Junior Research Group Leader
Prof. Dr. med. Frederik Trinkmann
Diagnostic work-up for obstructive lung disease such as bronchial asthma or COPD are primarily based on spirometry and clinical history. However, these guideline-based criteria do not meet the challenges set by the complex pathophysiology of either disease in any way. Symptoms despite normal spirometry are common and can be easily attributed to early stages missed by spirometric parameters.
Hence, early detection and refined phenotyping will become increasingly important. This relates to different “treatable traits” like predominant obstruction, chronic bronchitis, subtypes of inflammation, emphysema or hyperinflation and may justify medication even in absence of airflow limitation. Despite differences in the underlying pathophysiology of asthma and COPD, this holds true for both diseases. Moreover, frequent comorbidities such as cardiovascular disease set further diagnostic and therapeutic challenges and need to be addressed by personalized strategies.
Most often, impairment of small airway function is a shared hall mark of the entities and associated with symptoms. Promising new techniques for their assessment are available and exceed the diagnostic capabilities of spirometry by far. These include multiple breath washout (MBW) testing having the potential to reveal global and local ventilation heterogeneity. Oscillometry can be used for the determination of peripheral airway obstruction. Using quantitative computed tomography (qCT) delivers important information on both structural and functional changes. A combination of these techniques with routine diagnostics such as body-plethysmography or transfer factor was shown to be capable of identifying different COPD phenotypes (Trinkmann et al. ATS 2019, OA2409). In bronchial asthma, an additional value in differentiation of asthmatic patients with normal spirometry from healthy controls was demonstrated (Trinkmann et al. ERS 2019, PA349). Increasing peripheral deposition of the same drug alone can decrease peripheral obstruction by 30% as measured with oscillometry. In contrast, no changes were seen in spirometry (Biddiscombe et al. ERS 2018, PA9759). These findings are not only relevant for early diagnostics but also therapy monitoring. The aim of our study group is to find and evaluate more sensitive endpoints which can be reasonably provided by a combination of the above mentioned techniques.
Projects
- Importance of small airway disease in COPD patients – CAPTO
- Structural lung changes in patients with acute and after COVID-19 - crownless
- Asthma Cohort - ALLIANCE
- National COPD Cohort - COSYCONET
- Evaluation of Face Masks in patients at risk and healthy probands - MaskBREATHING à Link
- Cardio-respiratory interaction
- Secondary use of clinical big data in asthma and COPD
Scientific Staff
Dr. med. Ann-Sophie Unterschemmann
Alexandra Reif, MD
Carola Schulz, MD
Doctoral Students
Gabrijel Rai, cand. med.
Trinkmann F, Maros M, Roth K, Hermanns A, Schäfer J, Gawlitza J, Saur J, Akin I, Borggrefe M, Herth FJF, Ganslandt T. Multiple breath washout (MBW) testing using sulfur hexafluoride: reference values and influence of anthropometric parameters. Thorax 2021 Feb 16:thoraxjnl-2020-214717. doi: 10.1136/thoraxjnl-2020-214717. Online ahead of print. PMID: 33593931
Trinkmann F, Müller M, Reif A, Kahn N, Kreuter M, Trudzinski F, Eichinger M, Heussel CP, Herth FJF; Lung Network Rhine-Neckar-Region (2021). Residual symptoms and lower lung function in patients recovering from SARS-CoV-2 infection. Eur Respir J. 2021 Jan 21:2003002. doi: 10.1183/13993003.03002-2020
Trinkmann F, Lenz SA, Schäfer J, Gawlitza J, Schroeter M, Gradinger T, Akin I, Borggrefe M, Ganslandt T, Saur J. Feasibility and clinical applications of multiple breath wash-out (MBW) testing using sulphur hexafluoride in adults with bronchial asthma. Sci Rep. 2020 Jan 30;10(1):1527. doi: 10.1038/s41598-020-58538-x. PMID: 32001782.
Trinkmann F, Watz H, Herth FJF. Why do we still cling to spirometry for assessing small airway function? Eur Respir J. 2020 Jul 2;56(1):2001071. doi: 10.1183/13993003.01071-2020. PMID: 32616553.
Abdo M, Watz H, Veith V, Kirsten AM, Biller H, Pedersen F, von Mutius E, Kopp MV, Hansen G, Waschki B, Rabe KF, Trinkmann F, Bahmer T. Small airway dysfunction as predictor and marker for clinical response to biological therapy in severe eosinophilic asthma: a longitudinal observational study. Respir Res. 2020 Oct 21;21(1):278. doi: 10.1186/s12931-020-01543-5. PMID: 33087134
Gawlitza J, Haubenreisser H, Henzler T, Akin I, Schönberg S, Borggrefe M, Trinkmann F. Finding the right spot: Where to measure airway parameters in patients with COPD. Eur J Radiol. 2018 Jul;104:87-93. doi: 10.1016/j.ejrad.2018.05.003. Epub 2018 May 4. PMID: 29857872.
Trinkmann F, Gawlitza J, Künstler M, Schäfer J, Schroeter M, Michels JD, Stach K, Dösch C, Saur J, Borggrefe M, Akin I. Small Airway Disease in Pulmonary Hypertension-Additional Diagnostic Value of Multiple Breath Washout and Impulse Oscillometry. J Clin Med. 2018 Dec 9;7(12):532. doi: 10.3390/jcm7120532. PMID: 30544842.
Trinkmann F, Müller M, Reif A, Kahn N, Kreuter M, Trudzinski F, Eichinger M, Heussel CP, Herth FJF. Residual symptoms and lower lung function in patients recovering from SARS-CoV-2 infection. Eur Respir J (in press)
Gawlitza J, Sturm T, Spohrer K, Henzler T, Akin I, Schönberg S, Borggrefe M, Haubenreisser H, Trinkmann F. Predicting Pulmonary Function Testing from Quantified Computed Tomography Using Machine Learning Algorithms in Patients with COPD. Diagnostics (Basel). 2019 Mar 21;9(1):33. doi: 10.3390/diagnostics9010033. PMID: 30901865.
Schumacher G, Kaden JJ, Trinkmann F. Multiple coupled resonances in the human vascular tree: refining the Westerhof model of the arterial system. J Appl Physiol (1985). 2018 Jan 1;124(1):131-139. doi: 10.1152/japplphysiol.00405.2017. PMID: 29025900.
Trinkmann F, Saur J, Borggrefe M, Akin I. Cardiovascular Comorbidities in Chronic Obstructive Pulmonary Disease (COPD)-Current Considerations for Clinical Practice. J Clin Med. 2019 Jan 10;8(1):69. doi: 10.3390/jcm8010069. PMID: 30634565.
Trinkmann F, Götzmann J, Saur D, Schroeter M, Roth K, Stach K, Borggrefe M, Saur J, Akin I, Michels JD. Multiple breath washout testing in adults with pulmonary disease and healthy controls - can fewer measurements eventually be more? BMC Pulm Med. 2017 Dec 11;17(1):185. doi: 10.1186/s12890-017-0543-y. PMID: 29228942.
Trinkmann F, Benck U, Halder J, Semmelweis A, Saur J, Borggrefe M, Akin I, Kaden JJ. Automated non-invasive central blood pressure measurements by oscillometric radial pulse wave analysis - results of the MEASURE-cBP validation studies. Am J Hypertens. 2020 Nov 3:hpaa174. doi: 10.1093/ajh/hpaa174. Epub ahead of print. PMID: 33140085.