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Luxembourg Institute of Health - Annual Report 2021

Please note: All photos in which social distancing and other preventive measures are not adhered to were taken during a period when government restrictions on COVID-19 were lifted and new guidance was released.

Foreword

message from the CEO

message from the president

Our mission & vision

Our mission is to leverage knowledge and technology arising from research on patient derived data, with the aim of having a direct and meaningful impact on people’s health.

Our vision is to become a leading European institute for precision medicine and precision health, transforming research excellence into tangible benefits for patients, with the long-term goal of preventing diseases.

Discover our institute

LIH renews commitment to COVID-19 research

COVID-19: Mass screening reveals significant transmission risk from asymptomatic carriers

After nearly two years, the COVID-19 pandemic remains a public health emergency. Despite the employment of public health measures, such as restriction of movements and gatherings, personal protection, as well as massive vaccination campaigns, the coronavirus is still largely affecting the mortality and morbidity worldwide, including persisting symptoms after the infection.

Ever since its conception, large-scale testing for SARS-CoV-2 has been a topic of intense political and societal debate, with particular scrutiny placed on the rationale behind screening asymptomatic individuals. Nevertheless, the questionable role played by asymptomatic carriers remains an essential variable in population-based transmission and needs to be addressed.

In May 2020, Luxembourg became one of the first countries to implement a large-scale testing programme, offering all of its residents and cross-border workers the opportunity to receive regular free testing on a voluntary basis. The first phase of testing ran from 27 May until 15 September 2020, covering 49% of the resident and 22% of the cross-border worker populations, subsequently enabling the detection of 26% of all positive cases of the epidemic’s first wave. This provided decision makers with evidence-based data, helping to break infection chains early and slash total case numbers by as much as 43%, based on the results of computer simulations.

Predi-COVID extended to children

As the COVID-19 pandemic continues into its third year, the LIH continues to strive to help mitigate its societal impacts and improve patient outcomes through its ongoing research and innovation.

Originally launched in April 2020 with the aim of identifying risk factors and biomarkers associated with COVID-19 severity in the adult population, Predi-COVID (“Luxembourg cohort of positive patients for COVID-19: a stratification study to predict severe prognosis”) has now officially been extended to children. This will serve to elucidate risk factors for COVID-19 severity in the younger population.

Current research around COVID-19 has so far predominantly focused on disease evolution and treatment in adults, due to the higher incidence, severity and mortality observed. Although children typically develop the asymptomatic or milder variants of COVID-19, recent evidence suggests that the SARS-CoV-2 virus may be involved in the onset of more severe manifestations, leading for instance to multiple organ inflammation and failure (Pediatric Inflammatory Multisystem Syndrome) and even cardiac complications, such as myocarditis and coronary artery dilations as in Kawasaki disease. The aim of the paediatric extension of Predi-COVID is therefore to identify such factors and define the clinical, biological and microbiological characteristics of COVID-19 in younger patients.

LIH contributes to international COVID-19 research

With its ongoing study Predi-COVID, the Luxembourg Institute of Health (LIH) is adding to its existing efforts to combat COVID-19 by joining the international unCoVer network. This collaboration will create an international, harmonised real-world data bank to better understand the pathophysiology, progression and treatment, as well as epidemiological pattern of this disease.

The unCoVer (Unravelling data for rapid evidence based response to COVID-19) network includes 29 partners from 18 countries, who have been collecting COVID-19 patient information during the pandemic. Among these, LIH researchers from the Department of Precision Health and the Translational Medicine Operations Hub will contribute data from the Predi-COVID study.

Real-world data such as those gathered in the unCoVer project are critical to understand and respond to the pandemic, and include, for example, patient characteristics and risk factors, or information on treatment efficacy. The unCoVer approach captures and collects these data in a standardised format, unifying otherwise scattered datasets whilst maintaining patient anonymity across countries.

CON-VINCE study enters homestretch

As a member of the global community dealing with the COVID-19 pandemic, Luxembourg has been uniquely placed in its ability to monitor and record the disease in a significant fraction of its population. This continues to be a major asset that allows researchers at the LIH to improve understanding of the disease at both the local and global scales.

Originally launched in April 2020 under the aegis of the Research Luxembourg COVID-19 Taskforce, the CON-VINCE study aims to evaluate the prevalence and dynamics of the spread of COVID-19 within the Luxembourgish population, with a specific focus on asymptomatic and mildly symptomatic (oligosymptomatic) individuals. In order to identify this target group, a panel of over 1,800 individuals, representative of the Luxembourgish population, was tested for the presence of the SARS-CoV-2 virus and monitored over 12 months through a series of follow-up visits.

