Research focus of the Clinic for Pneumology

Breath analysis using mass spectrometry

Exhaled air contains thousands of volatile substances that can provide valuable information about metabolic processes in the body. We use highly sensitive, specially adapted mass spectrometry devices to detect these molecules in order to identify disease-specific respiratory 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 therapeutic effects measured via exhaled air. Our aim is to develop new, non-invasive diagnostic procedures that are simple, safe and precise.

COPD, emphysema and alpha-1-antitrypsin deficiency

Chronic obstructive pulmonary disease (COPD) is a progressive disease of the airways characterized by permanent inflammation and constriction of the bronchial tubes. It is often accompanied by emphysema, in which the alveoli are destroyed and oxygen uptake decreases. In this research focus area, we study patients with COPD and emphysema in order to better understand the course of the disease, the effects of concomitant diseases and the influence of physical activity. In the case of alpha-1-antitrypsin deficiency, a genetic cause of emphysema, we record clinical follow-up data in the Swiss and international register (EARCO.org). The aim of our research is to gain new insights that enable more individualized treatment and an improved quality of life.

A stay at high altitude or a flight means less oxygen availability for the body. How this lack of oxygen (hypoxia) affects people with lung diseases is still only partially understood. In our studies, we are investigating the effects of altitude exposure on patients with COPD, pulmonary hypertension, asthma and other chronic lung diseases, as well as healthy control subjects. We are investigating which factors predict reduced altitude tolerance, whether medication can prevent this and how effective therapies at altitude can be designed. Particular attention will be paid to possible gender differences in adaptation to altitude, changes in pulmonary hemodynamics, cardiac load and sleep-associated respiratory disturbances in hypobaric hypoxia at altitude.

Interventional pneumology 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 aim is to continuously develop diagnostic and therapeutic procedures so that new findings directly benefit patient care and improve the early detection of lung cancer.

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 severe lung diseases. Cystic fibrosis is a genetic disease that leads to chronic mucus build-up 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 and the effects of viral respiratory infections on patients after transplantation. The optimization of individual immunosuppression is a focal point. In the case of cystic fibrosis, we systematically analyze the course of the disease and the response to new drugs and targeted infection treatments. The aim of our clinical-translational studies is to improve therapy results, better understand long-term courses and continuously optimize patient care.

Respiratory insufficiency can occur in many patients with lung diseases or respiratory disorders. This weakness always manifests itself first during sleep.

Part of our research is focused on better understanding how such sleep-related breathing disorders and respiratory weaknesses develop and how they develop over time. We are also investigating how long-term ventilation can be improved.

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 enables us to better understand respiratory movements and respiratory drive.

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

By participating 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 of new technologies such as telemonitoring (digital monitoring and care at home) for the care and quality of life of patients.

Obstructive sleep apnea (OSA) is a very common disorder in which breathing stops repeatedly during sleep. This breathing disorder can develop very differently in different people – both in terms of its origin, the results of sleep tests, the symptoms and the possible consequences for the heart and circulation. The response to treatment also varies from person to person.

Our research focuses on describing the different forms of sleep apnea in more detail. We want to find out which patients have a particularly high risk of cardiovascular disease due to sleep apnea and how these risks can be better treated. Particular attention is paid to the different responses to different therapies – in other words, 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 stimulated slightly electrically via the skin in order to stabilize breathing during sleep.

With modern measurement methods, such as new markers from sleep studies, innovative sensors or the analysis of breathing air, we want to improve the diagnosis and monitoring of sleep apnea.

We also participate in European and international research projects and registers (e.g. ANDANTE, BAVENO, ESADA or IMPORTANCE). These studies provide important data on the long-term course of the disease and help us to continually improve treatment options.

Another focus of our work is to better understand sleep apnea and other sleep-related breathing disorders in patients with chronic lung or cardiovascular diseases. This knowledge should help to use therapies in a more targeted manner and increase the well-being of patients in the long term.

Pulmonary hypertension (PH), also known as pulmonary hypertension, is a spectrum of diseases in which the blood pressure in the pulmonary vessels is abnormally high. This puts a strain on the heart and can lead to shortness of breath, loss of performance and cardiac insufficiency. PH can occur with common lung diseases, but also after chronic pulmonary embolism, with left heart disease, genetically, associated with other diseases or without a recognizable cause, so-called idiopathic. Patients with various forms of the disease are cared for and included in clinical and experimental studies at the Clinic for Pneumology’s PH research focus. The aim is to gain a better understanding of the underlying disease mechanisms and to develop new therapeutic approaches. Particular attention is paid to oxygen supply – for example during physical exertion, at night or at altitude – and the question of how training or oxygen therapy can improve quality of life and performance. Other projects deal with new forms of training, the influence of altitude on the circulatory system, drug studies and modern measurement methods for assessing heart and lung function.

We examine the needs of people with chronic obstructive pulmonary disease (COPD) and determine which factors help them to lead a self-determined and normal life and thus achieve a good quality of life. We are investigating 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 or questionnaires.