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Linda Björkhem-Bergman's research group of Palliative Medicin

The overall aim of our research group is to find new pharmacological and non-pharmacological strategies to improve the quality of life in end-of-life patients.

We have a translational approach where we try to combine clinical trials with pre-clinical experiments for mechanistic studies. My main focus during recent years has been the role of Vitamin D in the immune system. In ongoing projects we study possible beneficial effects of Vitamin D supplementation to cancer patients to improve pain management, reduce the incidence of infections and improve the quality of life. We also have projects on immune function in end-of-life patients, studies on management of infections, projects on drug metabolism, different aspects of pharmacological treatments in palliative care including gender aspects. Our projects also involves the use of complementary treatments in palliative care and finally we perform studies on nutrition in end-of-life patients.

This research group was established at the Division of Clinical Geriatrics, NVS in January 2018. We have our clinical base at ASIH Stockholm Södra, (Advanced Medical Homecare and Hospice Ward). Our research questions are mainly based on clinical problems that we encounter in the every-day work at our Palliative unit.

Previously, we were a part of Peter Bergman´s research group at Division of Clinical Microbiology, Labmed, working in the field of immunology, vitamin D and infectious diseases, and we still have close collaborations in the experimental and translational parts of our projects.

Research group leader

Forskare

Linda Björkhem-Bergman

Enhet: Sektionen för klinisk geriatrik
E-post: Linda.Bjorkhem-Bergman@ki.se

Group members

Forskarstuderande

Helena Bergström

Enhet: Sektionen för klinisk geriatrik
E-post: helena.bergstrom.1@ki.se

Forskarstuderande

Maria Helde Frankling

Enhet: Sektionen för klinisk geriatrik
E-post: maria.helde.frankling@ki.se

Associated members

Collaborations

Assoc Professor Peter Bergman's group at Div of Clinical Microbiology, LABMED, KI: This is our former research group and we still have close collaborations in many projects. Peter Bergman´s research group works with translational research in the field of vitamin D and the Immune system and we carry out several research projects together.

PhD, MD Jenny Bergqvist: Clinical studies on vitamin D treatment to patients with advanced cancer disease. JB is co-supervisor to PhD-student Maria Helde-Frankling.

Assoc Prof Lena Ektröm's research group at Div of Clinical Pharmacology, LABMED, KI: Projects on drug metabolism, how genetic polymorphism affects the effect and metabolism of vitamin D, other pharmacological projects in pre-clinical and clinical settings. LE is co-supervisor to PhD-student Helena Bergström.

Assoc Professor Annika Karlsson's research group at Div of Clinical Microbiology, LABMED, KI : Collaborations on projects of Immune response in end-of-life patients.

Professor Petter Brodin research group at Division of Pediatrics, Department of Women's and Children's Health: Collaborations on projects of Immune response in end-of-life patients.

Prof Ulf Diczfalusy, Div of Clinical Chemistry, LABMED, KI: Projects on drug metabolism with focus on endogenous CYP3A-activity markers and new methods for analysis of 25-hydroxyvitamin D.

Assoc Prof Thomas Gustafsson, Div of Clinical Physiology, LABMED, KI: Studies on Vitamin D receptor polymorphisms and how it affects muscular physiology and muscular pain during statin treatment.

Assoc Prof Ylva Trolle-Lagerros, Div of Medical Epidemiology and Biostatistics,Dept of Medicine; Studies on self-assessed body image in Cancer Patients. Studies on how corticosteroid treatment affects apetite, weight and muscular strength in Cancer Patients. I am co-supervisor to Ylva Trolle-Lagerros PhD-candidate Charlotte Goodrose-Flores, Nutritionist.

Research projects

Palliative D – a randomized, placebo- controlled, double blind clinical studies on vitamin D treatment to palliative cancer patients
The primary objective of the ‘Palliative-D’-study is to test the hypothesis that vitamin D supplementation for 12 weeks reduces pain, measured as decline in opioid consumption. The secondary objectives are to study if vitamin D treatment reduces infections and fatigue as well as improvement in quality of life (QoL). 254 patients with advanced cancer disease admitted to ASIH and 25-hydroxyvitamin D < 50 nmol/L will be randomized to vitamin D 4000 IE/day or placebo for 12 weeks. Measurements at baseline, after 4,8 and 12 weeks includes opioid dose, antibiotic consumption, self-assessed QoL and symptom burden is measured. Blood samples are drawn at all 4 time-points and samples for biobanking are stored.

The function of the Immune system in the end-of-life patient
How is the function of the Immune system in end-of-life patients? How is the T-cell activity and bacterial killing capacity in blood? How is the effect of antibiotic treatment in the dying patient? Can markers for an exhausted immune system predict survival? Does vitamin D status affect the immune respons and the effect of antibiotics?

Drug prescription and drug metabolism in palliative patients
When are treatment with preventive cardiovascular medications in cancer-patients terminated? Are there any gender-differences? How does it affect the quality of life and comorbidity of cancer patients?
How is the drug-metabolism and capacity to eliminate drugs in end-of.life patients?

Complementary treatments in Palliative Medicin
How do tactile massage and yoga or other complementary “mind-body” treatments affects the quality of life and symptom burden in palliative patients?

Subcutaneous Venous Access Ports Infections
Infections in Subcutaneous Venous Access Ports is a recurrent problem in cancer-patients. In a clinical trial we evaluate two different strategies of Vancomycin treatment of these infections.

Nutrition in palliative cancer care
Patients with advanced cancer disease often suffer from substantial weight loss. How does this weight loss affect the body image and QoL in cancer patients? Are there any gender-differences?
How does corticosteroid treatment affect weight and muscle strength in cancer patients? How can we optimize the nutrition for our cancer patients? How is the effect and side-effects of parenteral nutrition?

Research support

  • ALF Projekt-medel och ALF Högre Klinisk Forskartjänst
  • Swedish Cancer Society
  • Karolinska Institutet
  • ASIH Stockholm Södra

Selected publications

30342545
29931657
29102921
29057787
28904010
28859173
27657724
27608043
27084421
26423691