Education

Employment history 

Current ongoing institutional responsibilities

Research projects (currently running, O. Distler as PI or Co-PI)

Supervision of graduate students and postdoctoral fellows (Ongoing)

Research group leaders: PD Dr. Przemyslaw Blyszczuk, PD Dr. Astrid Jüngel, PD Dr. Gabriela Kania, PD Dr. Britta Maurer, Prof. Dr. Michel Neidhart, PD Dr. Caroline Ospelt.

Postdoctoral fellows: Dr. Mike Becker, Dr. Stefan Dudli, Dr. Mojca Frank-Bertoncelj, Dr. Suzana Jordan, Dr. Emmanuel Karouzakis, Dr. Kerstin Klein, Dr. Elena Pachera, Dr. Florian Renoux.

PhD Students: Ion-Alexander Garaiman

Students for Doctor of Medicine: Elisabeth Blaja, Alexandra Grob, Jasmin Hernandez, Simon Kuster, Dominic Moret, Michele Trussardi, Lucas Tschalèr, Kevin Windirsch, Anja Wyss, Norina Zampatti.

Master students: Nina Hofmann, Noah Schweizer

Teaching activities (irregular lectures not listed)

• Clinical examination course (MeF): Internal Medicine, 8 hours per year
• Human biology block course (MNF): Pathophysiology and molecular biology of vegetative systems, 2 x 1.5 weeks/year
• Basic clinical lecture series (MeF): Infectious diseases and immunology, 2 hours front lectures per year
• Advanced clinical lecture series (MeF): Differential diagnosis of the musculoskeletal system – Rheumatology, 8 hours front lectures/year
• Basic clinical lecture series (ETH): 5 lectures/year

Reviewing activities (only major journals and institutions listed)

Ad hoc reviewer for all major Rheumatology journals (including the leading journals ARD, A&R, Lancet Rheumatology), for journals from General Internal Medicine and other fields (including NEJM and Lancet), different national and international funding agencies (including e.g. DFG), different foundations (including Pfizer Foundation, Hartmann Müller Foundation) and frequent abstract reviewer for the large international congresses in Rheumatology (including EULAR, ACR, Scleroderma World Congress). Editorial board member of Lancet Rheumatology and Annals of the Rheumatic Diseases (ARD).

Prizes and awards (last 5 years)

11/2019 Cloëtta-Award 2019, Foundation of Prof. Dr. Max Cloëtta

Organization of major scientific meetings

• Steering committee of the bi-annual Systemic Sclerosis World Congress since 2010
• Advisory board for the annual European Workshop of Rheumatology Research (EWRR) since 2011
• Program committee of the annual European League against Rheumatism (EULAR) 2012-2014
• President annual Meeting of the Swiss Society of Rheumatology (SGR) 2014-2018
• Program committee of the EUSTAR educational course on systemic sclerosis since 2015

Membership in scientific societies

Major scientific achievements

Our research focus is on systemic sclerosis (SSc), which is a difficult to treat chronic autoimmune disease with high morbidity and mortality. Skin fibrosis is the hallmark of this disease. Our research program spans from a preclinical program focusing on the identification and characterization of key molecules and intracellular signaling cascades that are driving the disease process to a translational and clinical program with emphasis on precision medicine and phase 2/3 clinical trial design. Our Center has been awarded a EULAR Center of Excellence due to the scientific achievements.

In our preclinical program, we could show that signaling via the Serotonin receptor 2b on fibroblasts is a key mechanism to promote fibrosis in a TGF-b dependent manner in vitro, but also in different animal models of skin fibrosis in vivo (Dees et al, 2011). These promising results led us to perform a proof of concept clinical study in patients with SSc using biomarkers as the primary endpoint. In the investigator-initiated study, we found strong effects on key features of fibrosis confirming the animal studies (Distler et al, paper in preparation). In collaboration with industry, we are now designing a state of the art phase 2b registration study.

Another focus in the laboratory are epigenetics and non-coding RNAs. In SSc, we have focused on miRNAs as a class of non-coding RNAs. We were the first to show that miR-29 is down-regulated in SSc by TGF-β, PDGF-B, and IL-4 and directly contributes to fibrosis by targeting collagen mRNA (Maurer et al, 2010). This resulted in a patent filed for the use of miR-29 in scleroderma. Furthermore, we have characterized additional miRNAs such as miR-193b, miR125b and miR-145 as important posttranscriptional regulators in SSc contributing to diverse pathophysiological processes like vasculopathy and fibrosis (Iwamoto et al 2014, Kozlova et al, 2019, Vettori et al, manuscript submitted). Recently, we have identified the novel long non-coding RNA H19X as a key mediator of TGFb profibrotic effects in a variety of fibrotic conditions. Knock-down of H19X completely prevented the profibrotic effects of TGFb. RNA Sequencing and ChiRP-Seq showed that these effects are mediated by steric interaction of H19X with the gene DDIT4L, which is a newly identified collagen inhibitory factor (Pachera et al, manuscript submitted).

Our laboratory has been centrally involved in the identification and characterization of animal models of SSc. For example, there was until recently no animal model available that resembled the vascular changes in human SSc. The further characterization and validation of the Fra-2 tg mice by our groups enabled the use of this animal model as a preclinical model for the vascular (and fibrotic) manifestations of SSc, and it is now one of the most frequently used preclinical model for SSc. We could show that these mice develop skin fibrosis likely mediated by initial apoptosis of endothelial cells, and that the vascular lesions largely resembles finding observed in human SSc tissues (Maurer et al, 2009; Maurer et al, 2012). In addition, we showed that VEGF tg mice develop skin fibrosis in a dose-dependent manner and are more susceptible to inducible models of fibrosis than control wt mice (Maurer et al, 2014).

Translational of our findings into potential clinical applications has always been a focus of our research. We had observed that some of our targets for intervention showed promising results in the animal models, but did not show effects in human proof of concept studies. Using the example of tyrosine kinase inhibitors (Distler, 2007), we could show that the anti-fibrotic effects were strongly depending on the level of activation of the targets, and that in the human disease target activation was often much lower than in the used animal models (Maurer et al, 2013). This lead to change in the use of animal models in preclinical characterization and to updated recommendations how to use animal models in SSc (Jordan et al, 2013). It also highlighted the importance of precision medicine in this disease and led to the development of a molecular imaging program. In this Sinergia funded program, we could show that molecular imaging using SPECT or PET/CT in mouse models of SSc allows individual identification of activated pathway involving folate receptor beta (FR-β) and integrin avβ3, paving the way for precision medicine approached against these pathways (Schniering et al, 2019).

Finally, our group has contributed to the optimization of clinical trial design leading to changes in the way clinical trials are conducted in SSc. Specifically, we could show that in randomized clinical trials targeting skin fibrosis, a lower extent of skin fibrosis is necessary to enrich the trial for patients with progressive skin fibrosis (Maurer et al 2015; Dobrota et al, 2016). We also provided a core et of variables for enrichment of patients that show progression of the overall disease and specific organ involvements (Becker et al 2019) and factors to identify patients with progressive interstitial lung disease (ILD) in the early, mild phase of the disease (Wu et al, 2018). These and other findings contributed to the design of a very large international randomized placebo-controlled trial with the multi-tyrosine kinase inhibitor nintedanib for SSc-ILD. It could be shown that nintedanib significantly slows the progression of SSc-ILD over placebo (Distler et al, 2019). These results led to the first FDA approved targeted therapy for SSc-associated interstitial lung disease (ILD).