Universitätsklinik
für Innere Medizin II Innsbruck

Research Foci

 

Michael Schirmer, MD, Assoc.Professor

1. Clinical Research Focus

Clinical research supports structural patients’ examinations and thus helps to improve the quality of our clinical work. Besides it considered important for bedside teaching of students and postdoctoral education.

We specifically work on the following topics:

• Arthritis (rheumatoid arthritis, ...)
  Rheumatoid Arthritis, as well as psoriatic arthritis and gout should be diagnosed and adequately
  treated as early as possible, to prevent structural damages of the joints. Swelling of single or
  multiple joints (smooth, not hard like bone) are the first signs and should be recognised. At present we study as diploma work of our students the quality of health care provided to our patients in the frame work of the project called SolutionX.
• Inflammatory spine diseases / spondyloarthritis (ankylosing spondylitis)
  Nearly 2% of the Austrian population suffer from spondyloarthritis, which is still diagnosed often
  years after its first signs. Chronic back pain, especially with rest and improving with exercise, is
  typical for this type of disease. In an epidemiological approach we currently work on the course of spondyloarthritides in the Tyrol, and participate in an international study to evaluate the classification criteria of spondyloarthritis.
• Inflammatory muscle diseases (Polymyalgia rheumatica)
  Polymyalgia rheumatica is the most frequent inflammatory muscle disease in the aged population,
  mostly together with serological signs of inflammation. During the past years we could initiate and participate in clinical studies on new classification criteria and recommendations for the management of polymyalgia rheumatic, and thus increase the quality of care to be applied for patients with this disease.
• Vasculitides (Giant cell arteritis, Behcet’s disease)
  
  - Giant cell arteritis is the most frequent vasculitis in the elderly and may present as temporal arteritis
    (with temporal headache) or as arteritis of the aorta and its major arterial branches. This disease
    may end up with blindness. Therefore investigations into pathophysiological mechanisms are very
    important for our laboratory work. We could participate in the development of new international recommendations for the use of F-FDG-PET as an imaging diagnostic tool.
  
  - Behçet’s disease is a systemic vasculitis involving small, medium and large vessels, and thus nearly  all human organs may be affected. This disease is rare in Austria, but can also lead to blindness or death – especially without adequate treatment. In an international cooperation we have established the Innsbruck registry for Behçet’s disease. During the last years we could also co-initiate the new diagnostic criteria and cooperate in an international working group on this important topic. As a multidisciplinary approach, the University Hospital of Innsbruck can now be considered as an experienced center for this disease.
   

• Other rare diseases (fever syndromes)
             - Fever syndromes are rare, but then even harder for the patients. Fever may occur regularly (e.g.
               monthly in TRAPS syndrome) or irregularly.

  The quality aspect is very important for rheumatology, too. We specifically focus on the following aspects:
  • Correct diagnosis and classification of the about 200-300 different rheumatic diseases
  • Role and relevance of biomarkers and imaging techniques in rheumatology (e.g. sonography, 
     SpA-antibodies, 18F-FDG-PET). Especially sonography can improve quality of health care in rheumatology, and therefore we regularly organize internationally accredited courses for sonography in rheumatology.
  • Treatment of chronic-inflammatory rheumatic diseases, with specific focus on possible side-effects and co-morbidities (e.g. we lead the Austrian part of an international registry for pregnancies in lupus patients treat with a certain biological).

  Since many years, for the structured long-term documentation of our patients’ disease courses, we work on a project called SolutionX together with colleagues from Switzerland, the Verein zur Förderung der Hämatologie, Onkologie und Immunologie and IT companies (supported by national and international institutions). SolutionX provides a lot of opportunities for research, teaching and quality assurance of clinical work. Since 2015 we organize seminars on this important epidemiological fresearch project (Keyword: Real-life data).

 

2. Foci of the laboratory work

In parallel to clinical research we are working on laboratory studies on the following diseases:
• Arthritis (rheumatoid arthritis, ...)
• Inflammatory spine diseases / spondyloarthritis (ankylosing spondylitis)
• Inflammatory muscle diseases (Polymyalgia rheumatica)
• Vasculitides (Giant cell arteritis, Behçet’s disease), and abdominal aortic aneurysm (together with the Univ. Clinic of Vascular Surgery, Innsbruck)
• Other rare diseases (fever syndromes)

Our primary aims are:
• Research on the pathophysiological mechanisms and the long-standing course of chronic inflammatory rheumatic diseases, on the cellular and the molecular level. Specific focus is ther differentiation of inflammatory and structural changes in spondyloarthritis, with the potential role of external influences.
• Effects of medical treatment approaches on immunological mechanisms

The aim of these projects support is to better know and understand the underlying causes of inflammatory rheumatic diseases and their longstanding courses. Thus the work shows a clear clinical perspective, possibly leading to new treatment strategies for these diseases.