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Collaborative topics

In parallel with the focal areas Community Medicine, Molecular Medicine and Individualized Medicine the research activities at UMG are also characterized by collaborative topics. They are reviewed approx. every five years on the basis of publication output and third-party funding. Currently main topics are “infection and inflammation”, “cardiovascular diseases” and “abdominal and metabolic diseases”.

Infection a. inflammation

Infections remain a huge health risk worldwide, even in the 21st century. The antibiotic resistance crisis exacerbates the situation and threatens to deprive our societies of the medical progress achieved during the past 100 years. Therefore, the WHO adopted an action plan to combat antibiotic resistance in May [2015]which was expressly endorsed by the German government and the other G7 states in June [2015].

The UMG enhances infection research to contribute to the solution of the problem. This requires a better understanding of the pathogens and the host’s defense mechanisms. Apart from individual projects the UMG has been and is involved in various coordinated programs addressing this topic:

Inflammation represents a defense reaction of the organism, e.g. against infections, that is assessed since antiquity on the basis of the five so-called cardinal symptoms:

  • reddening (rubor)
  • heat (calor)
  • swelling (tumor)
  • pain (dolor)
  • dysfunction (functio laesa)

Indeed, inflammation is commonplace. It arises once the immune system detects danger, e.g. during infections or cell and tissue destruction. Immune cells are activated and move towards the site of challenge. This reaction is vital but can also damage the organism if it

  • is directed against the wrong targets such as endogenous structures,
  • is excessively strong or
  • lasts very long.

Therefore it is essential that inflammation is regulated by antiinflammatory mechanisms so that the organism can rapidly regain homeostasis after a defense reaction. Consequently, the antiinflammatory regulatory processes also have to be considered in the investigation of inflammation and its consequences. Both excessive and sparse inflammation may equally cause problems.

Inflammation research at the UMG not only concentrates on infections but also on diseases that can be explained by a derailment of (anti)inflammatory processes. Examples are dilatative cardiomyopathy, an inflammatory heart failure, pancreatitis, multiple sclerosis and coagulation disorders. The Study of Health in Pomerania [link] at the UMG also comprises inflammation research, since excess weight or insufficient dental hygiene often induce a latent inflammatory reaction which is mostly weak but can elicit or promote diseases in the long run. Besides numerous individual projects inflammation research at the UMG has been and is organised in research centers and associations:

 

 

Cardiovascular diseases

Cardiovascular diseases still represent the primary cause for deaths in Germany. Hence diseases of the cardiovascular system are an important collaborative research topic at the UMG. Numerous institutes and clinics coordinate und pursue research projects that aim to improve prevention, diagnostics and therapies of the respective diseases in the long run. The research projects encompass a very broad spectrum reaching from molecular basic research to clinical trials and population-based and clinical cohort studies: (SHIP, GANI_MED) reicht.

Besides several individual projects the cardiovascular research at the UMG has been and is involved in various coordinated programs:

 

 

Abdominal and metabolic diseases

Abdominal and metabolic diseases constitute a collaborative research topic of the medical faculty. The most important diseases in this area are fatty liver disease, fatty liver inflammation (steatohepatitis) and pancreatitis. The non-alcoholic fatty liver disease (NAFLD) and the non-alcoholic steatohepatitis (NASH) are the most frequent cause for increased liver-related laboratory values of patients. NAFLD belongs to the major causes for cryptogenic liver cirrhosis, i.e. a form of liver degeneration without viral or bacterial involvement.

Within the SHIP cohort, 1,264 probands showed signs of fatty liver disease (approx. 30%). Usually this diagnosis is made by ultrasound. In approx. 16% of cases also pathological laboratory values can be found. Fatty liver disease is often associated with obesity (adipositas, increased body mass index (BMI)). On the basis of non-invasive examinations, i.e. without histology, a correct assignment can be achieved for only a third of probands.

Currently the joint group efforts of gastroenterologists, endocrinologists, functional geneticists, radiologists, pathologists and epidemiologists concentrate on a precise characterization of NAFLD and NASH. To this end, biomaterials such as DNA, RNA and proteins from blood or stool microbiome are investigated in the setting of two cohorts. One is the SHIP cohort with voluntary probands for whom fatty liver disease and fatty liver inflammation can be diagnosed by MR and ultrasound imaging as well as blood tests. The second cohort, recruited within the GANI_MED project, consists of 400 gastroenterologic patients who also had a fatty liver diseases, fatty liver inflammation or metabolic syndrom and are examined in the same way as the SHIP probands. Aims of the project are to better differentiate, e.g. on the basis of biomarkers and non-invasive imaging, between normal liver, liver “only” become fatty and fatty liver inflammation or fatty liver-caused cirrhosis and to identify factors that may serve as targets for a therapeutic intervention or that signal the transition to cirrhosis or hepatocarcinoma.

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