Ingrid Lundberg Group

Idiopathic inflammatory myopathies (IIM), also called myositis, is a group of autoimmune disorders characterized by inflammation related tissue damage, affect mainly muscle, skin and lungs of afflicted patients.

The aim of our research is to gain increased knowledge of the causes of myositis and the mechanisms that lead to muscle weakness in order to provide patients with the best possible treatment, as well as to understand the impact the disease and its treatment has on both patient reported outcomes, clinical assessments and risk of comorbidity.

The main goals of our research group are:

• To understand the underlying disease mechanisms.
• To understand the long-term effects of the disease on all aspects of our patients’ life, from self-experienced difficulties to increased risk of other diseases and death.
• To improve current pharmacological and non-pharmacological treatment approaches.

The basis for all our research projects is patients that are followed and cared for longitudinally in our outpatient clinic at Karolinska University Hospital, where patients consent to participate in studies throughout their clinical follow up.

To accomplish our goals, we use all assets available in the scientific tool kit; from basic science and advanced molecular research projects to registry-based outcomes research, via interventional randomized trials to assess impact of non-pharmaceutical treatment.

Our research is performed at the Center for Molecular Medicine (CMM), Karolinska Institutet and at Karolinska University Hospital. We follow patients at Karolinska University Hospital in a systematic way using the Swedish Rheumatology Quality register, SweMyoNet and the Global MyoNET, and by biobanking biological samples for longitudinal analysis over the years.

Disease etiology

Several of our projects are focused on understanding the role of autoantibodies in the development of myositis.

• Production of monoclonal antibodies.
• Functional studies on polyclonal and monoclonal antibodies.
• Studies to improve the understanding of the lung as a target of the immune system in patients with IIM.

We also study the cellular pathogenesis of myositis.

• Understanding the phenotype and function of cells in muscle tissue and peripheral blood from patients.
• Investigation of antigen specific T cells in patient samples
• Spatial proteomics/transcriptomics on tissue samples.

Clinical outcomes

By using data from the Swedish Quality Rheumatology Register and the international MyoNet, we study the outcomes of our patients.

• We study the natural history of myositis over time with respect to validated and established patient reported and clinician reported outcomes. Pain, fatigue, HAQ, etc. are included in these outcomes.
• We study the role of inflammation on patient global assessment and disease activity.
• We study if autoantibodies can predict different outcomes and how we better can identify high-risk populations in our clinical work.
• We assess the treatment outcomes in these data sources.

Long-term outcomes

By adding data from the nationwide and completely covering data sources on for example healthcare use and cancer diagnosis to the clinical cohorts, we study the long-term outcomes of our patients.

• We study if autoantibodies can predict death or other severe comorbidities.
• We study if different disease phenotypes have different risks of different outcomes.
• We explore the impact of genetics, proteomics and detailed clinical data on development of risk of different comorbidities.

Pharmaceutical and non-pharmaceutical trials

In several studies we have studied different interventions on patients with myositis. We do this aiming to understand what the best treatment options are for different patients.

• We randomize patient into different rehabilitation interventions where we study the mechanisms for muscle weakness and how exercise can improve muscle health, physical capacity, quality of life, and mental well-being.
• We participate in academic collaborations and industry sponsored pharmaceutical trial in all phases.

Group Leader: Ingrid Lundberg, MD, PhD, Rheumatologist, Professor, ingrid.lundberg@ki.se

Team Leader: Helene Alexanderson, RPT, PhD, Associate professor, helene.alexanderson@ki.se

Ingrid Lundberg Group:

Anneli Dikhan, Patient Research Partner, anneli@eneby.nu

Maryam Dastmalchi, MD, PhD, Senior Rheumatologist, maryam.dastmalchi@regionstockholm.se

Antonella Notarnicola, MD, PhD, Rheumatologist, Postdoc, antonella.notarnicola@ki.se

Fabricio Espinosa, MD, PhD, Rheumatologist, Postdoc, fabricio.espinosa@ki.se

Karin Lodin, MD, PhD, Rheumatologist, Postdoc, karin.lodin@regionstockholm.se

Lara Dani, MD, PhD, Rheumatologist, lara.dani@regionstockholm.se

Karina Gheorge, MD, PhD, Rheumatologist, karina.gheorghe@regionstockholm.se

Louise Ekholm, MD, PhD, Rheumatologist, louise.e.ekholm@regionstockholm.se

Angeles Shunashy Galindo-Feria, MD, PhD, Rheumatologist, Postdoc, angeles.galindo.feria@ki.se

