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Forskningens Genombrott Innehåll Jubileumsnumret JUBILEUMSNUMMER 2014 Hjärt-Lungfonden fi rar jubileum Forskningens genombrott Innehåll jubileumsnumret 4 SCAPIS. En unik forskningsstudie Forskningshistoria skapar nästa genom- 1904. En helt annan tid. Då lungsoten, brott. tuberkulosen, var en stor skräck i Sverige och tusentals dog i sjukdomen 6 Tuberkulos. Den his- varje år. Jag tänker på den tiden och på toriska kraftsamling- mina företrädare, som tog initiativet en som gav resultat. till Svenska Nationalföreningen mot Tuberkulos. De hade en vision, att utro- 12 Hjärtkirurgi. Hjärt- ta tuberkulosen som folksjukdom, men kirurgin har upplevt de hade inte den blekaste aning om hur många milstolpar. Hjärtkirurgi.Anders Jeppsson är mycket den visionen skulle betyda så hjärtkirurg och ser en snabb utveck- långt fram i tiden som 2014. 16 Pacemaker. En 14 ling av olika operationstekniker. Tuberkulosen slutade vara det stora svensk uppfi nning dödshotet i Sverige. I dag är vår vision gav miljoner ett nytt att besegra både hjärt- och lungsjuk- liv. Perspektiv. domarna, och vi är på god väg, mycket Nina Rehnqvist tack vare den otroligt framgångsrika 18 Perspektiv. Nina imponeras av forskningen! Rehnqvist har följt de framsteg Jag vill uppmana dig att läsa och hjärtvårdens utveck- som ägt rum. glädjas åt alla fantastiska upptäckter ling. som har gjorts genom åren och som i dag räddar många tusen liv. Jag talar 22 PCI och stent. Fler om vaccin mot tuberkulos, om hjärt- överlever hjärtinfarkt lungmaskinen, pacemakern, möjlighe- med ballongvidgning. ten att transplantera både hjärtan och lungor, om ballongvidgningar och stent 27 Transplantation. I och om en rad läkemedel som gör livet framtiden hoppas 18 lättare för alla drabbade. forskarna kunna laga Nu blickar vi framåt mot kommande trasiga hjärtan med Omslag. Omslagets genombrott. Du är välkommen att vara stamceller. 26 stilleben består av ett med på resan! stetoskop, en hjärt- 30 Lungsjukdom. Det modell, en inhalator, fi nns gott om histo- en pacemaker och Staff an Josephson riska milstolpar på Trombyltabletter. Generalsekreterare lungområdet, men KOL-forskningen väntar ännu på ett genombrott. 36 Barnkardiologi. I dag Transplantation. överlever de allra fl es- Arvid har fått ett nytt ta barn med medföd- hjärta och ett nytt liv. da hjärtfel. Forskning för hälsa CHEFREDAKTÖR OCH ANSVARIG UTGIVARE Ulrica Klettner REDAKTÖR Karin Myhrström, [email protected] REDAKTIONELL PROJEKTLEDNING Karin Strand, Appelberg, [email protected] REDAKTÖRER Anne Hammarskjöld och Sandra Lindström, Appelberg, LAYOUT Lena Palmius, Appelberg OMSLAGSFOTO Martin Sundström TRYCK Edita Bobergs, Falun. Citera oss gärna, men ange källan. Adress Biblioteksgatan 29, Box 5413, 114 84 Stockholm Hjärt-Lungfonden har insamlingskonton Telefon 08-566 24 200 Fax 08-566 24 229 pg 90 91 92-7 och bg 909-1927. issn bildades 1904 i kampen mot tuberkulos (tbc). Org nr 802006-0763 1653-9753 Gåvoservice Telefontid 08.00-18.00 I dag är fondens mål att besegra både hjärt- och E-post [email protected] Telefon 0200-88 24 00 lungsjukdomarna. Hjärt-Lungfonden samlar in och Hemsida www.hjart-lungfonden.se E-post [email protected] fördelar pengar till forskning samt informerar om hjärt-lungsjukdom. Fonden är helt beroende av gåvor Organisationer med 90-konto kontrolleras regelbundet av Svensk Insamlings kontroll. från privatpersoner och företag. 90-konto är en garanti för att pengarna används på rätt sätt. 2 Hjärt-Lungfonden Vi står inför en period med fl era stora forsknings- genombrott. Ordföranden i Hjärt-Lungfondens Forsk- ningsråd, professor Jan Nilsson, är övertygad om att ILLUSTRATION GETTY IMAGES GETTY ILLUSTRATION den världsunika kunskapsbanken SCAPIS kan bidra. Dags för nästa stora genombrott et är dags för nästa stora innebär att en data-, bild- och biobank – På så sätt kan vi tidigt se vilka genombrott inom hjärt- byggs och utgör forskningsunderlag för personer som löper hög risk för brustet forskningen. 1960- och i första hand forskare inom hjärt-, kärl- plack och utveckla läkemedel som 70-talen kännetecknades av och lungområdena. förhindrar att det brister. Dstora genombrott när det gäller kart- – I SCAPIS kan vi testa de hypoteser Biomarkörer är exempelvis proteiner, läggningen av riskfaktorerna bakom som vi har med oss från grund- molekyler, signalvägar eller annat som hjärt-kärlsjukdom, exempelvis högt forskningen, upptäcka vilka som är innehåller sådan information att man blodtryck och blodfettsrubbningar. I tillämp bara och vilka behandlingar vi med hjälp av dem kan ställa en diagnos. slutet av 70- och början av 80-talet kom kan utveckla, säger Jan Nilsson, som Ett enkelt blodprov skulle alltså kunna en serie läkemedel som verkade mot framför allt hoppas på visa om en person löper risk att få hjärt- dessa riskfaktorer. en