The last round of testing of the CON-VINCE participants commenced in April 2021, approximately one year after the first set of visits upon inclusion in the study. The data obtained from this final wave will provide a comprehensive insight into the evolution and transmission of the disease over an extended timeframe, particularly from an immunity perspective.

From CON-VINCE to ORCHESTRA

Despite the CON-VINCE study being brought to its final conclusion, researchers at the LIH are always aiming to take their role one step further in the fight against COVID-19. Now, in the footsteps of its predecessor, ORCHESTRA Luxembourg builds on this work to follow the immune response to COVID-19 vaccination over time and to provide evidence for the prevention and treatment of infections caused by SARS-CoV-2.

Led by the Research Luxembourg COVID-19 Taskforce, the CON-VINCE project provided essential data about many aspects of the pandemic in Luxembourg to scientists all over Europe. These included the progression of the infection while confinement measures were in place and the evolution of antibodies in the population following SARS-CoV-2 infection and vaccination. Furthermore, the information collected during the study will continue to help answer questions on immune response, infection pathways, genetic predisposition, mental well-being and the socio-economic impact of COVID-19.

Building on the data and information acquired from CON-VINCE, the European ORCHESTRA (Connecting European Cohorts to Increase Common and Effective Response to SARS-CoV-2 Pandemic) project was launched with the aim to further evaluate the long-term consequences of COVID-19 in the general population, with a focus on post-vaccination monitoring of participants, and the mid-to-long-term psychosocial impact of the pandemic on Luxembourg residents. The consortium is a major initiative, involving 26 partners from 15 countries, which is funded under the European Commission Horizon 2020 “ERAvsCORONA Action Plan”.

Developments in precision health at the core of LIH activities

LIH appoints new Director of the Department of Precision Health

The world of healthcare is constantly evolving but never more so than in recent decades with the meteoric rise in digital technologies. In a move to strengthen its digital health and artificial intelligence axis at the start of the year, the LIH moved to appoint Dr Guy Fagherazzi as the new head of its Department of Precision Health (DoPH). His appointment will further deepen the integration of digital data and Artificial Intelligence (AI) within the department’s and the institute’s research activities.

Dr Fagherazzi first joined LIH in June 2019 as Research Leader of the Digital Epidemiology and e-Health hub, having subsequently been appointed Group Leader of the newly established Deep Digital Phenotyping Research Unit. In these positions, he has started developing a transversal priority research axis around the topics of digital epidemiology, with the aim of strengthening the digital capacity of the department’s research groups, ultimately contributing to the creation of new and innovative public health solutions.

Dr Guy Fagherazzi
"I am deeply honoured to have taken on this new position and would like to take this opportunity to thank my predecessor, Prof Laetitia Huiart, for her remarkable work over the past three years. I am looking forward to reinforcing the collaborative work between DoPH and the other LIH departments, in line with the institute’s transversal and translational strategy, as well as continuing developing a relationship of trust with our national stakeholders and international partners” Dr Fagherazzi

New FNR PEARL Chair: Prof Dr Klucken bringing digitalisation to every-day patient care

In order to help guide the fast-paced world of healthcare digitalisation, the LIH is always searching for answers regarding how digital tools can be integrated into healthcare processes, and how data should be visualised to personalise patient care. These are only two of many questions that new FNR PEARL Chair Professor Dr Jochen Klucken began analysing from the middle of last year and will continue to examine over the coming four. Supported by the 3.3 MEUR grant, Prof Dr Klucken will develop digital health concepts for Luxembourg through a joint research programme involving the LIH, the Luxembourg Centre for Systems Biomedicine (LCSB) of the University of Luxembourg and the Centre Hospitalier de Luxembourg (CHL).

Data-driven medicine and innovative digital tools are on the verge of complementing existing healthcare procedures and change the way patients, healthcare providers, and researchers will work together in the near future. New digital patient-centred healthcare services will address the patients’ needs, continuously monitor and accompany individual patient journeys, and support healthcare providers in making clinical decisions. Real-life healthcare data will become available, and thus, add value. Its application in medicine has an enormous potential to reduce disease burden, improve healthcare and generate new solutions and services.

Professor Dr Jochen Klucken

The international Colive Voice study kicks off

In line with its drive to excel in the field of digital health, the end of June saw the LIH announce the launch of Colive Voice, a first-of-its kind digital health study that aims to advance the diagnosis, risk prediction and remote monitoring of various chronic conditions and symptoms by evaluating voice features.

