Annika Bergquist group

Our research is centered around autoimmune liver disease in particular primary sclerosing cholangitis (PSC) and bile duct cancer.

Primary sclerosing cholangitis, also known as PSC is an uncommon disease of the bile duct. PSC is characterized by inflammation of intra and extra hepatic bile ducts with close association to inflammatory bowel disease (IBD) and a high risk of development of biliary malignancy.   

We focus our studies on the increased risk of malignancy in PSC in the colon and the liver. In detail, we search for and evaluate new diagnostic tools and early markers for disease progression, prognosis, malignancy, chemoprevention as well as treatment issues.

Our large cohort of patients of this rare disease provides good opportunities to perform epidemiological, clinical and translational research. We participate in the national study group for liver diseases (SWEHEP) and in the International PSC Study Group (IPSCSG) network. We also have a close collaboration with the Norwegian PSC Research Center.

Key words:

Primary sclerosing cholangitis, cholangiocarcinoma, colorectal cancer, biomarkers

Ongoing projects

PiSCATIN – Simvastatin treatment for PSC – a randomized controlled trial 

We are conducting a study with simvastatin 40 mg and placebo in patients with PSC. The hypothesis is based on a register study where PSC patients that were exposed to statins had a reduced risk (by half) for liver transplantation and death. The PiSCATIN study is planned to start in spring 2020. The study will include 700 patients treated for 5 years. All patients with a verified PSC diagnosis can participate. The primary outcome measures are transplantation, death, cholangiocarcinoma or variceal bleed. The study is registered at clinicaltrials.gov; NCT04133792. 

New diagnostic and prognostic markers in PSC and cholangiocarcinoma 

Researcher/project manager: Martin Cornillet-Jeannin

Cancer risk in PSC 

Researcher: Aiva Lundberg Båve

A register based study on over all cancer risk in patients with PSC in Sweden, compared to controls from the general population.

Autoimmune and immune mediated disease in patients with PSC and their relatives compared to matched controls

Researcher: Aiva Lundberg Båve

Evaluating comorbidity with autoimmune disease and if autoimmune load can affect prognosis of PSC.

Skandinaviska PSC biobanken (The Scandinavian PSC Biobank)

Project manager: Lina Lindström Älgå

The PSC biobank is an international collaboration between Rikshospitalet in Oslo and Karolinska University Hospital. The aim is to include 1300 PSC patients and prospectively collect clinical and biological data, with the main goal to increase the knowledge on disease outcome in terms of cancer, death, and need for liver transplantation. The sampling includes clinical data in an eCRF as well as extensive biological sampling including serum, saliva, feces, and also bile, bile duct sampling, liver and colonic biopsies.

Primary sclerosing cholangitis (PSC) explained:

Group leader

Annika Bergquist

MD, PhD, principal investigator

Annika Bergquist is a adjunct professor since 2013 and research group leader. She received her PhD from the Karolinska Institutet in 2001 with the thesis “Cholangiocarcinoma in PSC”. Her clinical work is being a consultant in Hepatology at the Karolinska University Hospital since 2007 taking care of patients with chronic liver diseases including PSC before liver transplantation. She is the Chair of the national research network for liver disease SWEHEP (www.swehep.se) and member of the steering committee of Internations PSC Study Group (IPSCSG). The research focus is on clinical studies and biomarkers in PSC.

Group members

Aiva Lundberg Båve

MD, PhD-student

Aiva was appointed specialist in Internal Medicine in 2014 and appointed specialist in Gastroenterology and Hepatology in 2016. Her clinical work is 50 % at the IBD and general gastroenterology clinic and 50 % at the hepatology clinic. Aiva was registered as a PhD student in May 2018. She was awarded top 5 abstract prize at UEGW 2019. Aiva is interested and engaged in educational questions. She is responsible for medical students on clinical rotation and in implementing Team Based Learning as a pedagogical tool for education of medical students. When not at work Aiva enjoys jogging, yoga, gardening, literature and theatre.

Alexander Waldthaler

MD

Amanda Klein

PhD, Research coordinator

Amanda has a Master of Science in Molecular Biology and her PhD-work focused on fat cell metabolism in lean and obese state. She did her postdoctoral training in a muscle physiology group developing a cell-based platform to screen for activators of PGC-1alpha1. Amanda works as a project coordinator in the group and is currently developing an eCRF for the PiSCATIN study. In her spare time Amanda enjoys running, yoga and vintage shopping. 

Ann-Charlotte Elkan

PhD, Research nurse

Ann-Charlotte received her PhD in rheumatology at Karolinska Institutet 2009. She completed postdoctoral training, at the Institute of Environmental Medicine (IMM), Karolinska Institutet, where she was studying the impact of life style factors in developing rheumatic diseases 2011. She was also the initiator/manager and coordinator for a lifestyle clinic at the Dept. of Rheumatology, Karolinska University Hospital, 2011-2012. Ann-Charlotte is coordinating and managing the research conducted at the Gastro Center, Karolinska University Hospital.

Aristeidis Grigoriadis

MD, PhD-student

Aris is a consultant radiologist at Karolinska University hospital and has been Head of the Magnetic Resonance Imaging (MRI) Department at Huddinge since 2013. He is a PhD student at Karolinska Institutet since 2017 and his research focuses on standardization of MRI evaluation and validation of MRI as a diagnostic and prognostic tool in patients with PSC. 