relativt snabb ut- infarkt och en ny medicin skulle kunna – I och med att vi lärde oss att undvi- veckling av läkemedel förhindra att personen drabbas. ka riskfaktorer, kunde sätta in medicin- som eff ektivt kan läka – På samma sätt kommer informa- ska behandlingar där det behövdes och ut den infl ammation tionsinsamlingen inom ramen för samtidigt utvecklade guidelines och i kärlväggen som SCAPIS att hjälpa forskningen framåt kvalitetsregister kunde vi dramatiskt anses ligga bakom att inom andra områden som diabetes, sänka dödligheten i hjärt-kärlsjukdom, åderförfettningsplack stroke och KOL, säger Jan Nilsson. säger Jan Nilsson, professor i experi- brister och en blod- – När det gäller KOL vill vi kunna mentell kardiovaskulär forskning vid propp bildas. Professor stoppa utvecklingen av sjukdomen i ett Lunds universitet. Tack vare den Jan Nilsson. tidigt skede. Även här spelar infl amma- Efter 25 år av grundforskning i avancerade bildteknik tion en viktig roll och genom att kombi- laboratorier är det nu dags för nästa som används i SCAPIS kan forskarna nera den kunskap vi får från avancerad steg – stora befolkningsstudier som studera placken i deltagarnas kärl. bildteknik med det vi kan utläsa från SCAPIS, där forskarna samlar in så Samtidigt kan de titta på deltagarnas infl ammationsmarkörer i blod bör mycket information som möjligt. biomarkörer i blodet och jämföra med det gå att utveckla nya och eff ektivare SCAPIS är en världsunik studie dem som man redan identifi erat i expe- behandlingar. initierad av Hjärt-Lungfonden som rimentella studier. TEXT KARIN STRAND Tack för ditt stöd till svensk hjärt- och lungforskning. Nu kan du vara med och skapa nästa genombrott! Ring in din jubileumsgåva på 0200-89 19 00. Forskning för hälsa 3 Hitta högriskindividerna och individualisera behandlingen av dem. Det är målet för den stora befolkningsstudien SCAPIS som står i centrum för Hjärt-Lungfondens jubileumskampanj. Ju större studien blir, desto snabbare kommer resultaten. SCAPIS – en unik kunskapsbank ånga av riskfaktorerna för datortomografi (CT-kamera), ultra- personer på universitetssjukhus över de hjärt-, kärl- och lung- ljudsundersökningar och lungfunk- hela landet. relaterade sjuk domarna tionstester samt fyller i omfattande Kombinationen blodprover och Mär väl kända, men när frågeformulär. bildinformation kompletterad med det gäller att hitta de personer som Det övergripande målet med studien lungfunktionstester kan på samma verkligen är i riskzonen för sjukdom är att fi nna metoder att individuali- vis ge information om vilka personer är verktygen fortfarande trubbiga. De sera riskbedömningen för hjärt- och som löper risk att utveckla kroniskt så kallade riskscores som sjukvården i lungsjukdom och sätta in korrekt och obstruktiv lungsjukdom, KOL, och i dag använder för att uppskatta risken individanpassad behandling. förlängningen leda till individanpassad att drabbas hos enskilda personer är – Vår vision är att vi inom en inte vård även av den sjukdomen. baserade på statistik. alltför avlägsen framtid ska kunna ta ett CT-kameraundersökningen omfattar – Och det är långtifrån säkert att sta- blodprov på alla personer i 40-50-års- inte bara hjärta och lungor utan även tistiken stämmer överens med indivi- åldern och utifrån vissa biomarkörer halskärlen hos studiedeltagarna. Hos den, säger professor Göran Bergström, i blodet se vilka som har en förhöjd individer med inlagringar, plack, i hals- huvudansvarig för den studie som fått risk för hjärt-kärlsjukdom. De per- kärlen görs ytterligare en undersökning namnet Swedish CArdioPulmonary sonerna undersöks i nästa steg med med magnetkamera. bioImage Study, SCAPIS. Studien, som en CT-kamera. Slutligen kombineras – Genom undersökningarna lär vi oss har initierats och planerats av svenska informationen från blodprovet med mer om placken i halskärlen, vilket är forskare, drivs av Hjärt-Lungfonden informationen från CT-kameran och då viktigt med tanke på att instabila hals- och blir fullt utbyggd Sveriges hittills ser vi vilka som tillhör högriskgruppen, kärlsplack är en vanlig orsak till stroke, största befolkningsstudie inom områ- berättar Göran Bergström. säger Göran Bergström. det hjärta, kärl och lunga. Deltagarna i Om man får detta att fungera skulle till Ett annat fokus för SCAPIS är över- studien lämnar blodprover, genomgår exempel många av de som i dag drabbas vikt och fetma. av hjärtstopp utanför sjukhus kunna räd- – Vi vet att fetma, det vill säga BMI das till livet. De drabbade vet i allmänhet över 30, utgör en riskfaktor för hjärt- JUBILEUMSGÅVOR inte att de löper risk för en dödlig hjärt- kärlsjukdom, men hur ser det ut vid händelse – i dag är själva hjärtstoppet övervikt och måttlig fetma? Här kan TILL SCAPIS det första symptomet på sjukdomen. bildtekniken bli till
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