Brian Andonian, MD, MHSc

Faculty Member, Duke Molecular Physiology Institute


Assistant Professor of Medicine
Division of Rheumatology & Immunology
Duke University School of Medicine


Carmichael Building


Brian J. Andonian is an Assistant Professor in the Department of Medicine, Division of Rheumatology. He studies the effects of exercise training interventions on immune cell and skeletal muscle metabolic health and molecular function in persons with rheumatoid arthritis (RA). The goal of his translational research is to improve outcomes in patients with chronic inflammatory diseases, including disease activity and cardiometabolic risk in RA, via personalized lifestyle and pharmacologic prescription.

Since 2014, Dr. Andonian has worked closely with Dr. Kim Huffman at the DMPI studying the effects of exercise training on RA skeletal muscle and immune function and metabolism. Their group identified that older patients with RA significantly improve cardiorespiratory fitness and multiple domains of inflammatory disease activity following a high-intensity interval training program. Further, they showed that RA patients with the greatest benefit in disease activity improvement from exercise training were older, less fit, and with greater system inflammation; these benefits were also highly associated with gene expression alterations in RA skeletal muscle energy metabolism [1]. Their ongoing work focuses on understanding links between RA skeletal muscle and immune cell metabolism, as well the impact of exercise on RA T cell function.

Dr. Andonian also works closely with Dr. Bill Kraus at the DMPI studying the benefits and challenges of exercise training, prescription, and testing in patients with chronic diseases at risk for cardiometabolic complications. Their team demonstrated that while exercise training improves RA inflammatory disease activity and cardiorespiratory fitness, markers of skeletal muscle remodeling were altered in RA compared to a cohort—with similarly elevated risk for cardiometabolic disease—of prediabetes participants [2]. Their team also showed that both use of exercise treadmill testing and overall cardiorespiratory fitness has decreased over the past 40 years [3]. Their ongoing research focuses on evaluating novel platforms to improve clinical use and increase utilization of cardiopulmonary exercise testing in at-risk, aging populations.

Finally, Dr. Andonian is also interested in the interaction between inflammatory diseases and mechanobiology. Working with Dr. Alfonse Masi at the University of Illinois College of Medicine, Dr. Andonian showed that patients with ankylosing spondylitis (AS) have higher resting myofascial stiffness in their lumbar extensor musculature compared to healthy control participants [4]. This work provided evidence for the contribution of altered mechanical stress in the pathogenesis of inflammatory arthritis [5]. Ongoing work focuses on the understanding of altered mechanobiology in RA and other chronic diseases of aging.


Kim M. Huffman, MD, PhD