GRANTS. Of the SEK 59 million in grants for research at Sahlgrenska Academy from the Swedish Heart Lung Foundation, the majority (SEK 53 million) goes to projects at the Institute of Medicine. The funds will provide new insights into how inflammation in respiratory passages inflammation occurs with asthma, how to use artificial intelligence (AI) to evaluate sleep, and how to reduce complications after cardiac surgery.
About a quarter of all cardiac surgery patients experience atrial fibrillation after surgery, a condition that in the worst case can become permanent. The number of people affected depends on factors like the type of surgery performed and the patient’s age, but the percentage has been steady over the past 30 years.
“Why this affects some and not others is a bit of a mystery, and we will try to learn more about it,” says Anders Jeppsson, a professor of thoracic surgery and a chief physician at Sahlgrenska University Hospital.
He has been awarded SEK 4.5 million from the Heart Lung Foundation to study how complications after cardiac surgery, including atrial fibrillation, can be reduced. Using blood and tissue samples, his research team will try to find clues to the mechanisms behind the complications. The work is in collaboration with researchers conducting basic cardiovascular and metabolic research at the Wallenberg Laboratory.
Fewer complications from cardiac surgery
Different types of complications can occur after cardiac surgery. In addition to atrial fibrillation, patients can also suffer from bleeding, infections, and stroke. The overall goal of Anders Jeppsson’s research is to reduce complications and improve survival after cardiac surgery. He uses both registry studies, treatment studies in which participants randomly receive different treatments, and basic research.
“The goal is to identify which factors increase the risk of complications, to optimize treatment before, during, and after surgery, and to improve medication after surgery to reduce the risk of the underlying disease recurring.”
Among other things, his team will investigate how the use of platelet inhibitors (blood-thinning medications) can be optimized after coronary artery bypass surgery. An investigation of this is underway in a large Nordic randomized study initiated and led by Jeppsson that includes over 2,200 patients from 21 Nordic clinics. The study is funded by the Swedish Research Council, the Swedish Heart Lung Foundation and Region Västra Götaland.
“Current recommendations for medication after cardiac surgery have poorly supported by evidence, and we need more knowledge to optimize treatments,” says Jeppsson.
Examining the role of vesicles in asthma
About eight percent of Swedes have asthma, a disease caused by chronic inflammation of the respiratory passages. Asthma is divided into several subgroups (phenotypes) that can have different symptoms and require different treatment. It is not known why the inflammation occurs, and more knowledge is needed about both the mechanisms that create the inflammation and how treatment can be optimized for different patients.
Cecilia Lässer is a researcher at the Krefting Research Centre, which conducts research on allergy and pulmonary medicine. She receives SEK 1.2 million to investigate how extracellular vesicles can be linked to different types of asthma. Vesicles are very small membrane vacuoles that have functional molecules (e.g., proteins and RNA), which the vesicles can transport to surrounding cells and affect the physical properties of other cells.
“We hypothesize that cells in the respiratory passages change their signaling molecules in the vesicles they release and that they affect the ongoing inflammation in this way. We also believe that this process differs for different types of asthma,” says Lässer.
The research team’s goal is to contribute knowledge on how cells in the respiratory passages communicate through vesicles and what role the vesicles play in maintaining inflammation. They also hope to find diagnostic markers so that vesicles from the respiratory passages can be used to identify different subgroups of asthma.
“In this way we should be able to develop more effective and individualized treatments in the future.”
Developing AI to study sleep
Sleep has a major impact on our health, but the field needs to fill knowledge gaps. Better methods for studying sleep could contribute new knowledge on how to best treat common cardiovascular diseases and pulmonary diseases, such as high blood pressure, sleep apnea, and chronic obstructive pulmonary disease (COPD).
This will be investigated by a team at the Institute of Medicine headed by Ludger Grote, an adjunct professor at the Sleep Disorder Center and chief physician at Sahlgrenska University Hospital.
Little is known within this area, because it is difficult to analyze respiratory and cardiovascular function during sleep. Traditional sleep diagnostics require complex equipment, and specially trained personnel usually analyze the read outs manually.
“This creates long waiting times and limited access to investigations and treatment. The connection between the data collected and the patient’s problems also is usually limited, which can make it difficult to choose the right treatment method,” says Grote.
Can revolutionize diagnostics and treatment
Grote’s team is developing new and simpler methods for monitoring cardiovascular function, the autonomic nervous system, and the mechanisms that control breathing during sleep. It is also applying new methods for assessing the data. This makes it possible to gain new insights into patient morbidity and the risk of serious complications.
“As our next step, we will develop artificial intelligence to characterize normal and unhealthy breathing and cardiovascular function during sleep. The analysis is specifically aimed at patients with obstructive sleep apnea and COPD, but it also includes other sleep-related diseases.”
The work is being conducted together with a large European network of sleep researchers. The project has been named “Sleep Revolution,” which Ludger Grote thinks provides a good perspective on the goal of the research.
“The knowledge will have great clinical significance for both diagnostics and treatment. Through new methods and simpler sleep examinations, we can find better answers to the questions that are most relevant for patients and create better access to care for patients with sleep disorders.”
A total of 23 researchers at the Institute of Medicine have been awarded funding in this round of grants, including three who have received funding for two projects.
Read more about the distribution in Akademiliv (Academy Life).
BY: KARIN ALLANDER