Key Research Areas of the Department of Pulmonology

Breath Analysis Using Mass Spectrometry

Exhaled air contains thousands of volatile substances that can provide valuable information about metabolic processes in the body. Using highly sensitive, specially adapted mass spectrometry instruments, we detect these molecules to identify disease-specific breath profiles. In collaboration with ETH Zurich and the University of Basel, we are investigating whether lung diseases such as COPD, lung cancer, or sarcoidosis can be diagnosed and the effects of treatment measured using exhaled breath. Our goal is to develop new, non-invasive diagnostic methods that are simple, safe, and accurate.

COPD, pulmonary emphysema, and alpha-1 antitrypsin deficiency

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease characterized by persistent inflammation and narrowing of the bronchi. It is often accompanied by pulmonary emphysema, a condition in which the alveoli are destroyed and oxygen uptake decreases. In this research focus area, we are studying patients with COPD and pulmonary emphysema to better understand the course of the disease, the effects of comorbidities, and the impact of physical activity. For alpha-1 antitrypsin deficiency, a genetic cause of pulmonary emphysema, we collect clinical follow-up data in the Swiss and international registry (EARCO.org). The goal of our research is to gain new insights that will enable more personalized treatment and an improved quality of life.

High-Altitude Physiology in Lung Diseases

Staying at high altitudes or traveling by air means that the body has less oxygen available. The effects of this lack of oxygen (hypoxia) on people with lung diseases are still only partially understood. In our studies, we investigate the effects of high-altitude stays on patients with COPD, pulmonary hypertension, asthma, and other chronic lung diseases, as well as on healthy control subjects. In this research, we are investigating which factors predict reduced altitude tolerance, whether medication can help prevent it, and how effective treatments can be designed for use at high altitudes. Particular attention is given to possible gender differences in adaptation to altitude, changes in pulmonary hemodynamics, cardiac workload, and sleep-related respiratory disturbances during hypobaric hypoxia at high altitudes.

Interventional Pulmonary Center

Interventional pulmonology uses minimally invasive techniques to detect lung diseases, such as lung cancer, at an early stage and treat them in a targeted manner. At the Interventional Lung Center, research focuses on innovative procedures such as robot-assisted bronchoscopy, cryotechnologies, and state-of-the-art navigation methods. The goal is to continuously advance diagnostic and therapeutic methods so that new findings directly benefit patient care and improve the early detection of lung cancer.

Lung Transplantation and Cystic Fibrosis

A lung transplant is a surgical procedure in which one or both diseased lungs are replaced with donor lungs to improve breathing and quality of life in patients with severe lung diseases. Cystic fibrosis is a genetic disorder that leads to chronic mucus buildup in the airways, recurrent infections, and progressive lung damage. In our research on lung transplantation, we investigate the causes, diagnosis, monitoring, and treatment of chronic lung allograft failure, as well as the effects of viral respiratory infections on patients after transplantation. Optimizing individualized immunosuppression is a key focus. In cases of cystic fibrosis, we systematically analyze the course of the disease and the response to new medications and targeted treatments for infections. The goal of our clinical-translational studies is to improve treatment outcomes, gain a better understanding of long-term outcomes, and continuously optimize patient care.

Noninvasive Ventilation, Respiratory Physiology, and Neuromuscular Diseases

Respiratory failure can occur in many patients with lung diseases or breathing disorders. This weakness always first becomes apparent during sleep.

Part of our research focuses on gaining a better understanding of how such sleep-related breathing disorders and respiratory weakness arise and how they develop over time. As part of this, we are also investigating ways to improve long-term ventilation.

To analyze breathing more precisely, we use modern measurement methods such as surface electromyography, which measures the activity of the respiratory muscles, and the Forced Oscillation Technique (FOT, oscillometry), which helps us better understand respiratory movements and the respiratory drive.

Another focus of our work is non-invasive long-term ventilation (home ventilation) for patients with chronic respiratory failure, particularly those with neuromuscular disorders such as Duchenne muscular dystrophy.

Through our participation in the Swiss Registry for Neuromuscular Diseases and in European research initiatives such as the ERS CRC IMPORTANCE, we are investigating the long-term effects of these therapies and the benefits that new technologies—such as telemonitoring (digital monitoring and care at home)—have for patient care and quality of life.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a very common condition characterized by repeated pauses in breathing during sleep. This sleep-related breathing disorder can manifest very differently in different people—in terms of its onset, the results of sleep studies, the symptoms, and the potential consequences for the heart and circulatory system. Responses to treatment also vary from person to person.

Our research focuses on describing the different forms of sleep apnea in greater detail. We want to determine which patients are at particularly high risk for cardiovascular disease due to sleep apnea and how these risks can be better managed. Particular attention is paid to differences in response to various therapies—that is, to why some treatments work well for certain patients but less so for others. We are also interested in new forms of therapy, such as transcutaneous electrical stimulation. With this method, the upper airway is gently stimulated electrically through the skin to stabilize breathing during sleep.

Using modern diagnostic methods—such as new markers identified through sleep studies, innovative sensors, or breath analysis—we aim to improve the diagnosis and monitoring of sleep apnea.

In addition, we participate in European and international research projects and registries (such as ANDANTE, BAVENO, ESADA, and IMPORTANCE). These studies provide important data on the long-term course of the disease and help us continue to improve treatment options.

Another focus of our work is gaining a better understanding of sleep apnea and other sleep-related breathing disorders in patients with chronic lung or cardiovascular diseases. This knowledge is intended to help make the use of therapies more targeted and to improve patients’ well-being in the long term.

Pulmonary Hypertension, Shortness of Breath, Physiology During Exercise

Pulmonary hypertension (PH), also known as high blood pressure in the lungs, is a spectrum of conditions characterized by abnormally high blood pressure in the pulmonary vessels. This puts a strain on the heart and can lead to shortness of breath, decreased performance, and heart failure. PH can occur in connection with common lung diseases, but also following chronic pulmonary embolisms, in cases of left-sided heart disease, as a genetic condition, in association with other diseases, or without any apparent cause—what is known as idiopathic PH. The PH research focus at the Department of Pulmonology cares for patients with various forms of the disease and enrolls them in clinical and experimental studies. The goal is to better understand the underlying disease mechanisms and to develop new therapeutic approaches. Special attention is given to oxygen supply—for example, during physical exertion, at night, or at high altitudes—and to the question of how exercise or oxygen therapy can improve quality of life and physical performance. Other projects focus on new forms of training, the effect of altitude on the circulatory system, as well as drug studies and modern measurement methods for assessing heart and lung function.

Disease Management for Severe Chronic Obstructive Pulmonary Disease (COPD)

We are studying the needs of people with chronic obstructive pulmonary disease (COPD) and identifying the factors that help them lead independent, normal lives and thus achieve a good quality of life. In this study, we are examining the effect of care-guided counseling and coaching programs on quality of life and emotions. To this end, we use various research methods, such as individual interviews and questionnaires.