̽»¨¾«Ñ¡

Chronic Obstructive Lung Disease (COPD)

Characterization of the patients is crucial and includes symptoms (questionnaires), lung function tests (spirometry, body plethysmography, diffusion capacity, and impulse oscillometry), imaging (Chest X-ray and computer tomography), 6 minute walk test, echocardiography and blood chemistry. Sampling of biological material from the lung is performed by bronchoscopy where tissues and cells from the large and from the small airways are harvested.

We are interested in exploring inflammatory mechanisms in the lung and systemically in common respiratory disorders. Specifically, the link between the inflammatory response and development of structural changes (remodeling) in the lung is of interest. We collaborate with a number of highly skilled laboratories depending on our research questions, using various methods including immunohistochemistry, flow cytometry, PCR, cell culture techniques and omics methods. During the last year, the research group has also been involved in projects dealing with Covid-19.

COPD is a disease with a prevalence of 10% and is increasing with age. The patients experience dyspnoea, cough but have also significant co-morbidities and systemic manifestations. There are obvious gender differences both in the epidemiology and in the clinical presentation of the disease. In addition, manifestations of COPD caused by chronic cigarette smoking also vary between different individuals of the same sex. This leads to the consequence that COPD patients differ in particular with regard to emphysema, bronchitis, bronchiolitis, reversibility of bronchodilators rate of exacerbations and systemic involvement. The reasons for development of these various responses to cigarette-smoke exposure are largely unknown. 

Smoking-associated COPD

In a cohort of 40 COPD-patients, 40 smokers with normal lung function and 40 neversmokers (Karolinska COSMIC study) we have made significant attempts, by performing bronchoscopy, to characterize inflammation and structural changes in various levels in the airways as well as in the systemic circulation. A 9-year follow-up of the COSMIC patient cohort has now been finished where symptom registration, spirometry and high-resolution computed tomography are performed. The study will, in particular, gain knowledge on predisposing factors for developing of airway obstruction in smokers.

Chronic airway obstruction associated to prematurity

There are a number of other risk factors besides smoking for development of  chronic airway obstruction. We are interested in early events, i.e. low birth weight and premature birth. In collaboration with Sachs´ Childrens Hospital, Södersjukhuset, Stockholm, adult prematurely born children with and without bronchopulmonary dysplasia (PBD) are compared with mild asthmatics and matched healthy neversmokers in a cross-sectional study (LUNAPRE-study). Bronchoscopy, imaging, lung function tests, echocardiography is, among other methods, used. The study will explore one explanation to chronic airway obstruction not caused by tobacco smoke. A number of researchers, including PhD students and post-docs, are now compiling data and performing experiments looking on various aspects of pulmonary complications in adult age due to prematurity.

Chronic airway obstruction in neversmokers (BRONCHO-SCAPIS study)

Recently, it has become evident that chronic airway obstruction in never-smokers is more prevalent than previously known. A number of epidemiological studies suggest that at least 20-25 % of all COP-patients have never smoked. In this national multicenter study we will identify factors associated with chronic airway obstruction in never-smokers and to determine the molecular mechanisms of this disease in order to find potential targets for intervention. Also, we will identify prognostic markers in early stages of disease.

The project is based on a national population-based cohort, Swedish CArdioPulmonary bioImage Study (SCAPIS) including 30 000 well characterized individuals. In this group, we have identified persons with chronic airway obstruction who have never smoked. These individuals, and appropriate control groups, have been invited to each clinic for in-depth clinical characterization. Associating factors, including occupational and environmental, will be identified. Bronchoscopy have been performed in some patients, with the aim of collecting airways and lung samples. Molecular phenotyping including, immunohistochemistry and "omics" strategies will take place. A research network including six university hospitals in Sweden (UmeÃ¥, Uppsala, Stockholm, Linköping, Gothenburg, Lund) have been formed. During 2023, patient inclusion was closed and compilation of data and additional analyses are now in progress.

Our research group are also involved in a 9-year follow-up of the main SCAPIS study which will take place from 2024. Spirometry, diffision capacity and impulse oscillometry will then be performed.