Ingrid Gerhardson, Research Nurse, ingrid.gerhardson@regionstockholm.se

Helene Sandlund, Research Nurse, helene.sandlund@regionstockholm.se

Begum Horuluoglu, PhD, Assistant Professor, begum.horuluoglu@ki.se

Andrea Kemp, MSc, Research Assistant, andrea.kemp@ki.se

Marina Galešić, MSc, PhD student, marina.galesic@ki.se

Maho Nakazawa, MD, PhD, Rheumatologist, Postdoc, maho.nakazawa@ki.se

Yue-Bei Luo, MD, PhD, Neurologist, Postdoc, yuebei.luo@ki.se

Eveline Van Gompel, MSc, PhD Student, eveline.van.gompel.2@ki.se

Deniz Demirdal, MD, Rheumatologist, PhD Student, deniz.demirdal@regionstockholm.se

Gloria Rostvall, Lab Technician, gloria.rostvall@ki.se

Eva Lindroos, Lab Technician, eva.lindroos@ki.se

Helene Alexanderson Team:

Helene Alexanderson, PhD, RPT, Associate Professor, helene.alexanderson@ki.se

Kristofer Andreasson, RPT, PhD student, kristofer.andreasson@ki.se

Malin Regardt, OT, PhD, malin.regardt@regionstockholm.se

Marie Holmqvist Team:

Marie Holmqvist, MD, PhD, Associate Professor, marie.holmqvist@ki.se

Weng Ian Che, PostDoc, weng.ian.che@ki.se

Irene Peralta, MD, Rheumatologist, Research Assistant, irene.peralta.garcia@ki.se

Luigi Annichiarico, MSc, Biostatistician, luigi.annichiarico@ki.se

Valerie Leclair, MD, PhD, valerie.leclair@mcgill.ca

Charlotta Preger, MSc, PhD

Weng Ian Che, PhD, weng.che@ki.se

Quan Tang, PhD

Maryam Fathi, MD, PhD, Maryam.fathi@regionstockholm.se

Li Alemo, Alemo Munters, LAlemoMu@ITS.JNJ.com

Jayesh Pandya

We are part of a Swedish Myositis Network (SweMyoNet) and of an international myositis network (MyoNet), www.myonet.eu which was established by Prof. Ingrid Lundberg. We contribute to the international myositis registry MyoNet (former EuroMyositis registry), www.euromyositis.eu, in which more than 6000 patients with idiopathic inflammatory myopathies from over 30 centers have been enrolled.  We are also part of several international collaborations such as the International Myositis Assessment and Clinical Studies group (IMACS), the Myositis International Health collaborative Alliance (MIHRA) and the OMERACT Myositis Working Group.

Swedish Research Council (VR), Lung and Heart foundation, Avtal om Läkarutbildning och Forskning (ALF), The Myositis Association (TMA), Reumatikerförbundet, Stig Thunes fond, Stiftelsen Promobilia, Private funding from CMM, Professor Nanna Svartz Stifltelsen, King Gustaf V 80^th year Foundation (GV80), Åke Wiberg Foundation, Alex and Eva Wallström Foundation, Karolinska Institutet Research Foundation, Promobilia foundation, Private Donation#, Postdoctoral funding of Fuqing Project Xiangya Hospital, China.

“To the Karolinska University Hospital Myositis Team: The Myositis Association distinguished award Heroes in Health Care, 2024”. Myositis Clinic Received Heroes in Healthcare 2024

Helene Alexanderson, 2023 ARP Distinguished Scholar Award, and the 2021 Swedish Rheumatism Association and Pfizer Nanna Svartz Stipend.

Ingrid Lundberg,

• Scandinavian Journal Prize in Rheumatology Research, 2001.
• The Swedish Rheumatism Association memory of Professor Nanna Svartz, 2002.
• Honorary lecture “Börje Olhagen Lecture” The Swedish Society for Medicine, 2002.
• Medal from Karl University, Prague, Czech Republic. 2008.
• The major Wyeth prize in Rheumatology, 2008.
• Karolina Prize for Quality care work in myositis, Karolinska University Hospital, 2009.
• Affiliated Professor in Rheumatology, University of Southern Denmark 2013-2018.
• Master Award, American College of Rheumatology, 2015.
• Excellence in Investigative Mentoring award, American College of Rheumatology, 2016.
• Dr Feng Pao Hsii lecturer, Singapore, 2017.
• The Myositis Association 25 year achievement award, 2018.
• Van Bremen Medal, Dutch Society of Rheumatology, 2022.
• Karolinska Institutet, Grand silver medal, 2022.

