2024-2025 Review

patient care highlights

The Division of Rheumatology ranked #10 in the nation in the annual U.S. News & World Report Best Hospitals rankings.

Answering Questions About

Antiphospholipid Syndrome (APS)

The APS Program Community Q&A Series, written by Yu (Ray) Zuo, MD, was created to answer questions Michigan Medicine receives from the APS community. This past year included articles on the impact APS can have on kidneys, GLP-1 medications and weight loss, and information on CAR-T cell therapy and how it may help APS patients in the future.

Using Science to Improve a Patient's Life

In early 2022, Susan Chrysogelos began experiencing painful joints and tightening, darkening skin—symptoms that soon led to a diagnosis of rapidly progressing scleroderma. Despite trying multiple immunosuppressant medications, her condition worsened. By 2024, Dinesh Khanna, MD, recommended she join a new CAR-T clinical trial. After chemotherapy and receiving her modified T cells, she became the first U-M Health patient to undergo this treatment for scleroderma. The recovery was demanding and required close monitoring. Within months, Susan's skin softened, movement improved and she was able to return to activities she’d long missed. She calls the experience life-changing and says that although CAR-T is a difficult process, the results were worth it for her. Her care team believes her progress shows the promise of CAR-T therapy for patients with severe, treatment-resistant scleroderma. Susan stated, “For so long I hadn’t been able to get my hands to function or couldn’t stand on my feet long enough to bake like I wanted to. Despite some lingering fatigue from the treatment, it was amazing to be able to work on the things I enjoy again no matter how small.” “Susan’s case shows that CAR-T is an exciting treatment for those with severe and/or progressive scleroderma who are not responding to standard care therapy,” stated Dr. Khanna.

The Complexities Behind Lupus and Evolving Strategies on Lupus Care

J. Michelle Kahlenberg, MD, PhD, sat down with ReachMD to discuss the mechanisms that contribute to the development of autoreactive immune responses and shared insights on emerging biologics, CAR-T innovations, and potential barriers in translating treatment breakthroughs into real-world patient care.

research highlights

Anti-CD38 Antibody Shows Promise in Targeting Fibrosis

A dedicated, multidisciplinary scleroderma program was created to unite clinicians, scientists, and computational experts to advance personalized care and accelerate new discoveries for patients with scleroderma. Led by John Varga, MD, in collaboration with the Mayo Clinic and TeneoBio, the team reported promising results for a novel fibrosis therapy. Building on their discovery that the enzyme CD38—linked to aging metabolism—is elevated in scleroderma, they developed a highly selective, heavy-chain–only antibody that blocks CD38 activity. In preclinical models, these antibodies nearly eliminated tissue scarring and inflammation and corrected metabolic abnormalities, offering a compelling path toward future treatments.

Targeting Glycolysis Reduces NET Formation in APS

Ajay Tambralli, MD, found that neutrophils in antiphospholipid syndrome (APS) rely heavily on glycolysis, fueling the formation of neutrophil extracellular traps (NETs) that contribute to clots. By blocking glycolysis or related metabolic pathways, the researchers were able to reduce NET formation and shrink blood clots in model systems—without increasing bleeding. These findings point to metabolism-based strategies as a promising new direction for APS treatment, with the potential to offer safer, more effective options beyond lifelong blood thinners. The team is now working to identify what drives these metabolic changes to help develop targeted therapies for APS and other NET-related diseases.