Covid-10 projects

The research group are also involved in projects dealing with Covid-19. In the project “Pathphysiology, diagnosis and follow-up of Covid-19 and related diseases: an imaging approach, ImCOV, (PI Sven Nyren, associate professor, Dept Radiology, Karolinska University Hospital Solna and Mats Danielsson, professor, the Royal Institute of Technology (KTH) we aim to examine in what way imaging can be combined with patient related data to improve clinical decision-making in patients with Covid-19 and similar conditions by developing deep neural networks (AI). 

Idiopathic pulmonary fibrosis (IPF)

Idiopathic pulmonary fibrosis (IPF) is a deadly, progressive form of lung fibrosis, with a reported median survival of 2-5 year. The disease is characterized by progressive cough and dyspnoea and the disease result in increased healthcare resources utilization and high direct ̽»¨¾«Ñ¡ costs. An estimation of incidence is 7-16/100.000 and a prevalence of 14-42 /100.000. In a recent study, based on ICD codes, the incidence in Sweden was estimated to 13.9/100.000, and the prevalence to 68/100.000 in the year 2015. The exact prevalence of IPF in Sweden is, however, unknown. There is a need to establish new tools to characterize this disease to enable a rational allocation of resources inside the national health-care program. We also need to build up a solid platform to enable translational research to detect new biomarkers and new therapy targets. 

The program will target the goal to create a national registry for IPF and a highly qualified translational centre for the diagnosis and care of IPF and rare lung diseases in Stockholm. We have build-up a national registry including 25 pulmonary units throughout the country. In addition, the set up of a biobank to collect biological samples from patients with IPF for research purposes is in progress. Currently, we collect blood cells and serum/plasma, but in a near future we are planning to include samples from the upper and lower respiratory tract and tissue obtained by bronchoscopy. This sub-project will provide not only basic data on disease manifestations of IPF in Sweden, but also, in a longer perspective, shed light on inflammatory and fibrotic mechanisms on this devastating model of an interstitial lung disease.

The research group

, Group leader, Professor of Respiratory Medicine, MD, PhD, Department of Medicine Solna, ̽»¨¾«Ñ¡, Senior Consultant, Department of Respiratory Medicine and Allergy, Karolinska University Hospital

, MD, PhD, Senior Consultant, Department of Respiratory Medicine and Allergy, Karolinska University Hospital Solna

, MD, PhD, ST Respiratory Medicine, Department of Respiratory Medicine and Allergy, Karolinska University Hospital Solna

, RN, PhD student, registry holder, Swedish National IPF registry

, MD, PhD-student, Division of Respiratory Medicine and Allergy, Karolinska University Hospital Solna

, MSc, PhD, affiliated, Division of Respiratory Medicine, Dept Medicine Solna. Lung biology, Lund University

, affiliated, MD, PhD, Professor, University of Alberta, Edmonton, AB, Canada

, PhD, post doc, division of Respiratory Medicine, Dept Medicine Solna

, MD, PhD, post doc, affiliated, Division of Respiratory Medicine, Dept Medicine Solna

, MD, PhD, post doc, CF-center, Karolinska University Hospital, Division of Respiratory Medicine, Dept Medicine Solna

Mervi Kreus, post-doc, Division of Respiratory Medicine, Dept Medicine Solna 

Maria Diakopoulou, MD, clinical resource, IPF. Karolinska University Hospital

, research nurse, co-ordinator BRONCHO-SCAPIS, clinical part

, RN, research nurse

Simon Scherp, RN, research nurse

Sandra Karlsson, BSc, registry co-ordinator, Swedish IPF-registry

Funding

Swedish Heart-Lung Foundation, ALF Medicine (̽»¨¾«Ñ¡ and Stockholm County Council), Swedish Asthma and Allergy Foundation, King Gustaf V and Queen Victorias Freemasons Foundation, Hesselmans stiftelse, Swedish Medical Research Council, ̽»¨¾«Ñ¡, Paul och Ragna Nybergs fond. Investor-initiated grants from pharmaceutical industry (Boehringer Ingelheim, Roche).