2024

Weng Ian Che, PhD, Idiopathic inflammatory myopathies and cancer: familial risk, genetics and consequences

2023

Valerie Leclair, Risk Factors and Outcomes in Inflammatory Myopathies

Lara Dani, Clinical and epidemiological project in cancer-associated dermatomyositis: the role of anti-Tif1g antibodies

Hector Fabricio Espinosa Ortega, Studies on Autoantibodies and Inflammatory Markers in Patients with Idiopathic Inflammatory Myopathies

2022

Angeles Shunashy Galindo-Feria, Characterization of immune specificities in idiopathic inflammatory myopathies

2020

Antonella Notarnicola, Studies on pathogenesis, clinical features and comorbidities of idiopathic inflammatory myopathies

2018

Quan Tang, Immune mechanisms in chronic rheumatic muscle inflammation, myositis

Previous theses from the last 10 years:

John Svensson (2017) Epidemiologic studies on rheumatic muscle inflammation, myositis

Joan Raouf (2017) PGE2 and other lipids in rheumatic diseases

Louise E. Ekholm (2016) Autoantibodies and the type I interferon system in idiopathic inflammatory myopathies

Cátia Cerqueira (2016) Studies on the role of autoantibodies and autoantigens in rheumatoid arthritis and myositis

Mei Bruton (Zong) (2014) Molecular mechanisms in idiopathic inflammatory myopathies

Jayesh M. Pandya (2014) T cell subsets and disease mechanisms in inflammatory myopathies

Malin Regardt (2014) Hand function, activity limitation and health-related quality of life in patients with polymyositis and dermatomyositis

Li Alemo Munters (2013) Physical exercise as a targeted therapy in idiopathic inflammatory myopathies

A new perspective on myositis subgrouping using genetics.

Persistent T cells identified in the muscle of patients with idiopathic inflammatory myopathies

Jan Andersson, Stefan Einhorn and Ingrid Lundberg awarded the 2022 Grand Silver Medal

Full publication list link

Autoantibodies and damage in patients with idiopathic inflammatory myopathies: A longitudinal multicenter study from the MYONET international network. Espinosa-Ortega F, Lodin K, Dastmalchi M, Vencovsky J, Diederichsen LP, Shinjo SK, Danieli MG, Selva-O’Callaghan A, de Visser M, Griger Z, Ceribelli A, Gómez-Martin D, Andersson H, Mercado MV, Chinoy H, Lilleker JB, New P, Krogh NS, Lundberg IE, Alexanderson H; MYONET Registry Study Group. Semin Arthritis Rheum. 2024 Oct;68:152529. doi: 10.1016/j.semarthrit.2024.152529. Epub 2024 Aug 8. PMID: 39178739.

Distinct HLA associations with autoantibody-defined subgroups in idiopathic inflammatory myopathies. Leclair, V., Galindo-Feria, A. S., Rothwell, S., Kryštůfková, O., Zargar, S. S., Mann, H., Diederichsen, L. P., Andersson, H., Klein, M., Tansley, S., Rönnblom, L., Lindblad-Toh, K., Syvänen, A. C., Wahren-Herlenius, M., Sandling, J. K., Dissect Consortium and The Immunoarray Development Consortium, McHugh, N., Lamb, J. A., Vencovský, J., Chinoy, H., … Diaz-Gallo, L. M. EBioMedicine, 2023 Oct; 96, 104804.

Comparison of clinical features between patients with anti-synthetase syndrome and dermatomyositis: Results from the MYONET registry. Hum, R. M., Lilleker, J. B., Lamb, J. A., Oldroyd, A. G. S., Wang, G., Wedderburn, L. R., Diederichsen, L. P., Schmidt, J., Danieli, M. G., Oakley, P., Griger, Z., Phuong, T. N. T., Kodishala, C., Vazquez-Del Mercado, M., Andersson, H., De Paepe, B., De Bleecker, J. L., Maurer, B., McCann, L., Pipitone, N., … Chinoy, H. Rheumatology (Oxford, England), 2023 Sep; kead481. Advance online publication.

