Two young researchers receive SFO grants for studies of ALS and HPV vaccine

Lisen Arnheim Dahlström and Fang Fang at the Department of Medical Epidemiology and Biostatistics have received funding for two projects from SFO – funding for strategic research areas from Karolinska Institutet.

HPV vaccination

Lisen Arnheim Dahlström’s planned studies have both clinical and public health relevance, as they lay the scientific basis for guidelines, recommendations and clinical practice for HPV vaccination. The Human papilloma virus (HPV) vaccine has been available since 2006. In Sweden the vaccine was subsidized for girls age 13-17 until 2012 when HPV-vaccination became part of the school-vaccination program. In addition to protection against cervical cancer, one of the two existing HPV vaccines also offers protection against genital warts. The effectiveness of the HPV vaccine against genital warts has been studied in the Swedish population during the five first years after its introduction. However, genital warts are not caused by the same HPV types as those causing cervical cancer. Therefore, there is a need to also investigate vaccine effectiveness on other HPV related outcomes such as precancerous lesions of the cervix. Further, the continuous evaluation on vaccine safety is important to ensure an acceptable balance between benefits and risks with HPV vaccines and to maintain public trust in the vaccine program.

By using Swedish nationwide health care registers that can be linked on an individual level Lisen Arnheim Dahlström will:

1. Investigate the HPV vaccine effectiveness on HPV related high grade cervical lesions;
2. Study the HPV vaccine effectiveness on HPV related high grade cervical lesions by vaccine dose level and timing of doses;
3. Explore the HPV vaccine effectiveness on genital warts by vaccine dose level and timing of doses;
4. Investigate the safety of the HPV vaccine in the Danish and Swedish populations.

ALS etiology

Fang Fang hopes that her research efforts will improve our understanding of ALS etiology and consequently contribute to future treatment strategies for this devastating disease.

Amyotrophic lateral sclerosis (ALS) is the third most common neurodegenerative disease. Although relatively rare, ALS generally progresses very fast and has an average survival of 2-3 years after diagnosis. The only established risk factors are older age, male sex, and family history. Genetic studies have recently identified several important genetic variants responsible for increasing proportion of familial ALS cases. However, more than 90% of ALS patients have no clear family history and the overall genetic contribution to ALS etiology appears weak still. Therefore, a complex interplay among genetics, environmental exposures, and lifestyle factors is likely to be in place for ALS, especially sporadic ALS.

Long before genetic studies were available, various hypotheses had been proposed on ALS etiology, usually as a result of clinical observations. Among these, hypermetabolism, metals, inflammation, and elite athletics are of the greatest interest. Based on the unique research materials in Sweden, United States and a newly launched European ALS Consortium (STRENGTH), Fang Fang aims to investigate these tempting hypotheses in concert, rather than individually, with the goal of identifying their underlying common pathogenetic pathways. Specifically, there are four main research questions:

1. Hypermetabolism – a prodromal symptom or risk factor for ALS?
2. Higher concentrations of metals in ALS – epiphenomenon or causal relation?
3. Retrograde or anterograde degeneration of motor neurons in ALS – new evidence?
4. The myth of ALS among elite athletes – a synthesis of hypermetabolism, metals, inflammation and chronic traumatic encephalopathy?