New Dedicated Translational Immunology Research Lab Space

We marked the opening of the new Translational Immunology Research Laboratory space at the University of Michigan’s North Campus Research Complex in Ann Arbor, Michigan. This state-of-the-art facility brings together laboratories from adult and pediatric rheumatology as well as dermatology, creating a highly collaborative and efficient research environment. The shared space provides access to cutting-edge equipment, expanded technology core resources, and direct engagement with experts from the Gilbert S. Omenn Department of Computational Medicine and Bioinformatics. This unified laboratory space has already had a significant scientific impact, serving as a key facilitator in the awarding of a five-year, $7.7 million NIH P01 grant to the Kahlenberg and Gudjonsson laboratories to study cutaneous lupus and UV light responses in patients with autoimmune disease. By consolidating teams and resources, the space has improved efficiency in the use of shared equipment and reagents, allowing investigators to pool resources and maximize productivity. Thoughtful design has reduced the need for extensive wet lab space while maintaining research output, with shared data-analysis workstations that promote collaboration, shared learning, and daily interaction among team members. Beyond efficiency, the environment has strengthened the culture of the research community. As Dr. Kahlenberg noted, “the teams are not only more efficient and organized, but are genuinely happier in the new space. They enjoy learning from each other and also celebrating each other’s successes.” The layout encourages camaraderie—whether through spontaneous scientific discussion or the occasional shared donut, pie, or cake—reinforcing a sense of community that supports both scientific excellence and investigator well-being. The laboratory brings together investigators from the Fox, Gudjonsson, Billi, Kahlenberg, Varga, Tsou, Turnier, Jansen, and Tsoi laboratories, supporting collaborative research across a wide range of immune-mediated diseases. Together, this shared space exemplifies how intentional design and collaboration can accelerate discovery and enhance the research experience.

How Neutrophil Calprotectin Unmasks Future Atherosclerotic Heart Disease Risk

Yu (Ray) Zuo, MD, and his team, in collaboration with University of Texas Southwestern Medical Center, utilized samples and data from the Dallas Heart Study to explore the relationship between a novel biomarker, calprotectin, and atherosclerotic cardiovascular disease, including whether calprotectin can help predict future heart disease risk.

education highlights

Rheumatology Research Training Program: T32

The T32 program, directed by Jason Knight, MD, PhD, along with Michelle Kahlenberg, MD, PhD, and Dinesh Khanna, MD, MSc, is a nationally recognized postdoctoral training initiative dedicated to preparing MD and PhD scientists for independent research careers focused on rheumatic diseases. Guided by principles established in 1976, the program emphasizes recruitment of trainees with strong investigative potential, individualized mentorship, multidisciplinary collaboration, and access to the University’s exceptional research infrastructure. Roughly 25% of our fellows stay and complete our two-year, Rheumatology Research Training Program: T32. The program is structured around four major scientific themes—biologic drivers of clinical heterogeneity, immune-mediated mechanisms of disease, injury and repair, and patient-centered outcomes and innovative clinical trials—and supports up to four fellows annually for a minimum of two years. Trainees develop personalized development plans that integrate rigorous research training, elective coursework aligned with career goals, and professional development in scientific communication, ethics, and reproducibility.

Rheumatology Fellowship Training Program

The Rheumatology Fellowship Training Program is an ACGME-accredited program with a long and distinguished history of training outstanding clinicians and physician-scientists. It is one of the largest and most renowned rheumatology training programs in the United States, recognized nationally for its commitment to excellence in clinical care, education, and research. The program’s mission is to prepare fellows for successful careers in patient care, academic medicine, and scientific discovery, with a strong emphasis on advancing the understanding and treatment of rheumatic diseases. Many program alumni have gone on to become leaders at the University of Michigan and at academic and clinical institutions across the country, reflecting the program’s enduring impact on the field. The fellowship offers flexible training pathways that support diverse career goals. It is supported by a large and accomplished faculty of 64 members, including 37 clinicians actively engaged in patient care and 17 faculty with major research programs. This breadth of expertise enables robust clinical training, diverse scholarly opportunities, and a consistently high-quality educational experience for all fellows, regardless of their chosen career path.

2025 Medical Education Scholars Program

Congratulations to Ibtissam Gad, MD, as a 2025 Michigan Medicine RISE (Research, Innovation, Scholarship, Education) Cohort 5 Scholar. Her work, Helping Hand 2.0, is the first simulation curriculum of its kind to teach and assess learners' ability to detect small joint swelling in the hand. Dr. Gad's article has been published in the Journal of Clinical Rheumatology. 

Updates in Rheumatology

Our division hosted the 2024 online continuing medical education course, Updates in Rheumatology, providing healthcare professionals across the United States with the latest guidance on managing and treating rheumatic diseases. Directed by Dinesh Khanna, MD, MSc, the program featured presentations from Jacqueline Madison, MD; Wendy Marder, MD; Erica Mulcaire-Jones, MD; and guest speaker Daniel Furst, MD, (UCLA). The course drew strong attendance and generated thoughtful questions and lively discussion.