Recent Publications Magnus Sköld (since 2018)

Parasa VR, Forsslund H, Enger T, Lorenz D, Kullberg S, Eklund A, et al
Respir Med 2018 05;138S():S38-S44

Yang M, Kohler M, Heyder T, Forsslund H, Garberg HK, Karimi R, et al
Respir. Res. 2018 03;19(1):40

Yang M, Kohler M, Heyder T, Forsslund H, Garberg HK, Karimi R, et al
Respir. Res. 2018 03;19(1):39

Ferrara G, Luppi F, Birring SS, Cerri S, Caminati A, Sköld M, et al
Eur Respir Rev 2018 Mar;27(147):

Li CX, Wheelock CE, Sköld CM, Wheelock ÅM
Eur. Respir. J. 2018 05;51(5):

Lee J, Arisi I, Puxeddu E, Mramba LK, Amicosante M, Swaisgood CM, et al
PLoS ONE 2018 ;13(4):e0194803

Che KF, Tufvesson E, Tengvall S, Lappi-Blanco E, Kaarteenaho R, Levänen B, et al
Clin. Sci. 2018 05;132(9):959-983

Pesonen I, Carlson L, Murgia N, Kaarteenaho R, Sköld CM, Myllärniemi M, et al
Multidiscip Respir Med 2018 ;13():14

Cottin V, Koschel D, Günther A, Albera C, Azuma A, Sköld CM, et al
ERJ Open Res 2018 Oct;4(4):

Fuchs D, Hamberg M, Sköld CM, Wheelock ÅM, Wheelock CE
J. Lipid Res. 2018 10;59(10):2025-2033

Johansson N, Vondracek M, Backman-Johansson C, Sköld MC, Andersson-Ydsten K, Hedlund J
Eur. J. Clin. Microbiol. Infect. Dis. 2019 Feb;38(2):297-304

Sköld CM, Arnheim-Dahlström L, Bartley K, Janson C, Kirchgaessler KU, Levine A, et al
Respir Med 2019 Aug;155():72-78

Ezzat K, Pernemalm M, Pålsson S, Roberts TC, Järver P, Dondalska A, et al
Nat Commun 2019 05;10(1):2331

Um-Bergström P, Hallberg J, Pourbazargan M, Berggren-Broström E, Ferrara G, Eriksson MJ, et al
Respir. Res. 2019 May;20(1):102

Sköld CM, Arnheim-Dahlström L, Bartley K, Janson C, Kirchgaessler KU, Levine A, et al
Respir Med 2019 Aug;155():72-78

Roos Ljungberg K, Joshua V, Skogh T, Eklund A, Sköld CM, Svärd A, Catrina AI, Kastbom A.
Rheumatology (Oxford). 2019 Sep 5. pii: kez377. doi: 10.1093/rheumatology/kez377. [Epub ahead of print].

Vikgren J, Khalil M, Cederlund K, Sörensen K, Boijsen M, Brandberg J, et al
Acad Radiol 2019 Jul;():

Ekström MP, Blomberg A, Bergström G, Brandberg J, Caidahl K, Engström G, Engvall J, Eriksson M, Gränsbo K, Hansen T, Jernberg T, Nilsson L, Nilsson U, Olin AC, Persson L, Rosengren A, Sandelin M, Sköld M, Sundström J, Swahn E, Söderberg S, Tanash HA, Torén K, Ã–stgren CJ, Lindberg E.
Thorax. 2019 Oct;74(10):958-964. doi: 10.1136/thoraxjnl-2019-213349. Epub 2019 Aug 21.

Ekström M, Bornefalk H, Sköld M, Janson C, Blomberg A, Sandberg, J, Bornefalk-Hermansson A, Igelström H, Sundh J.
BMJ Open Respir Res. 2019 Sep 18;6(1): e000381. doi: 10.1136/bmjresp-2018-000381. eCollection 2019.

Naz S, Bhat M, Ståhl S, Forsslund H, Sköld CM, Wheelock ÅM, Wheelock CE.
Metabolites 2019 Oct 1;9(10). pii: E212. doi: 10.3390/metabo9100212.

