Research Projects

Research

Main focus of our group is to identify mechanisms, which allow organ protection in the perioperative phase. Over years we have worked in vitro, in vivo as well in clinical trials on elucidating the role of volatile anaesthetics as potential immunomodulators within the innate immunity system. It is evident from our preclinical studies that sevoflurane, one of the most used volatile anaesthetics worldwide, attenuates inflammation by decreasing expression of inflammatory mediators including recruitment of effector cells, finally leading to improved organ function in scenarios of ischemia-reperfusion injury and severe inflammation. This topic was expanded to inflammatory processes in perioperative cancer cell biology to see if volatile anaesthetics have an impact on the presence of in the blood circulating tumour cells.

In collaboration with the ETH Zurich magnetic nanoparticles were designed and tested if they allow removal of proteins, metals, but also cells from the blood. Within the National Research Program NRP64 2011-2015 we were able to provide proof of principle that this technology is feasible.

Research Projects

1) Nontraumatic subarachnoid hemorrhage (SAH) caused by the rupture of cerebral aneurysms leads to 30% mortality in hospital. The effect of volatile anesthetics remains controversial. In a recent study, SAH in rats showed an attenuation of edema formation caused by sevoflurane. No information concerning long-term repair is available now. This project focuses on the short- and long-term outcomes of sevoflurane postconditioning after SAH.

2) Antibody-mediated rejection (AMR) represents a significant problem in kidney transplantation. Donor-specific antibodies (DSA) are directed against the human leucocyte antigens (HLA) of the donor, and they cause AMR. Functionalized magnetic nanoparticles are tested to eliminate extracorporeal (DSA) from patient blood to improve the outcome concerning kidney transplantations.

3) Liver resection helps to cure patients with primary liver tumors and metastasis, while 30-40% of patients fail to achieve surgery because of the extended tumor progression. ALPPS (Associating Liver Partition and Portal vein ligation for Staged Hepatectomy) is a two-stage procedure which after the first stage with portal vein ligation (PVL) and parenchymal transection allows the tumor-free liver to rapidly regenerate to have enough functional liver remnant after the second stage with hepatectomy. The mechanisms of rapid liver regeneration, however, are poorly understood. In this study in rodents, the role of polarized liver macrophages in ALPPS are explored in comparison to a model of non-accelerated liver regeneration in PVL.

4) Hexafluoroisopropanol (HFIP), the water-soluble primary metabolite of the volatile anesthetic sevoflurane, could be crucial in mediating protective effects concerning dysregulated inflammatory processes in patients. The microvascular compartment is considered to play an essential role in the

pathogenesis of these processes. In an in vitro study of human endothelial cells, blood samples, and macrophage epigenetic modifications, phospho-proteome profiling and pathway analysis are approached. Profound information would allow potential translation into a clinical study.

Recent publicationsAnaesthesiology