Molecular Plaque Imaging – experimental level
Molecular imaging of atherosclerotic plaques and their key vulnerability parameters in combination with blood biomarkers may characterize the stage of the disease and its prognostic implications (Figure 1). Interestingly, many of the key pathogenetic factors involved in plaque formation (e.g. fibroblast activating protein) play also an important role in other inflammatory processes such as arthritis and tumor spreading (Brokopp et al, EHJ 2012). Thus, in collaboration with Nuclear Medicine, Oncology, Rheumatology, Gastroenterology and Pathology at the University Hospital in Zurich we join forces to identify novel biomarkers for inflammatory diseases with a vascular component.
Fig. 1 Potential approaches for biological and morphological plaque imaging. While morphological imaging tools are broadly applied in patients, most biological approaches remain at the experimental level. Limitations concern the signal-to-noise ratio, clinical applicability, costs and added value (Matter et al, EHJ 2009).
Searching for diagnostic and prognostic biomarkers in acute coronary syndromes (ACS)
Two other projects translate from our experimental bench to the patients' bedside: Acute coronary syndromes (ACS) are the most frequent causes leading to myocardial infarction and death. The underlying problem is rupture of a vulnerable plaque or plaque erosion in a major epicardial coronary artery. Among others, activated inflammatory pathways are involved in these events. Yet, the key triggers of the disease remain incompletely understood and the risk stratification of patients after ACS needs to be improved.
Our goal is to identify and validate novel biomarkers that predict major adverse cardiovascular events (MACE) in patients using novel screening tools and systems biology. For this purpose, we take advantage of samples derived from the multicentric Swiss-wide cooperative project on «Inflammation and acute coronary syndrome (ACS)» funded by the Swiss National Science Foundation (SNSF).
Novel prognostic biomarkers after venous thromboembolism (VTE)
In parallel, we will use targeted and untargeted approaches to investigate biomarkers predicting recurrent events in patients with venous thromboembolism. These projects are part of the SNSF-funded multicentric project "Swiss Venous Thromboembolism Cohort 65+ (SWITCO-65+)".
We anticipate that these collaborative efforts facilitate the discovery and validation of novel approaches for improving our management of patients with ACS and venous thromboembolism.
Molecular plaque imaging in atherosclerotic mice (von Lukowicz et al, J Nucl Med 2007)
Imaging the vulnerable plaque – from bench to bedside (Matter et al, EHJ 2009)
Fibroblast activation protein in human atherosclerotic plaques (Brokopp et al, EHJ 2012)
Multimodality imaging in patients with ACS – SPUM (Räber et al, JAMA 2012, EHJ 2014)
SWITCO65+ adherence to guidelines (Frey et al, J Thromb and Hemost 2014)