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This November, our team and collaborators will share 12 research studies, including four oral presentations, along with three invited presentations at ACR Convergence, the American College of Rheumatology’s annual meeting. We’re proud of the people behind this work and grateful to the many patients and funders who helped make it possible. Click any research title below to read the full abstract.
Oral Presentations
What skin can reveal about small-vessel disease in APS
Small skin biopsies donated by our Michigan patients are giving Dr. Yiran Shen a new window into APS. Her work uncovered changes in immune cells called macrophages and a related blood protein, which she found to be associated with small-vessel disease and worse kidney function. We hope these discoveries will help us better recognize, understand, and treat microvascular APS.
Understanding the risk of recurrent blood clots
Our team contributed to this international APS ACTION study led by Dr. Alex Luta. Many of our Michigan patients generously shared blood samples and clinical information that supported the study. A history of small-vessel disease was associated with approximately twice the risk of another blood clot over an average of six years.
Why calcium deposits develop in juvenile dermatomyositis
What we learn from APS can sometimes help us tackle other autoimmune diseases. Dr. Kavya Sugur and Dr. Yu (Ray) Zuo are bringing that experience to juvenile dermatomyositis, a disease affecting children’s muscles and skin. Their work offers clues to how antibodies and neutrophils contribute to the harmful calcium deposits that can make life especially difficult for some of these children.
Testing a new kind of cell therapy for autoimmune diseases
Dr. Jacqueline Madison contributed to a multicenter study with Dr. Guillermo Valenzuela and fellow U-M rheumatologist Dr. Dinesh Khanna. The team is testing an exciting new approach to autoimmune diseases in which donor immune cells are engineered to remove the B cells that produce harmful antibodies. Early safety findings in 25 participants were encouraging, although temporary blood-count abnormalities and other side effects did occur.
Poster Presentations
Tiny pores that help drive inflammation and clotting
Dr. NaveenKumar Somanathapura is exploring whether tiny pores in neutrophil membranes could be a new treatment target in APS. In laboratory experiments, blocking these pores reduced inflammatory signals and the release of clot-promoting webs called NETs, while mice lacking the pore-forming protein developed smaller blood clots. It’s an encouraging lead as we look for ways to treat the inflammation underlying APS.
Small particles with a possible role in APS blood clots
Dr. NaveenKumar Somanathapura’s work is also taking us beyond NETs. He found increased numbers of novel particles called migrasomes in APS blood. Migrasomes are released as neutrophils crawl, and we found that these particles are highly effective at activating platelets in laboratory experiments, especially when APS antibodies are present. This work gives us a new connection between inflammation and clotting to explore.
A shared signal connecting neutrophils and platelets
We’re especially pleased to highlight undergraduate student Arnav Akhaury’s work. Mentored by Dr. NaveenKumar Somanathapura, Arnav found that blocking a protein called Syk quieted several clot-promoting responses involving neutrophils and platelets in laboratory studies of APS. A Syk inhibitor is already approved to treat another autoimmune condition, and his work suggests a potential way to interrupt activation of two important APS cell types.
Making APS research criteria work better for children
APS does not always look the same in children as it does in adults. Dr. Jacqueline Madison and Dr. Yu (Ray) Zuo partnered with our collaborator Dr. Elizabeth Sloan from Texas to lead a nine-center study. The team found that existing research criteria leave out many children with clinically diagnosed APS. Their work strengthens the case for criteria designed specifically with children in mind, an effort our team is eager to help advance.
Helping neutrophils clear damaged mitochondria
Dr. Ajay Tambralli is finding that APS neutrophils struggle with a basic housekeeping task: clearing out damaged mitochondria. Dr. Tambralli found that a naturally occurring ketone helped restore this process, reducing NET release in laboratory experiments and clotting in mice. His long-term goal is to determine how restoring healthier cell function through dietary changes might calm the inflammation behind APS.
Characterizing small-vessel disease in APS
Our involvement in APS ACTION lets us learn from the experiences of patients all around the world. Dr. Emre Sahin and colleagues studied 130 people with antiphospholipid antibodies and known small-vessel disease and found that the kidneys were the organs most often affected by this small-vessel involvement. During follow-up, new clots in larger blood vessels occurred only in patients who had experienced such clots before.
Tracing the signals that trigger inflammatory NETs
Thalia Newman is untangling the signals that tell neutrophils to release NETs in response to APS antibodies. Blocking one signal, carried by a protein called p38, reduced NET release in laboratory experiments and blood clotting in mice. Each step we understand more deeply gives us a clearer picture of where we might interrupt harmful NET release more selectively.
Mapping inflammation in the body’s largest artery
Our team’s interest in blood vessels sometimes takes us beyond APS. Dr. Katarina Kmetova and Dr. Yu (Ray) Zuo worked with U-M rheumatologists Dr. Ora Singer and Dr. Julia Ford to study aortitis, inflammation of the body’s largest artery. By mapping individual cells and their locations in the artery wall, they uncovered a distinctive pattern of immune activity in a form called clinically isolated aortitis. Their findings point toward antibody-producing cells as a possible focus for future treatment research.
Invited Presentations
New directions for treating microvascular APS
Microvascular APS is an area where we especially want to see better options for our patients. Dr. Doruk Erkan from the Hospital for Special Surgery in New York and Dr. Jason Knight will discuss the challenges of recognizing and treating this often organ-threatening small-vessel involvement. In his part of the session, Jason will highlight how discoveries about inflammation, blood-vessel remodeling, and harmful antibodies could eventually guide precision treatments beyond blood thinners.
Meet the Professor: Antiphospholipid Syndrome
Dr. Knight will also lead two Meet the Professor sessions on APS, sharing lessons from our Michigan APS program with the broader rheumatology community. These small-group discussions are an opportunity to raise awareness of the full spectrum of APS and share practical approaches to day-to-day diagnosis and treatment.
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