Ascherman DP, Levesque MC, Barohn RJ, Feldman BM, Harris-Love MO, Koontz DC, Fertig N, Kelley SS, Pryber SL, Miller FW, Rockette HE, . Rituximab in the treatment of refractory adult and juvenile dermatomyositis and adult polymyositis: a randomized, placebo-phase trial. Arthritis Rheum. 2013 Feb; 65(2): 314-24. PMID: 23124935, PMCID: PMC3558563, DOI: 10.1002/art.37754, ISSN: 1529-0131.

Srikuea R, Symons TB, Long DE, Lee JD, Shang Y, Chomentowski PJ, Yu G, Crofford LJ, Peterson CA. Association of fibromyalgia with altered skeletal muscle characteristics which may contribute to postexertional fatigue in postmenopausal women. Arthritis Rheum. 2013 Feb; 65(2): 519-28. PMID: 23124535, PMCID: PMC3558634, DOI: 10.1002/art.37763, ISSN: 1529-0131.

Bush HM, Pagorek S, Kuperstein J, Guo J, Ballert KN, Crofford LJ. The Association of Chronic Back Pain and Stress Urinary Incontinence: A Cross-Sectional Study. J Womens Health Phys Therap. 2013 Jan; 37(1): 11-8. PMID: 23794961, PMCID: PMC3688274, DOI: 10.1097/JWH.0b013e31828c1ab3, ISSN: 1556-6803.

Salt E, Crofford L. Rheumatoid arthritis: new treatments, better outcomes. Nurse Pract. 2012 Nov 11/10/2012; 37(11): 16-22; quiz 23. PMID: 23032511, DOI: 10.1097/01.NPR.0000421427.01505.0e, ISSN: 1538-8662.

Hanaoka BY, Peterson CA, Crofford LJ. Glucocorticoid effects on skeletal muscle: benefit and risk in patients with autoimmune inflammatory rheumatoid diseases [editorial]. Expert Rev Clin Immunol. 2012 Nov; 8(8): 695-7. PMID: 23167679, DOI: 10.1586/eci.12.76, ISSN: 1744-8409.

Brogden NK, Milewski M, Ghosh P, Hardi L, Crofford LJ, Stinchcomb AL. Diclofenac delays micropore closure following microneedle treatment in human subjects. J Control Release [print-electronic]. 2012 Oct 10/28/2012; 163(2): 220-9. PMID: 22929967, PMCID: PMC3725617, PII: S0168-3659(12)00627-X, DOI: 10.1016/j.jconrel.2012.08.015, ISSN: 1873-4995.

Aschbacher K, Adam EK, Crofford LJ, Kemeny ME, Demitrack MA, Ben-Zvi A. Linking disease symptoms and subtypes with personalized systems-based phenotypes: a proof of concept study. Brain Behav. Immun [print-electronic]. 2012 Oct; 26(7): 1047-56. PMID: 22687333, PMCID: PMC3725324, PII: S0889-1591(12)00144-4, DOI: 10.1016/j.bbi.2012.06.002, ISSN: 1090-2139.

Hanaoka BY, Peterson CA, Horbinski C, Crofford LJ. Implications of glucocorticoid therapy in idiopathic inflammatory myopathies. Nat Rev Rheumatol [print-electronic]. 2012 Aug; 8(8): 448-57. PMID: 22688888, PII: nrrheum.2012.85, DOI: 10.1038/nrrheum.2012.85, ISSN: 1759-4804.

Arnold LM, Stanford SB, Welge JA, Crofford LJ. Development and testing of the fibromyalgia diagnostic screen for primary care. J Womens Health (Larchmt) [print-electronic]. 2012 Feb; 21(2): 231-9. PMID: 22165952, DOI: 10.1089/jwh.2011.3029, ISSN: 1931-843X.

Shang Y, Gurley K, Symons B, Long D, Srikuea R, Crofford LJ, Peterson CA, Yu G. Noninvasive optical characterization of muscle blood flow, oxygenation, and metabolism in women with fibromyalgia. Arthritis Res. Ther. 2012; 14(6): R236. PMID: 23116302, PMCID: PMC3674608, PII: ar4079, DOI: 10.1186/ar4079, ISSN: 1478-6362.

Schiopu E, Phillips K, MacDonald PM, Crofford LJ, Somers EC. Predictors of survival in a cohort of patients with polymyositis and dermatomyositis: effect of corticosteroids, methotrexate and azathioprine. Arthritis Res. Ther. 2012; 14(1): R22. PMID: 22284862, PMCID: PMC3392815, PII: ar3704, DOI: 10.1186/ar3704, ISSN: 1478-6362.

Sarnes E, Crofford L, Watson M, Dennis G, Kan H, Bass D. Incidence and US costs of corticosteroid-associated adverse events: a systematic literature review. Clin Ther [print-electronic]. 2011 Oct; 33(10): 1413-32. PMID: 21999885, PII: S0149-2918(11)00617-5, DOI: 10.1016/j.clinthera.2011.09.009, ISSN: 1879-114X.

Kojima F, Matnani RG, Kawai S, Ushikubi F, Crofford LJ. Potential roles of microsomal prostaglandin E synthase-1 in rheumatoid arthritis. Inflamm Regen. 2011 Mar; 31(2): 157-66. PMID: 22308189, PMCID: PMC3269760, ISSN: 1880-9693.

Lommel K, Bandyopadhyay A, Martin C, Kapoor S, Crofford L. A pilot study of a combined intervention for management of juvenile primary fibromyalgia symptoms in adolescents in an inpatient psychiatric unit. Int J Adolesc Med Health. 2011; 23(3): 193-7. PMID: 22191183, ISSN: 0334-0139.

Boomershine CS, Crofford LJ. A symptom-based approach to pharmacologic management of fibromyalgia. Nat Rev Rheumatol. 2009 Apr; 5(4): 191-9. PMID: 19337283, PII: nrrheum.2009.25, DOI: 10.1038/nrrheum.2009.25, ISSN: 1759-4804.

Boomershine CS, Crofford LJ. A symptom-based approach to pharmacologic management of fibromyalgia. Nat Rev Rheumatol. 2009 Apr; 5(4): 191-9. PMID: 19337283, PII: nrrheum.2009.25, DOI: 10.1038/nrrheum.2009.25, ISSN: 1759-4804.

Dubois RN, Abramson SB, Crofford L, Gupta RA, Simon LS, Van De Putte LB, Lipsky PE. Cyclooxygenase in biology and disease. FASEB J. 1998 Sep; 12(12): 1063-73. PMID: 9737710, ISSN: 0892-6638.