Research

The epidemiology team studies of the distribution of Juvenile Myositis in populations and the factors that influence the occurrence of the disease. Our Project Manager, Maria Amoruso (MPH) develops protocols, designs studies and evaluates their outcomes while working hand-in-hand with the institutional review board to keep those studies involving human subjects strictly compliant with federal guidelines. Gabrielle Morgan (MA) is the Project Facilitator whose focus is the research project, "Quality of Life in JDM, genetic and social interactions." She also handles the data entry and clinical organization.

In the area of hands-on science, our laboratory team is lead by Dan Zhao(MD, PhD), currently finishing second year of post-doctoral fellowship. He will transition to a Research Assistant Professor in September, paid for by Cure JM. With a background in calcium absorption, he is now focusing his expertise on the hows and whys of pathologic calcification development. He is being assisted in this research by Annette Urganus (BS), our newest research associate.

Two other areas of concentration involve molecular biology and immunobiology. The validations of our gene expression profile data is being investigated by Sheela Shrestha (MS), while Nicholas Geraci (MS) is delving into the molecular biology of the immune response in newly diagnosed JDM patients.

Trainees: We have a lot of students involved in understanding JDM! In the summer of 2007 we had two additional students, one whose salary came from the Arthritis Foundation, Greater Illinois Chapter, (Kenley Barrett), and the other (Jessica Kim), a student who received the Wellesley City Scholars Summer Scholarship award. Another study, by a third year medical student, Brock Daniels (MPH) is assessing indicators of disease activity in untreated children with JDM. Our first year Pediatric Rheumatology Fellow, Maria Ibbara, MD, will study calcifications in JDM, while a Pediatric Resident, Josaphine Scalici, MD, has selected a JDM related topic for her senior project.

This desk top model arrived in our lab on June 19, 2007 (the order was placed to Belgium in January). This highly accurate machine will localize calcifications and give very accurate readings of their "volume" or "mass." The final cost of this machine was over $95,000 and was paid for by Cure JM. We had wanted to get this sensitive instrument for 2 years!

3. Publications since January, 2007: 4 manuscripts published or in press, 2 more are under review

1. Rouster-Stevens KA, Langman CB, Price HE, Seshadri R, Shore RM, Abbott K, Pachman LM. Receptor activator of nuclear factor-�B ligand/osteoprotegerin and bone mineral density in untreated children with juvenile dermatomyositis. Arthritis Rheumatism 56, (3): 977-983, 2007.
   This manuscript shows that children with longer duration of untreated JDM have lower bone density, reflected by circulating markers of bone growth.
    

2. Zhao D, Fedczyna TO, McVicker V, Caliendo J, Li H, Pachman LM: Apoptosis in the Skeletal Muscle of Untreated Children with Juvenile Dermatomyositis: Impact of Duration of Untreated Disease, Clinical Immunology, doi:10.1016/jclin 2007.06.011
   This study shows that the mode of damage to muscle changes over time in children prior to therapy, and shows that there are several kinds of cell death in the muscle.
    

3. Christen-Zäch, S; Seshadri, R; Sundberg, J, Paller, AS, Pachman, LM. Pathological nailfold capillaroscopy changes in Juvenile Dermatomyositis: association with duration of untreated disease, skin involvement over 36 months and a non-unicyclic disease course. Arthritis & Rheumatism (in press) 2007.
   We found that 40% of children repair their nailfold capillaries at 36 months after start of therapy, and that continued skin involvement is associated with persistent nailfold capillary damage.
    

4. Rouster-Stevens KA, Gursahaney A, Ngai K-L, Daru JA, Pachman LM. Pharmacokinetic study of prednisolone compared to intravenous methylprednisolone in patients with Juvenile Dermatomyositis. Arthritis Care and Research (In press) 2008.
   This study shows that the vasculitis of JDM, reflected by nailfold capillary dropout, impairs absorption of prednisone given by mouth. This provides the rationale for the intravenous route for corticosteroid administration.

4. "Parent Advocate Interactions"

We were delighted to have Jacque DenUyl join us as a Parentwise volunteer in our JDM clinic, which the parents greatly appreciate. This is the first outpatient clinic at Children’s Memorial Hospital to have such attention..