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Prof. Dr. med. Thomas Daikeler

Department of Clinical Research
Profiles & Affiliations

Focus of research

-Diagnostic and disease activity assessment in primary vasculitis and polymyalgia with focus on quantitative imaging and biomarker. and treatment outcomes

We have a large longitudinal local cohort of GCA patients at our institution. An important focus is on diagnosis of giant cell arteritis (GCA). We developed, the now internationally as new diagnostic standard accepted ultrasound (US) compression sign of the temporal artery for GCA. We are longitudinally studying vessel imaging.I am interested in the differential diagnoses of polymyalgia treatment and outcome measures. We work on the first national Swiss cohort for GCA and PMR patients, which had been implemented within the SCQM in 2020. 


-Young patients with rheumatic diseases in between pediatric and adult care.

About 50% of children with a rheumatological disease need further medical care in adulthood. Hence, these patients will experience a change from the pediatric to the adult healthcare setting. In addition to changing the medical care team, these adolescents need to assume responsibility for managing their illness in daily life, which so far had been done mainly by their parents. Crucial for a successful transition into adult healthcare is a well-planned transition built on an individual, structured management plan. Yet, the Swiss pediatric rheumatology clinics organize this transition process very diversely. There is no plan all clinics generally agree and adhere to.

Thus, the overall objectives and aims of the HEROES study https://www.ukbb.ch/en/research/research-groups/heroes-study.php is to develop, implement, and evaluate a transitional care program for adolescents and young adults with a rheumatic disease moving from pediatric to adult settings in Switzerland.

 

The HEROES study is a collaborative effort involving medical centers all over Switzerland, including Aarau, Basel, Bellinzona, Bern (n= 2), Chur, Lausanne, Luzern, Geneva, St. Gallen, Winterthur, and Zürich. 

All twelve pediatric rheumatology centers, along with the adult center they primarily transfer their patients to, will participate in the study.

Selected Projects & Collaborations

Project cover

Giant Cell Arteritis towards a molecular understanding of pathogenesis

Research Project  | 3 Project Members

Failure of the immune system to discriminate self from non-self can result in autoimmune disease. An integrative model suggests that the balance between auto-reactive T cells and so-called regulatory T cells (Tregs) dictates the likelihood to develop autoimmunity. We aim to test this hypothesis in patients with Giant cell arteritis (GCA), an autoimmune disease of the blood vessels. Both, IL-17 producing Th17 cells -that represent the prototype of auto-reactive effector T cells- and Tregs, have been linked to GCA pathogenesis. We will investigate, whether dysregulated Treg function contributes to disease pathogenesis, e.g. via insufficient suppression of auto-aggressive T-cells or by inducing a Th17 promoting cytokine milieu. Following antigenic stimulation, T effector cells expand clonally. T cell receptor (TCR) sequencing can be used to assess the clonal T cell repertoire. In chronic infections, certain cancers and autoimmune diseases, T cell clones have been identified that occur frequently and are shared between different patients affected with the same disease ('public T cell clones'). Little is known about the TCR repertoire in GCA. We hypothesize that clonally expanded T cells detect common vascular self-antigens in GCA, which should be reflected in a narrow TCR repertoire and the presence of public TCR. To test this hypothesis, we aim to define the TCR repertoire at the site of autoimmune inflammation in GCA, taking advantage of laser capture microdissection of infiltrating T cells, combined with an unbiased PCR approach. Using computational epitope prediction tools, the target antigen will then be further characterized. As a clinical application, identification of disease-specific TCR clonotypes in inflamed tissue would permit to track and characterize them in the peripheral blood, opening the possibility for highly specific biomarker-research.