Human voice is a powerful communication medium that conveys feelings and emotions, but that can also immediately reflect the changes in an individual’s health. This notion, coupled with the widespread adoption of digital tools and artificial intelligence in healthcare, makes a case for the use of voice-based technologies for diagnostic and medical purposes. Vocal biomarkers could soon be used in various contexts such as telemedicine purposes, telemonitoring of patients between clinical visits or to assess the effectiveness of a drug in a clinical trial. To this end, audio, clinical, epidemiological data and patient-reported outcomes need to be collected simultaneously and systematically via well-structured methodologies.

Enabling precision cardiometabolic disease prevention through artificial intelligence

The rapid increase in the incidence of cardiometabolic conditions, such as type 2 diabetes and hypertension, urgently calls for better prevention strategies, moving from a one-size-fits-all to a precision approach in the general population. As leaders in the field of research into digital and personalised healthcare, the LIH is utilising cutting edge technologies to navigate the deep complexity of this task.

One of the biggest problems regarding precision care in cardiometabolic disease, is the high variability observed in individuals in terms of genetic profiles, inflammation, oxidative stress, insulin resistance and sugar levels, and how all these variables relate to the ensuing risk of developing cardiometabolic disorders. In this context, artificial intelligence and machine-learning approaches can prove to be very valuable.

In August, researchers from the LIH Department of Precision Health (DoPH) and from the LIH Quantitative biology Unit (QBU) leveraged advanced artificial intelligence and machine-learning approaches to classify a sample of individuals representative of the Luxembourgish population into distinct risk groups, paving the way towards more targeted strategies for the prevention of cardiometabolic diseases at a population level.

Dietary fiber determines predisposition to foodborne enteric pathogens

The gut microbiome is a hot topic in the world of biomedical research, providing a whole new perspective on the intimate relationship between our bodies and our health. Just one aspect of this has been understanding the relationship between diet and health, a subject under intense scrutiny by researchers at the LIH.

Despite step by step improvements in global food safety, infections with foodborne human enteric pathogens, such as Listeria monocytogenes and Salmonella Typhimurium, still cause large numbers of hospitalisations and fatalities every year. It turns out that some small but specific changes in diet might be a powerful solution, along with a helping hand from our personal microbial armies.

In a study published in November, Prof Mahesh Desai, Leader of the Eco-Immunology and Microbiome research group at DII, looked at the impact of dietary fibre on the susceptibility of mice to Listeria and Salmonella. They found that depriving mice of dietary fiber protected them from infections with these pathogens compared to mice fed a standard diet.

An apple a day: Could diet be used to manage autoimmune diseases?

Autoimmune diseases, such as multiple sclerosis, rheumatoid arthritis and inflammatory bowel disease are a hallmark of many modern societies. While existing autoimmune disease therapies do not consider the influence of the gut microbiome in pathogenesis, researchers from the Eco-Immunology and Microbiome research group at the LIH have been looking to explore this in a collaboration with the US University of Michigan Medical School (UMMS).

Autoimmune diseases are characterised by an immune system that erroneously attacks the healthy host cells. In the past decades, the incidence of autoimmune diseases has risen sharply and, while their rate is plateauing in industrialized countries, newly industrialised nations are experiencing a similar rise in new cases. These patterns highlight their growing public health burden globally as well as the important role of the non-genetic factors in triggering autoimmune disease.

Novel game-changing insights in the field of cancer research

A National Center for Translational Cancer Research

As our technologies and understanding of disease and the human body continue to grow, the global healthcare community has never been better equipped to tackle some of the most challenging health issues that we have ever faced. Beating cancer remains one of the toughest endeavors ever undertaken in biomedical research, and the LIH continues to play its part, driving initiatives focused on patient-centric translational research.

As a major addition to its cancer research strategy, in July the LIH announced its coordinating role in a new National Centre for Translational Cancer Research (NCTCR). This initiative of the Plan National Cancer-2 (PNC2), aims to foster patient-oriented cancer research in Luxembourg and provide access to clinical studies and innovative treatments to patients.

Having already received seed funding by the FNR, the project will officially commenced in late April 2022, bringing together the various stakeholders throughout oncology (medical doctors, care providers, researchers, patient-support groups…), to consolidate the consortium and to collect ideas for the future.

Hijacking DNA repair to overcome resistance to anti-cancer therapy

How do you treat a disease that can evolve to survive even the most sophisticated therapies? This is just one of the many challenges faced by LIH researchers working to understand some of the most dangerous types of cancer out there.

