Despite major advances in intensive care medicine, ARDS remains one of the most severe lung diseases and is associated with high mortality. Even after surviving the acute phase, many patients continue to suffer from long-term consequences of the disease. However, why some lungs recover while others develop progressive scarring is still not sufficiently understood. This is precisely where Thorben Pape’s research project begins. Together with his clinical mentor PD Dr Benjamin Seeliger and his scientific mentor Prof. Dr Jonas Schupp, he aims to decipher the mechanisms that determine the transition from inflammation to regeneration – or, in unfavourable cases, to fibrosis.

The project builds on findings from recent years, particularly those gained during the COVID-19 pandemic and through modern single-cell analyses. These findings show that ARDS does not follow the same course in all patients, but is characterised by different inflammatory patterns and disease trajectories. However, suitable markers for identifying these differences at an early stage and using them therapeutically are still lacking in clinical practice. To close this knowledge gap, Thorben Pape is using state-of-the-art technologies such as spatial transcriptomics, single-nucleus RNA sequencing and other multi-omics approaches. By analysing lung tissue as well as corresponding blood and bronchoalveolar lavage samples, the project aims to make visible the cellular and molecular processes that determine whether healing occurs or lasting lung damage remains. The findings will then be validated using data from the existing ARDS registry at Hannover Medical School, which already includes several hundred patients.

Another focus of the project is on the long-term consequences of the disease. As part of the project, patients are to be connected to a standardised follow-up pathway in a post-ARDS outpatient clinic. In addition to clinical examinations, this will include biosampling analogous to the ARDS registry as well as psychosomatic care. This approach is intended to improve understanding of how secondary diseases, particularly pulmonary fibrosis, develop and how they can be predicted at an early stage. “Our goal is to identify high-risk patients after severe ARDS at an earlier stage and to better understand both acute and long-term lung damage. To achieve this, we want to combine clinical observations with cutting-edge molecular analyses,” explains Thorben Pape. In the long term, the project aims to develop a clinically applicable biomarker panel that will help physicians provide more individualised follow-up care and more targeted treatment.

The project brings together the expertise of numerous BREATH researchers from the fields of respiratory medicine, pathology, radiology, anatomy, rheumatology and psychosomatic medicine, as well as national and international partner centres. Together, they aim to gain new insights into the development, different courses and long-term consequences of acute respiratory distress syndrome, thereby helping to sustainably improve care for affected patients.

We warmly congratulate Thorben Pape on his acceptance into the PRACTIS programme and wish him every success in carrying out his research project.

Text: BREATH/AB

Photo: privat