Kalafatis D, Gao J, Pesonen I, Carlson L, Sköld CM, Ferrara G
BMC Pulm Med. 2019, Nov 27;19(1):222. doi: 10.1186/s12890-019-0994-4. PMID: 31771560

Torén, K, Schiöler L, Lindberg A, Andersson A, Behndig AF, Bergström G, Blomberg A, Caidahl K, Engvall JE, Eriksson MJ, Hamrefors V, Janson C, Kylhammar D, Lindberg E, Lindén A, Malinovschi A, Persson HL, Sandelin M, Eriksson Ström J, Tanash H, Vikgren J, Östgren CJ, Wollmer P, Sköld CM.
BMJ Open Resp Res 2020;7:e000600. doi:10.1136/bmjresp-2020-000600

Pesonen IHA, Gao J, Kalafatis K, Carlson L, Sköld CM, Ferrara G.  
Respiratory Medicine: X Volume 2, November 2020, 100017, ;

Malinovschi A, Zhou X, Bake B, Bergström G, Blomberg A, Brisman J, Caidahl K, Engstrom G, Eriksson, M, Frølich A, Janson C, Jansson K, Vikgren J, Lindberg A, Linder R, Mannila M, Persson L, Sköld CM, Toren K, Ã–stgren CJ, Wollmer P, Engvall J. 
Eur Respir J. 2020 Aug 13;56(2):1901995. doi: 10.1183/13993003.01995-2019.  

Ekström M, Bornefalk H, Sköld CM, Janson C, Blomberg A, Bornefalk-Hermansson A, Igelström H, Sandberg J, Sundh J.
2020 Nov;60(5):968-975.e1. doi: 10.1016/j.jpainsymman.2020.05.028. Epub 2020 Jun 6 

Joshua V, Hensvold AH, Reynisdottir G, Hansson M, Cornillet M, Nogueira L, Serre G, Nyren S, Karimi R, Eklund A, Sköld CM, Grunewald J, Chatzidionysiou K, Catrina AI. 
RMD Open. 2020 Sep;6(2):e001278. doi: 10.1136/rmdopen-2020-001278. PMID: 32917833 

Kvien TK, Balsa A, Betteridge N, Buch MH, Durez P, Favalli E, Favier G, Gabay C, Geenen R, Gouni-Berthold I, van den Hoogen F, Kent A, Klareskog L, Ã˜stergaard M, Pavelka K, Polido-Pereira J, Grete Semb AG, Sköld M, Dougados M.
RMD Open 2020 Jul;6(2): e001211. 

Holland AE, Corte T, Chambers DC, Palmer A, Ekström M, Glaspole I, Goh NSL, Hepworth G, Khor YH, Hoffman M, Vlahos R, Sköld M, Dowman L, Troy LK, Prasad JD, Walsh J, McDonald CF. 
BMJ Open 2020 Dec 13;10(12):e040798. doi: 10.1136/bmjopen-2020-040798 

Merikallio H, Kaarteenaho R, Lindén S, Padra M, Karimi R, Li CX, Lappi-Blanco E, Wheelock, Sköld CM. 
Respir Res. 2020 Sep 18;21(1):239. doi: 10.1186/s12931-020-01498-7. PMID: 32948202 

 
Ekström M, Bornefalk H, Sandberg J, Sköld CM, Janson C, Blomberg A, Bornefalk-Hermansson A, Currow DC, Johnson MJ, Sundh J.
Eur Respir J. 2020 Dec 17:2002823. doi: 10.1183/13993003.02823-2020. Online ahead of print. PMID: 33334935 

Nouws J, Wan F, Finnemore E, Roque W, Kim S, Bazan I, Li CX, Skold M, Yan X, Neumeister V, Sweasy J, Bindra R, Wheelock Ã…, Gomez-Villalobos J, Kaminski N, Lee PJ, Sauler M. 
JCI Insight. 2020 Dec 8:134218. doi: 10.1172/jci.insight.134218. Online ahead of print. PMID: 33290275. 

Torén K, Schiöler L, Lindberg A, Andersson A, Behndig AF, Bergström G, Blomberg A, Caidahl K, Engvall JE, Eriksson MJ, Hamrefors V, Janson C, Kylhammar D, Lindberg E, Lindén A, Malinovschi A, Persson HL, Sandelin M, Ström JE, Tanash H, Vikgren J, Ã–stgren CJ, Wollmer P, Sköld CM.
Clin Physiol Funct Imaging. 2020 Dec 7. doi: 10.1111/cpf.12684. Online ahead of print. PMID: 33284499 

Gao J, Kalafatis D, Carlson L, Pesonen I, Li CX, Wheelock Ã…, Magnusson J, Sköld CM. 
Respir Res 2021; 22:40 ;

