Research Group Carina Mihai

SSc-related GI complications negatively impact most patients and may lead to significant dysfunction and death in severe cases. Our group recently published a retrospective longitudinal single-center study, where we determined that patients with SSc had significantly fewer severe GI symptoms after at least 6 months of exposure to immunosuppressive therapy (IST). Therefore, we aim to evaluate in the first prospective, multicentric observational study, if newly initiated IST may improve SSc-GI symptoms.

Gastrointestinal dysmotility is the most common visceral manifestation of SSc and can lead to serious complications and even death lead. While the involvement of the GI tract in SSc has already been analyzed in detail, little is known about its incidence of GI diseases are known over time. In this study on a large patient cohort we want to analyze the incidence of gastrointestinal manifestations by disease stage.

The risk of ischemic cardiovascular events in increased in patients with SSc. Endothelial dysfunction is a surrogate for increased cardiovascular risk. In a collaboration with the Heart Centre USZ, we are investigating endothelial function in patients with SSc by flow-stimulated vasodilation and retinal vessel analysis, aiming to evaluate if treatment with tocilizumab and, respectively, with nintedanib, improves endothelial function.

Cardiac magnetic resonance (CMR) is the non-invasive diagnostic modality of choice for SSc myocarditis and myocardial fibrosis. CMR also provides comprehensive information on ischaemic heart disease. In this cross-sectional study, we analyze CMR findings in a large cohort of patients with SSc from our center.

A definition of primary heart involvement (pHI) in SSc was recently developed (Bruni C et al. J Scleroderma Relat Disord. 2022;7:24-32).  In this longitudinal study, together with Dr. Cosimo Bruni, MD, PhD, we aim to evaluate the prognostic value of CMR-supported diagnosis of SSc-pHI in a real-life cohort of patients with SSc from our centre.

Analyzing the chemical composition of a patient’s exhaled breath by mass spectrometry can retrieve information on hundreds to thousands of volatile organic compounds. This technique is a promising tool to be used in discriminating patients with SSc-ILD from SSc patients without ILD. We also intend to study if it can discriminate progressive from stable SSc-ILD, in a prospective observational cohort, in collaboration with the Department of Pneumology of the USZ.