Birgitta von Wachenfeldt Kilander

Research nurse

Charlotte Hedin

MD, PhD, senior researcher

Dr Charlotte Hedin is a specialist in gastroenterology and internal medicine at the Karolinska University Hospital. She completed her PhD "Microbial, immunological, phenotypic and genetic markers of risk: aspects of Crohn’s disease that are shared by unaffected siblings" at King’s College London and Queen Mary University of London. In 2017 she was awarded a UEG Rising Star award for her research in IBD and in 2018 she was awarded the Karolina prize for “Exemplary patient flow and quality work” at the Karolinska Hospital. She holds a clinical post-doctorate from the Karolinska Hospital. She is a member of the Swedish Organisation for the study of IBD and is committee member for the European Crohn’s and Colitis Organisation. Charlotte’s research focusses on: 1. Extraintestinal inflammation in IBD including PSC, 2. Delineating pathogenic pathways in IBD through studying at-risk individuals (families of IBD patients) and 3. Defining the process of mucosal healing.

 

Christina Villard

MD, PhD, postdoctoral researcher

Christina Villard is a MD working at the Department of Transplantation, Karolinska University Hospital. She finished her PhD in 2011, on gender differences in abdominal aortic aneurysms, while doing her surgeon specialization training at the Department of Vascular Surgery. Previous research has focused on colorectal liver metastases, as Christina has until recently been working as a surgeon at the Department of Cancer, Divison of Upper GI.

Erik von Seth

MD, PhD, postdoctoral researcher

Erik von Seth was appointed specialist in internal medicine in 2019 and now in training for specialization in gastroenterology and hepatology. He defended his thesis in 2018 which focused on ERCP and diagnostic methods of cholangiocarcinoma in PSC. Erik is investigating cancer risk, new methods to improve detection of malignant and pre-malignant lesions in the biliary tree and immunological aspects of bile duct inflammation in PSC.

Ghada Nouairia

Engineer, PhD, Postdoc researcher

Ghada has a PhD in molecular genetics since 2018 (Carthage University, Tunisia). Driven by curiosity, she moved to explore molecular evolution as a computational biologist in Stockholm University. Now she redirected her skills to the exciting field of clinical research with focus on multiomics data analysis of PSC.

Ghada is an eager reader of science, psychology, history, politics and much more!

Lina Lindström Älgå

MD, PhD, postdoctoral researcher

Lina is a MD specialized in gastroenterology. She finished her PhD in 2012 with main focus on IBD in PSC patients. She is currently training to be a transplant hepatologist at the department of transplantation and coordinating the PSC biobank. In her spare time she spends time with her children but dreams of writing more poetry. 

Linda Nordström

Biomedical scientist

Mari Hult

MD, PhD, researcher

Martin Cornillet-Jeannin

Engineer, PhD, Researcher Coordinator

Martin finished his PhD in 2014 focused on autoantibodies in Rheumatoid arthritis (Toulouse, France). He is now studying immunology of liver diseases, with a specific interest in the pathophysiology and prognosis of Primary Sclerosing Cholangitis (PSC). He likes cooking, practicing sports (karate, tennis, football) and is interested in art and music discovering.

Sirje Laur

Research nurse

Sirje is a research nurse currently working with PSC patients in Annika Bergquist Group. She graduated with BSc degree in nursing in 2008 and is experienced in medical and surgical nursing. Sirje is trained in Good Clinical Practice and Clinical Trial in Medicine at University of Gothenburg.

She has previously coordinated the care of liver patients throughout the pretransplant process. As a member of the national bord of HCC (hepatocellular cancer) medical program she contributes to nursing aspects of the program.

As a member of hepatology nursing team at Karolinska University Hospital Sirje has an interest in developing hepatology nursing to improve patient experience and advanced care planning. She is also dedicated to improve health education of patients and their families to increase knowledge and understanding of the liver disease.

Susanne Bouiche

Research nurse

Collaborations

Caroline Nordenvall

Affiliated to research
Colorectal Surgery
K1 Department of Molecular Medicine and Surgery

Niklas Björkström

Principal researcher

Selected publications

Statin Use Is Associated With Improved Outcomes of Patients With Primary Sclerosing Cholangitis.
Stokkeland K, Höijer J, Bottai M, Söderberg-Löfdal K, Bergquist A
Clin. Gastroenterol. Hepatol. 2019 Aug;17(9):1860-1866.e1

Genomic characterization of cholangiocarcinoma in primary sclerosing cholangitis reveals novel therapeutic opportunities.
Goeppert B, Folseraas T, Roessler S, Kloor M, Volckmar AL, Endris V, et al
Hepatology 2020 Jan;():

Diagnostic performance of a stepwise cytological algorithm for biliary malignancy in primary sclerosing cholangitis.
von Seth E, Ouchterlony H, Dobra K, Hjerpe A, Arnelo U, Haas S, et al
Liver Int. 2019 02;39(2):382-388

Association between reduced levels of alkaline phosphatase and survival times of patients with primary sclerosing cholangitis.
Lindström L, Hultcrantz R, Boberg KM, Friis-Liby I, Bergquist A
Clin. Gastroenterol. Hepatol. 2013 Jul;11(7):841-6

Increased risk of primary sclerosing cholangitis and ulcerative colitis in first-degree relatives of patients with primary sclerosing cholangitis.
Bergquist A, Montgomery SM, Bahmanyar S, Olsson R, Danielsson A, Lindgren S, et al
Clin. Gastroenterol. Hepatol. 2008 Aug;6(8):939-43