Meister I, Zhang P, Sinha A, Sköld CM, Wheelock Ã…M, Izumi T, Chaleckis R, Wheelock CE. 
Anal Chem 2021 Mar 30;93(12):5248-5258. doi: 10.1021/acs.analchem.1c00203. Epub 2021 Mar 19 

Finnegan SL, Pattinson KTS, Sundh J, Sköld M, Janson C, Blomberg A, Sandberg J, Ekström M.
ERJ Open Res. 2021 Jun 28;7(2):00818-2020. doi: 10.1183/23120541.00818-2020. eCollection 2021 Apr. PMID: 34195256 

Jalde FC, Beckman MO, Svensson AM, Bell M, Sköld M, Strand F, Nyren S, Kistner A.  
Front Med (Lausanne). 2021 Jun 29;8:666723. doi: 10.3389/fmed.2021.666723. eCollection 2021.PMID: 34268322 

Kjellberg A, Douglas J, Pawlik MT, Kraus M, Oscarsson N, Zheng X, Bergman P, FrÃ¥nberg O, Kowalski JH, Nyren SP, Silvanius M, Skold M, Catrina SB, Rodriguez-Wallberg KA, Lindholm P. 
BMJ Open. 2021 Jul 5;11(7):e046738. doi: 10.1136/bmjopen-2020-046738. PMID: 34226219 

Durheim MT, Bendstrup E, Carlson L, Sutinen EM, Hyldgaard C, Kalafatis D, Myllärniemi M, Sköld CM, SjÃ¥heim T. 
Respirology. 2021 Jul 22. doi: 10.1111/resp.14116. Online ahead of print.PMID: 34291523 

Kistner A, Tamm C, Svensson AM, Beckman MO, Strand F, Sköld M, Nyrén S.
BMC Nephrol. 2021 Aug 31;22(1):297. doi: 10.1186/s12882-021-02469-w.PMID: 34465289

 
Tornhammar P, Jernberg T, Bergström G, Blomberg A, Engström G, Engvall J, Fall T, Gisslén M, Janson C, Lind L, Sköld CM, Sundström J, Söderberg S, Zaigham S, Östgren CJ, Andersson DP, Ueda P.
BMJ Open. 2021 Sep 2;11(9):e051359. doi: 10.1136/bmjopen-2021-051359.PMID: 34475186

Bergström G, Persson M, Adiels M, Björnson E, Bonander C, Ahlström H, Alfredsson J, AngerÃ¥s O, Berglund G, Blomberg A, Brandberg J, Börjesson M, Cederlund K, de Faire U, Duvernoy O, Ekblom Ö, Engström G, Engvall J, Fagman E, Eriksson M, Erlinge D, Fagerberg B, Flinck A, Goncalves I, Hagström E, Hjelmgren O, Lind L, Lindberg E, Lindqvist P, Ljungberg J, Magnusson M,  Mannila M, Markstad H, Mohammad MA, Nystrom F, Ostenfeld. E, Persson A, Rosengren A, Sandström A, Själander A, Sköld M, Sundström J, Swahn E, Söderberg S, Torén K, Östgren CJ, Jernberg T.
Circulation 2021:144 (12); 916-929

Finnegan SL, Pattinson KTS, Sundh J, Sköld M, Janson C, Blomberg A, Sandberg J, Ekström M.
ERJ Open Res. 2021 Jun 28;7(2):00818-2020. doi: 10.1183/23120541.00818-2020. eCollection 2021 Apr.PMID: 34195256 PMCID: PMC8236755 DOI: 10.1183/23120541.00818-2020

Kalafatis D, Löfdahl A, Näsman P, Dellgren G, Wheelock ÅM, Elowsson Rendin L, Sköld M, Westergren-Thorsson G.
Int J Mol Sci. 2021 Dec 14;22(24):13421. doi: 10.3390/ijms222413421. PMID: 34948231

Ekblom-Bak E, Börjesson M, Bergman F, Bergström G, Dahlin-Almevall A, Drake I, Engström G, Engvall JE, Gummesson A, Hagström E, Hjelmgren O, Jernberg T, Johansson PJ, Lind L, Mannila M, Nyberg A, Persson M, Reitan C, Rosengren A, RÃ¥dholm K, Schmidt C, Sköld MC, Sonestedt E, Sundström J, Swahn E, Öhlin J, Östgren CJ, Ekblom Ö. 
Scand J Med Sci Sports. 2022 Jan 26. doi: 10.1111/sms.14131. Online ahead of print.PMID: 35080270