Autoantibodies against the melanoma differentiation-associated protein 5 in patients with dermatomyositis target the helicase domains. Van Gompel, E., Demirdal, D., Fernandes-Cerqueira, C., Horuluoglu, B., Galindo-Feria, A., Wigren, E., Gräslund, S., De Langhe, E., Benveniste, O., Notarnicola, A., Chemin, K., & Lundberg, I. E. Rheumatology (Oxford, England), 2023 Aug; kead400. Advance online publication.

Single-cell profiling of muscle-infiltrating T cells in idiopathic inflammatory myopathies. Argyriou, A., Horuluoglu, B., Galindo-Feria, A. S., Diaz-Boada, J. S., Sijbranda, M., Notarnicola, A., Dani, L., van Vollenhoven, A., Ramsköld, D., Nennesmo, I., Dastmalchi, M., Lundberg, I. E., Diaz-Gallo, L. M., & Chemin, K. EMBO molecular medicine, 2023 Oct; 15(10), e17240.

Reliability and validity of PROMIS physical function, pain interference, and fatigue as patient reported outcome measures in adult idiopathic inflammatory myopathies: International study from the OMERACT myositis working group. DiRenzo D, Saygin D, de Groot I, Bingham Iii CO, Lundberg IE, Needham M, Park JK, Regardt M, Sarver C, Song YW, Maxwell L, Beaton D, de Visser M, Christopher-Stine L, Mecoli CA, Alexanderson H. Semin Arthritis Rheum. 2023 Feb;58:152111. doi: 10.1016/j.semarthrit.2022.152111. Epub 2022 Nov 3. PMID: 36410180; PMCID: PMC10354786.

Contribution of Rare Genetic Variation to Disease Susceptibility in a Large Scandinavian Myositis Cohort. Bianchi M, Kozyrev SV, Notarnicola A, Hultin Rosenberg L, Karlsson Å, Pucholt P, Rothwell S, Alexsson A, Sandling JK, Andersson H, Cooper RG, Padyukov L, Tjärnlund A, Dastmalchi M; ImmunoArray Development Consortium; DISSECT Consortium, Meadows JRS, Pyndt Diederichsen L, Molberg Ø, Chinoy H, Lamb JA, Rönnblom L, Lindblad-Toh K, Lundberg IE. Arthritis Rheumatol. 2022 Feb;74(2):342-352.

Factors Associated With Treatment Response in Patients With Idiopathic Inflammatory Myopathies: A Registry-Based Study. Espinosa-Ortega F, Holmqvist M, Dastmalchi M, Lundberg IE, Alexanderson H. Arthritis Care Res (Hoboken). 2022 Mar;74(3):468-477.

Autoantibodies against Four-and-a-Half-LIM Domain 1 (FHL1) in Inflammatory Myopathies: Results from an Australian Single-Center Cohort. Galindo-Feria AS, Horuluoglu B, Day J, Fernandes-Cerqueira C, Wigren E, Gräslund S, Proudman S, Lundberg IE, Limaye V.  Rheumatology (Oxford). 2022 Jan 12:keac003.

Idiopathic inflammatory myopathies. Lundberg IE, Fujimoto M, Vencovsky J, Aggarwal R, Holmqvist M, Christopher-Stine L, Mammen AL, Miller FW.  Nat Rev Dis Primers. 2021 Dec 2;7(1):86.

Expert Perspective: Management of Refractory Inflammatory Myopathy. Lundberg IE.  Arthritis Rheumatol. 2021 Aug;73(8):1394-1407.

Functional Index-3: A Valid and Reliable Functional Outcome Assessment Measure in Patients With Dermatomyositis and Polymyositis. Ernste FC, Chong C, Crowson CS, Kermani TA, Mhuircheartaigh ON, Alexanderson H. J Rheumatol. 2021 Jan 1;48(1):94-100.

Distribution and trajectory of direct and indirect costs of idiopathic inflammatory myopathies Leclair V, Moshtaghi-Svensson J, Regardt M, Hudson M, Lundberg IE, Holmqvist M. Semin Arthritis Rheum. 2021 Oct;51(5):983-988.

Familial aggregation and heritability: a nationwide family-based study of idiopathic inflammatory myopathies. Che WI, Westerlind H, Lundberg IE, Hellgren K, Kuja-Halkola R, Holmqvist M.  Ann Rheum Dis. 2021 Nov;80(11):1461-1466.

