Biomarkers and disease prediction in Mixed Connective Tissue Disease: results from Norwegian nationwide MTCD cohort (NorMCTD).
PhD student: Joanna Haydon
Supervisors: Øyvind Molberg (Dept. of Rheumatology), Ragnar Gunnarsson (Dept. of Rheumatology) og May Brit Lund

Mixed connective disease in children: Longterm outcome and risk of interstitial lung disease, pulmonal hypertension and cardiovascular disease
PhD student: Siri Opsahl
Supervisors: Vibeke Lilleby, Berit Flatø og Øyvind Molberg (Dept. of Rheumatology)
Collaborator: May Brit Lund

Long-term survivorship after acute lymphoblastic leukemia (ALL) treated during childhood and adolescence.
PhD Student: Adriani Kanellopoulos.
Supervisor: Ellen Ruud (Division of Pediatrics)
Collaborator: May Brit Lund

Physical Fitness and High-Intensity Training following Lung Transplantation: The HILT study
A PhD project in cooperation with Norwegian School of Sport Sciences.
PhD student:  MD Mariann Ulvestad. Main supervisor: Elisabeth Edvardsen PhD MSc. Co-supervisor:  Ass Prof. Dr.med  May Brit Lund Co-investigator: Prof. Dr.med Johny Kongerud and MD Michael Durheim.

This project aims to determine the relationships between pulmonary function, cardiorespiratory fitness, muscle function, body composition, physical activity, and quality of life, and to evaluate the effect of a high-intensity training intervention, in patients who have undergone lung transplantation. Lung transplant recipients frequently continue to suffer from poor physical fitness, despite dramatic improvement in lung function. The mechanisms underlying this discrepancy are not fully understood. We have developed a high-intensity exercise training intervention, which we have demonstrated to be effective among patients undergoing surgical treatment for lung cancer. Our study will illuminate the complex mechanisms underlying the discrepancy between lung function and physical fitness among lung transplant recipients. In a randomized controlled trial, we will demonstrate the effect of our high-intensity training intervention in this complex patient population.

Dissecting asthma phenotypes in adults by combining clinical data, inflammatory markers and next-generation gene sequencing.
A PhD project in cooperation with Telemark Central Hospital.
PhD student: Geir Klepaker. Main supervisor Prof. Dr.med Johny Kongerud. Co-supervisor: PhD MD Anne Kristin Fell
In 2013, a random sample of 50.000 inhabitants aged 16-50 living in Telemark county received a validated questionnaire regarding respiratory symptoms and occupational exposure. We have collected comprehensive clinical, inflammatory, occupational and environmental data and have for the first time in Norway applied an asthma-specific job-exposure-matrix (JEM) on a large sample (N=16.099) from the general population. The aim of the study is to analyze this unique data set for identifying clinical and genetically distinct phenotypes in asthma, possible risk factors and ultimately more personalized treatment for asthma patients.

Medical Student Research Programme
Project Description

Inflammatory processes and organ function in organ procurement for lung transplantation
Medical student: Henrik Auråen. Main supervisor: Dr.med Are M. Holm . Co-supervisor: Arnt Fiane
Name of co-investigators: Dr.med Øystein Bjørtuft, Prof PhD Neil Alexis, Prof. Dr.med Johny Kongerud, Dr.med May Britt Lund, Prof Dr.med Tom Eirik Mollnes, Prof. Dr.med Odd Geiran and Dr.med Arnt Fiane
To improve the availability and quality of organs for lung transplantation, we study the impact of systemic inflammatory processes on the lungs in the donor during organ harvesting. In particular, we study the activation of innate immune processes such as complement. Also, we relate these pre-transplant observations to inflammatory and clinical markers such as graft dysfunction and rejection in the recipient after transplantation. This project is a cooperation between The Department for Thoracic Surgery and The Institute for Immunology, both at Oslo University Hospital, and our department.

Symptom clusters and immune dysfunction in COPD (SCID-COPD-study)
In a multicentre study involving several hospitals in south-eastern Norway, we register the symptom burden in COPD patients using comprehensive questionnaires in addition to an extensive pulmonological assessment. Also, blood samples are drawn for analyses of certain immune markers. The patients are followed for one year. The project is a cooperation between The Center for Shared Decision Making and Nursing Research, the University of California San Francisco, The Norwegian Institute of Public Health and our department.

Patients' symptom experiences before and after lung cancer surgery - predictors of patients' symptom burden.

Health effects after exposure to ammunition fumes from military hand weapons
Name of investigators: AK Borander, LIB Sikkeland,  Ø Voie, R Øvstebø, S Grahnstedt, TE Danielsen, K Longva and J Kongerud

Fumes released during firing of small arms contain a mixture of gases, vapors and solid particles. The major combustion products from the propellants are H2O, CO, CO2, H2 and N2. Also minor concentrations of NH3, HCN, and benzene and metals such as tin (Sn) and bismuth (Bi) may be present. In addition inhalable metal particles from brass cartridges and bullets are released, typically copper (Cu), zinc (Zn), antimony (Sb), and lead (Pb). The aim of the present study was to explore the health effects after firing of small arms with three different types of ammunition (leaded, and two types of lead-free ammunition).Spirometry, exhaled Nitric Oxide (NO) and collection of blood and sputum samples were performed 2 to 4 days before shooting and 24 hours (blood and spirometry) and 48 hours (sputum) after firing. All the samples have been collected and we will during this year carry out biological and data analysis as well as present the data.
This project is a cooperation between Norwegian Defence Research Establishment, Division Protection, Kjeller, Department of Occupational and Environmental Medicine and Department of Medical Biochemistry, Oslo University Hospital, Ullevål, and our department.