Ahmadi Z, Igelström H, Sandberg J, Sundh J, Sköld M, Janson C, Blomberg A, Bornefalk H, Bornefalk-Hermansson A, Ekström M.
ERJ Open Res. 2022 Jan 24;8(1):00460-2021. doi: 10.1183/23120541.00460-2021. eCollection 2022 Jan. PMID: 35083321

Um-Bergström P, Pourbazargan M, Brundin B, Ström M, Ezerskyte M, Gao J, Berggren Broström E, Melén E, Wheelock ÅM, Lindén A, Sköld CM.
Eur Respir J. 2022 Feb 24:2102531. doi: 10.1183/13993003.02531-2021. Online ahead of print.PMID: 35210327. Även editorial i Eur Respir J. 2022 Sep 29;60(3):2200984. doi: 10.1183/13993003.00984-2022.

Pournaras N, Andersson A, Kovach M, Padra M, Che KF, Brundin B, Yoshihara S, Bozinovski S, Lindén S, Jansson PA, Sköld CM, Qvarfordt I, Lindén A.
Int J Chron Obstruct Pulmon Dis 2022 May 20; 17: 1179-1194. doi: 10.2147/COPD.S353753. eCollection 2022. PMID: 35620349

Lung Perfusion Disturbances in Non-Hospitalized Post-COVID with Dyspnea – An MRI feasibility study.
Yu J, Granberg T, Shams R, Petersson S, Sköld CM, Nyren S, Lundberg J.
J Intern Med 2022 Dec;292(6):941-956. doi: 10.1111/joim.13558. Epub 2022 Aug 26.

.
Li CX, Gao J, Sköld CM, Wheelock ÅM.
Front. Genet. 2022, 13:1010048. doi: 10.3389/fgene.2022.1010048. PMID: 36468026

Joshua V, Loberg-Haarhaus M, Hensvold AH, Wähämaa H, Gerstner C, Hansson M, Israelsson L, Stålesen R, Sköld M, Grunewald J, Klareskog L, Grönwall C, Réthi B, Catrina A, Malmström V.
Arthritis Rheumatol 2023 May 16. doi: 10.1002/art.42549. PMID: 37192126

Machine-Learning Slice-Wise Whole-Lung CT Emphysema Score Correlates with Airway Obstruction.
Lidén M, Spahr A, Hjelmgren O, Bendazzoli, Sundh J, Sköld M, Bergström G, Wang C, Thunberg P.
Eur Radiol 2023 Aug 8. doi: 10.1007/s00330-023-09985-3. PMID: 37552259

Malinovschi A, Xingwu Zhou X, Andersson A, Backman H, Bake B, Blomberg A, Caidahl K, Eriksson M, Eriksson Ström J, Hamrefors V, Hjelmgren O, Janson C, Jansson K, Karimi R, Kylhammar D, Lindberg A, Lindberg E, Liv P, Olin AC, Shalabi A, Sköld CM, Sundström J, Tanash H, Torén K, Wollmer P, Zaigham S, Östgren CJ, Engvall JE. 
Am J Respir Crit Care Med 2023 Jun 20. doi: 10.1164/rccm.202212-2341OC. PMID: 37339507

Kalafatis D, Joshua V, Hansson M, Mathsson-Alm L, Hensvold A, Sköld M.
Respirology. 2023 Jun 27. doi: 10.1111/resp.14543. PMID: 37376768

High prevalence of interstitial lung abnormalities in middle-aged never smokers’.
Pesonen I, Johansson F, Johnsson Å, Blomberg A, Boijsen M, Brandberg J, Cederlund K, Egesten, A, Emilsson ÖI, Engvall J, Frølich A, Hagström E, Lindberg E, Malinovschi A, Stenfors N, Swahn E, Tanash H, Themudo R, Toren K, Vanfleteren L, Wollmer OP, Zaigham S, Östgren CJ, Sköld CM.
ERJ Open Research 2023 (in press)