Thank you for your interest in and support of our APS Program! We continue to pursue personalized, proactive treatments for APS with a long-term goal of a cure. We do this work to make lives better, and we hope we can use these emails to build a community of others who want the same. We’re all in this together!

Antiphospholipid Syndrome: A 2022 Update

Yu (Ray) Zuo, MD, MS provides a brief historical perspective on antiphospholipid syndrome, discusses clinical manifestations and current approaches to treatment, and also highlights studies on APS antibodies in COVID-19. Listen to Dr. Zuo's lecture.

APS 101: AUGUST 2022

RESEARCH & CLINICAL TRIALS

Endothelial Cells and the Origins of Antiphospholipid Vasculopathy

We were very happy to learn earlier this year that our grant application to the Department of Defense’s 2022 Lupus Research Program was selected for funding. The project is slated to begin September 1st and will last for three years. The Lupus Research Program was created by Congress in 2017 (based on strong advocacy) to support innovative and impactful lupus research. We successfully convinced the review panel that our work in APS fits this bill! We continue to think about a day in the future when programs like this will exist for APS. In the meantime, our specific project plans are summarized below.

APS is a leading cause of blood clotting and pregnancy loss. Roughly one-third of patients with systemic lupus erythematosus (SLE) harbor antiphospholipid antibodies, and many will eventually be diagnosed with APS. Although APS is often first recognized in the setting of a time-stamped blood clotting event, up to half of patients with APS will also acquire other types of more insidious damage to their bodies over time, including premature dementia, accelerated heart disease, and progressive kidney failure.

Livedo reticularis and racemosa are netlike skin discolorations found on the bodies of many patients with APS. The presence of livedo indicates sluggish or even obstructed blood flow in the small blood vessels of the skin and sometimes tracks with various “internal” problems of APS including abnormal brain imaging and even strokes. For this project, the plan is to apply cutting-edge methodologies to the easily accessible blood vessels of the skin. In doing so, we hope to discover what causes APS blood vessels of the deep organs to fail over time. This will allow us to identify APS patients at risk for organ (brain, heart, kidney, etc.) damage proactively. We also hope to learn what types of medications should be deployed in these individuals.

Building upon what we have already learned from preliminary skin biopsies of APS patients, Specific Aim 1 of the project will characterize the gene expression and function of APS endothelial cells (the blood vessel-lining cells that are in direct contact with blood). The hypothesis is that APS endothelial cells, under constant attack from antiphospholipid antibodies in the blood, are key orchestrators of blood vessel failure over time.

In pursuit of personalized medicine for our patients, Specific Aim 2 will expand the number of patients with APS who undergo skin biopsies (30 new patients). This profiling should identify the genes and proteins that drive blood vessel failure. Furthermore, this Aim will develop a noninvasive model to predict which patients carry these changes and therefore require proactive therapy.

Our strong preliminary data have already demonstrated the feasibility and potentially paradigm-shifting nature of this work. Through this research, we hope to understand problems of great and immediate interest to our patients such as why their thinking and memory deteriorate at an earlier age than expected.

Learn more about this study and our other clinical trials and research.

Our lab is comprised of many talented and dedicated researchers all working towards the common goal of making the lives of APS patients better. This month we are highlighting one of our research assistants, Caroline Vance.

Meet Caroline Vance

Caroline Vance, a senior at Skyline High School in Ann Arbor, worked in Dr. Jason Knight’s Lab as a research assistant this summer. Caroline hopes to attend the University of Michigan to study science next fall. Read more.

You may recall that long back, my family and I adopted an easily distractible beagle after he was found galivanting on a country road. Sparky just turned 6 years old a couple full-moon phases ago. This summer vacation newsletter is going to describe for you “a day in the life” of Sparky the beagle.

6 AM: This is when Sparky wakes up. His first morning activity is to go for a quick trip into the backyard before having breakfast and one-half of a Greenies “toothbrush” as provided by my dad. After he gobbles these items down, he goes back to sleep.

10 AM: This is when Sparky gets to go into the backyard to do his work (he typically is not allowed out earlier because all his howls wake the neighbors). Once Sparky meanders outside, he does many sprints around the yard to stretch his hind legs, which I like to call hound legs. He additionally likes to sniff around the fence barrier to see if he can find any new scents. The next several hours are hard to document as Sparky goes to and fro, here and there, and inside and outside innumerable times.

2 PM: Around this time, Sparky likes to take a cat nap. He does not like it to be called a cat nap, though, for obvious reasons.

3 PM: Sparky likes to go outside to sunbathe. Sometimes he lies on his back to sun his white belly, which possibly also functions as a solar panel that gives him energy.

4 PM: On this particular day, Sparky and I had an intense tug-of-war battle. I was ultimately defeated. After that, we played tag. Unfortunately, I, as the tagger, was never able to tag Sparky due to his speed and low-to-the-ground stature. I personally find it a little unfair because Sparky can do sharp turns much faster than I.

6 PM: This may very well be Sparky's favorite time of the day. He gets the second half of his Greenies toothbrush treat as well as dinner. This typically happens when my dad gets home. My dad thinks that he and Sparky are BFFs, but I am pretty sure Sparky just associates him with all the feedings.

7 PM: This is when Sparky chills out in the backyard. If a deer saunters by, then it is less chill with lots of guarding of the fence and most likely arrooo-ing.

7:30 PM: Sparky gets a long nighttime walk. Once Sparky gets back, he typically decides to retire for the night and hit the hay.

That's all for now! Thanks for coming to my Spark Bark.