My lab is interested in the interface between immune cells and tissue function and we focus on the immune-mediated regulation and function of the vascular-stromal compartment in lymphoid tissues and skin with the idea that we can use this understanding to better treat rheumatologic diseases. Lymphoid tissue vascular-stromal elements have traditionally been understudied and we have contributed to the growth in this research area in the 15 years. Notably we have been one of the few to study the vascular‐stromal growth that occurs with lymph node swelling during normal and pathologic immune responses. We have delineated distinct stages of the vascular-stromal growth and identified novel roles for dendritic and other CD11c+ myeloid cells in regulating the expansion, function, and/or survival of blood and lymphatic endothelial and fibroblastic reticular cells. We have further shown that this vascular-stromal regulation then modulates the ongoing B cell response and recently published on the regulation of plasma cells by a subset of vascular-regulated fibroblastic reticular cells.
We have also begun to apply our understanding of immune cell-mediated regulation of vascular-stromal cells in lymph nodes to study skin manifestations of rheumatologic diseases, as understanding skin pathophysiology may eventually help us to better understand the systemic immune abnormalities of diseases such as SLE and scleroderma. We are finding that antigen-presenting cells also regulate the vascular-stromal compartment in skin and showed that dendritic cells maintain the survival of mesenchymal stromal cells in the dermal adipose tissue in scleroderma skin fibrosis. We are also studying the pathogenesis of lupus photosensitivity and have found a role for Langerhans cells (epidermal antigen-presenting cells) in protecting skin by limiting ultraviolet radiation (UVR)-induced keratinocyte apoptosis and skin injury. We are further delineating the regulation of this Langerhans cell-skin axis in health and disease and additionally examining the role of lymphatic function in lupus. As part of these efforts, we have recently started to use suction blistering to allow us to examine human skin immune and epidermal cells along with interstitial fluid.