Overall and site-specific cancer before and after diagnosis of idiopathic inflammatory myopathies: A nationwide study 2002-2016. Dani L, Ian Che W, Lundberg IE, Hellgren K, Holmqvist M. Semin Arthritis Rheum. 2021 Feb;51(1):331-337.

Serum-circulating His-tRNA synthetase inhibits organ-targeted immune responses. Adams RA, Fernandes-Cerqueira C, Notarnicola A, Mertsching E, Xu Z, Lo WS, Ogilvie K, Chiang KP, Ampudia J, Rosengren S, Cubitt A, King DJ, Mendlein JD, Yang XL, Nangle LA, Lundberg IE, Jakobsson PJ, Schimmel P. Cell Mol Immunol. 2021 Jun;18(6):1463-1475.

Neutrophil dysregulation is pathogenic in idiopathic inflammatory myopathies. Seto NL, Torres-Ruiz JJ, Carmona-Rivera C, Pinal-Fernandez I, Pak K, Purmalek MM, Hosono Y, Fernandes-Cerqueira C, Gowda PC, Arnett N, Gorbach A, Benveniste O, Gómez-Martín D, Selva-O’Callaghan A, Milisenda JC, Grau-Junyent JM, Christopher-Stine L, Miller FW, Lundberg IE, Kahlenberg JM, Schiffenbauer AI, Mammen AL, Rider LG, Kaplan MJ. JCI Insight. 2020 Jan 16.

Proinflammatory Histidyl-Transfer RNA Synthetase-Specific CD4+ T Cells in the Blood and Lungs of Patients With Idiopathic Inflammatory Myopathies. Galindo-Feria AS, Albrecht I, Fernandes-Cerqueira C, Notarnicola A, James EA, Herrath J, Dastmalchi M, Sandalova T, Rönnblom L, Jakobsson PJ, Fathi M, Achour A, Grunewald J, Malmström V, Lundberg IE.  Arthritis Rheumatol. 2020 Jan;72(1):179-191.

Exercise therapy in patients with idiopathic inflammatory myopathies and systemic lupus erythematosus – A systematic literature review. Alexanderson H, Boström C.  Best Pract Res Clin Rheumatol. 2020 Apr;34(2):101547. doi: 10.1016/j.berh.2020.101547.

Focused HLA analysis in Caucasians with myositis identifies significant associations with autoantibody subgroups. Rothwell S, Chinoy H, Lamb JA, Miller FW, Rider LG, Wedderburn LR, McHugh NJ, Mammen AL, Betteridge ZE, Tansley SL, Bowes J, Vencovský J, Deakin CT, Dankó K, Vidya L, Selva-O’Callaghan A, Pachman LM, Reed AM, Molberg Ø, Benveniste O, Mathiesen PR, Radstake TRDJ, Doria A, de Bleecker J, Lee AT, Hanna MG, Machado PM, Ollier WE, Gregersen PK, Padyukov L, O’Hanlon TP, Cooper RG, Lundberg IE; Myositis Genetics Consortium (MYOGEN).  Ann Rheum Dis. 2019 Jul;78(7):996-1002.

Mitochondrial dysfunction and role of harakiri in the pathogenesis of myositis. Boehler JF, Horn A, Novak JS, Li N, Ghimbovschi S, Lundberg IE, Alexanderson H, Alemo Munters L, Jaiswal JK, Nagaraju K.  J Pathol. 2019 Oct;249(2):215-226.

OMERACT 2018 Modified Patient-reported Outcome Domain Core Set in the Life Impact Area for Adult Idiopathic Inflammatory Myopathies. Regardt M, Mecoli CA, Park JK, de Groot I, Sarver C, Needham M, de Visser M, Shea B, Bingham CO 3rd, Lundberg IE, Song YW, Christopher-Stine L, Alexanderson H. J Rheumatol. 2019 Oct;46(10):1351-1354.

Abatacept in the treatment of adult dermatomyositis and polymyositis: a randomized, Phase IIb treatment delayed-start trial. Tjärnlund A, Tang Q, Wick C, Dastmalchi M, Mann H, Tomasová Studýnková J, Chura R, Gullick N, Salerno R, Rönnelid J, Alexanderson H, Lindroos E, Aggarwal R, Gordon, Vencovský J, Lundberg IE. . Ann Rheum Dis, 2018 77:55-62.