The research interests of Ashima Makol, M.B.B.S, are focused on the pathogenesis, epidemiology, early detection and treatment of systemic sclerosis and other scleroderma spectrum diseases. Specifically, Dr. Makol is engaged in clinical trials for skin, lung disease and Raynaud disease associated with systemic sclerosis.
In addition, Dr. Makol studies rare diseases such as multicentric reticulohistiocytosis and extra-articular manifestations of rheumatic diseases, such as systemic rheumatoid vasculitis, inflammatory eye manifestations in rheumatoid arthritis and anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitides, to fill knowledge gaps and advance the understanding of the most optimal therapeutic strategies for the treatment of these conditions.
- Clinical trials in systemic sclerosis and scleroderma. Through collaboration with the pharmaceutical industry and the Scleroderma Clinical Trials Consortium, Dr. Makol leads clinical trials to evaluate novel therapeutic immunosuppressive and anti-fibrotic agents for the treatment of systemic sclerosis, Raynaud disease, skin disease, lung fibrosis and interstitial lung diseases. The goal of these clinical trials is to discover safer, more effective and potentially disease-modifying treatments for scleroderma.
Epidemiology studies in systemic sclerosis and scleroderma. Using resources of the Rochester Epidemiology Project and in collaboration with Cynthia (Cindy) S. Crowson, Ph.D., Dr. Makol is leading several studies to understand the epidemiology of systemic sclerosis. These studies are analyzing the trends in incidence, risk factors, therapeutics and outcomes of severe internal organ manifestations of systemic sclerosis, with particular focus on cardiac, pulmonary and vascular disease.
In collaboration with the Scleroderma Research Foundation, Dr. Makol aims to better understand early systemic sclerosis pathogenesis and potential biomarkers for disease progression. She also studies the impact of disease on short- and long-term patient-reported outcomes to gain better insights on how to improve functional quality of life with this complex disease.
- Nailfold videocapillaroscopy (NVC) in rheumatic disease. Raynaud disease is an early sign of microvascular dysfunction in systemic sclerosis that provides a window of opportunity for early disease detection and intervention prior to development of fibrotic disease manifestations. Dr. Makol is studying the role of NVC as an imaging biomarker in systemic sclerosis and other rheumatic diseases.
- Gastrointestinal disease and microbial dysbiosis in systemic sclerosis. More than 90% of people with systemic sclerosis report gastrointestinal symptoms. There is a high prevalence of small intestinal bacterial overgrowth in this population as well, but the pathophysiology of these gut dysfunctions remains elusive at best. Dr. Makol is collaborating with colleagues in the Department of Gastroenterology and Hepatology and the Center for Individualized Medicine to study the role of microbial dysbiosis in gastrointestinal manifestations and malnutrition in systemic sclerosis.
Significance to patient care
Dr. Makol leads a multidisciplinary research team that aims to improve the health and long-term outcomes of people with systemic sclerosis. While recent advances in available treatments, including some biologics and anti-fibrotics, have improved outcomes in systemic sclerosis, the disease burden is still high for these patients and there is critical need for better therapeutics.
Dr. Makol's hope is that through her research, better tools will be developed to help understand disease pathogenesis, diagnose patients early and predict who is at risk of severe cardiopulmonary or vascular disease. She aims to help physicians target preventive strategies to the right patients to prevent, or delay, development of comorbidities and thereby improve long-term outcomes. She also hopes to prioritize the patient voice in therapeutic decisions through greater use of patient-reported outcomes to enhance quality of life in patients with systemic sclerosis.
- Site principal investigator, Collaborative National Quality and Efficacy Registry (CONQUER), Scleroderma Research Foundation, 2022-present
- Site principal investigator, Scleroderma Clinical Trials Consortium (SCTC), 2017-present
- Member, Study Group on Capillaroscopy & Microcirculation in Rheumatic Diseases, European Alliance of Associations for Rheumatology, 2015-present
- Catalyst for Advancing in Academics award, Department of Internal Medicine, Mayo Clinic, 2019
- Department of Medicine Laureate award, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, 2018
- Philip S. Hench Award for Excellence in Rheumatology Research, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, 2013