Asthma in Telemark
Name of investigaors: PhD student Geri Klepaker, PhD MD Regine Abrahamsen, PhD MD Anne Krisitin Fell, Prof. Dr.med Johny Kongerud

Population-based study – Asthma in Telemark
In 2013, a random sample of 50.000 inhabitants aged 16-50 living in Telemark county received a validated questionnaire regarding respiratory symptoms and occupational exposure. The aim of the study was to estimate the occurrence of respiratory symptoms and physician-diagnosed asthma in Telemark. In addition, the project also has the opportunity to study other areas of interest regarding asthma such as environmental exposures, gender, age, physical activity, allergy, co morbidity, home environment and nutrion (eating pattern).  Currently, the project is working on analysis of the data material and preparations of papers for publications.
Case Control – Asthma in Telemark
All subjects with physician-diagnosed asthma and a control group from the study cohort are currently invited to participate in a nested case-control study. The participants will receive a questionnaire with questions on specific occupational exposures, co morbidity and patient-reported outcome variables. They will also participate in a medical consultation where they contribute with lung function tests, FeNO measurements and blood sample including measurements for levels of inflammatory markers etc.
Next generation gene sequencing in asthma – Asthma in Telemark
The case-control study will also allow analysis of heritability through gene sequencing in patients with asthma and a control group. The aim is to identify difference phenotypes of asthma by using Next-Generation gene sequencing (NGS). Rare variants can be detected by NGS of the asthma candidate genes and may thus explain some of the “missing heritability” of asthma. The focus area of this project is occupational asthma and asthmatics that are overweight.

Lung cancer is responsible for the majority of cancer deaths in men and women in Norway, and the incidence is still increasing. As surgery by far is the best documented tumor treatment with curative intent, selection of patients for resection has become an increasing important task.

A. Since 2005/2006 lung cancer surgery in Health Region South  (1,4mill inh) has been centralized to our hospital, and the final selection of patients fit for resection has become the responsibility of our Department. A database has been constructed to follow up all patients referred for cancer treatment. This database contains extensive information regarding all patients, comorbidity, lung-function, tumor type/extension, selection of invasive / non-invasive diagnostic strategy, type of treatment given and survival. Today more than 1000 patients are included. We now will be able to answer questions like the value of PET - CT in diagnosis of lung cancer, degree of positive PET related to molecular tumor testing, to compare patient survival in our health region with that of regions not utilizing modern invasive and non-invasive diagnostic tools, assess gender differences regarding tumor extension/ prognosis, the degree and consequences of co-morbidity in selecting patients fit for surgery. Besides, time delay in investigation and treatment start can be documented in all patients.

B. Translocational research

C. The value of interventional bronchoscopy

In Norway, the number of lung transplantations has increased steadily the last few years, currently approaching 30 individuals per year. Our department is the national referral centre for organ transplantation in Norway and is a medium-sized centre for lung transplantation by international standards.

Bronchiolitis obliterans syndrome after lung transplantation: Inflammatory and Innate Immune Responses

Name of principal investigators: PhD Liv Ingunn Bjoner Sikkeland and Dr.med Are M. Holm
Name of co-investigators: MSc Tonje Bøyum Riste, Dr.med Øystein Bjørtuft, Prof PhD Neil Alexis, Prof. Dr.med Johny Kongerud, Dr.med May Britt Lund, Prof Dr.med Tom Eirik Mollnes and Dr.med Arnt Fiane

A significant proportion of the lung transplant (TX) patients develop Bronchiolitis Obliterans Syndrome (BOS) (~50%), a disease marked by loss of lung function and excessive and destructive airways inflammation, frequently involving airways neutrophilia. BOS represents the single most important obstacle to successful long term outcome in lung transplantation.The cause of BOS is unknown, but evidence indicates that the innate host defense function may be impaired.

By using advanced immunological and molecular methods we aim to improve the understanding of BOS and chronic allograft rejection, thus specifically developing improved diagnostic tools and possibly identifying new therapeutic targets for this common disorder within transplantational medicine. We also want to compare the utility of induced sputum with the more invasive BAL in monitoring of inflammatory conditions (BOS and other) in the lungs, and hence whether BAL can be justified as a surveillance tool compared to sputum.

Clinical study of predictive factors in lung transplantation
Name of principal investigator:  Dr.med Are M. Holm
Name of co-investigators: Henrik Auråen MD, Prof. Dr.med Arnt Fiane
Utilizing data from the registry of lung transplantated patients and including data from the other Nordic centres in the Scandiatransplant collaboration, predictive factors for the development of allograft dysfunction and for survival are studied.

ScanCLAD study

EPOS study

High Intensity Training after Lung Transplantation
Name of principal investigators: Michael Durheim MD, Elisabeth Edvardsen. PhD
Name of co-investigators: Marianne Ulvestad MD, Dr.med May Brit Lund, Prof Dr.med Johny Kongerud

Despite the survival benefit and significant improvement in pulmonary function associated with lung transplantation, physical fitness often remains poor among recipients. High intensity exercise training has been shown to be effective among other patient groups, including heart transplant recipients in Norway. The High Intensity Training after Lung Transplantation (HILT) study is a randomized controlled trial of a high intensity training intervention among lung transplant recipients at our centre. Patients undergo detailed assessment of cardiopulmonary physiology and, if randomized to the intervention group, undergo personalized interval and strength training at locations throughout Norway. The objectives are to better understand the relationships between pulmonary function, cardiovascular fitness and physical activity among lung transplant recipients, and to determine the effects of high intensity training in this patient group.

Lung transplantation and inflammation

Occupational exposure

Lung cancer

Nursing research

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PhD projects

Other collaborative projects