Treatment resistance of cancers can arise for various reasons, one of these being the reassembly of cancer cell DNA after initial damage by both radiation treatment and chemotherapy. In September ground-breaking research was published by the DNA Repair and Chemoresistance research group led by Dr Eric Van Dyck, where it was shown that the mechanisms involved in the repair of specific ‘double-stranded’ DNA breaks (DSBs) may be responsible for the developed resistance. The group found that by disrupting proteins crucial to the repair pathway, resistant cancer cells were unable to repair the DNA damage correctly and therefore became susceptible to treatment effects.

A digital diagnostic tool to revolutionise the identification and treatment of sarcoma

With the development of new technologies comes the potential for innovation in healthcare, particularly with the advent of artificial intelligence and machine learning softwares that enable researchers to analyse data in a whole new way. This can be particularly useful in searching for patterns in large datasets that might be challenging for human eyes. At the LIH, these new technologies are being embraced and developed, lending fresh perspectives to the wealth of data at the fingertips of its researchers. In January, the power of these tools was exemplified in a collaborative publication between the team of Dr Michel Mittelbronn, from the LIH’s Department of Cancer Research, and over 50 partner institutions from around the globe.

Masters of Disguise: New tactics in the hunt for shapeshifting cancers

Glioblastoma (GBM) is a highly aggressive form of cancer that develops in the brain, leaving sufferers with an average survival time of just 12-18 months. This is despite the substantial range of treatments available, including surgical intervention, radiation and chemotherapies. The problem is that with the current tools it is virtually impossible to stop the targeted tumours from growing back.

Back in December, continuing its work investigating the origins of treatment resistant cancers, a team led by Dr Anna Golebiewska, group leader of the NORLUX Neuro-Oncology Laboratory at the Luxembourg Institute of Health (LIH), published a comprehensive review of the existing literature to gain more insights into the issue.

‘Suffocating’ cancer: Promising headway in melanoma immunotherapy

The ability of cancers to adapt in order to survive is not limited to just treatment resistance, but also to localised environmental changes, making them extremely robust. But what if some of these more fundamental survival skills of cancer cells were to take a hit? This is the question that was probed back in June by Dr Bassam Janji’s researchers in the LIH’s Tumour Immunotherapy and Microenvironment (TIME) group.

Melanoma is a type of skin cancer that develops from melanocytes, cells that are responsible for the production of pigments. Melanomas become harder to treat if not detected early, with emerging treatment resistance being an important barrier to their effective management.

A pledge in collaborative programmes that benefit patients

ParkinsonNet Luxembourg celebrates 5 years

At the LIH, improving outcomes and quality of life for patients is a cornerstone of our research. This requires engagement and interaction at all levels, creating networks and collaborations that link patients directly to cutting-edge knowledge and technologies, while ensuring healthcare providers are able to deliver exceptional patient-centered care.

In light of this collaborative mindset, the LIH, along with researchers, health professionals and their patients from various institutions, recently came together to celebrate 5 years of ParkinsonNet Luxembourg; a programme centered on care for patients with Parkinson’s Disease.

ParkinsonNet Luxembourg began full operations in 2018, modelled after the highly effective Dutch programme founded by Prof Dr Bas Bloem from Radboud University Nijmegen. The concept focuses on building an integrated care network for people with Parkinson’s disease (PD) at all stages. Thanks to its close link to international research, it allows its members to benefit, during their continuous training, from the latest findings and use state of the art treatments. The quality of life of people with PD is at the centre of all activities and it continually improves the exchange between the different healthcare professionals.

Advancing the treatment of Parkinson’s disease

In August, continuing its dedicated work investigating the care and treatment of patients with Parkinson’s Disease (PD), the LIH and the Centre Hospitalier de Luxembourg (CHL) announced the launch of “SCOL” (Study of Continuous Oral Levodopa). This unique international clinical trial aims to assess the safety, tolerability and efficacy of a new drug delivery system designed to better treat the symptoms of Parkinson’s Disease. The clinical trial, which is being conducted concomitantly in Italy, Spain and Luxembourg, has the potential to revolutionise the treatment of this common neurodegenerative disease by facilitating drug delivery and reducing side effects.

"The SCOL study is yet another instance of the pioneering clinical efforts carried out in Luxembourg by the LIH and its partners. Indeed, Luxembourg one of the first three countries in the world to be trialing this novel levodopa delivery method, owing to our longstanding expertise in PD exemplified by joint initiatives such as the National Centre of Excellence in Research on Parkinson’s Disease” concludes Prof Rejko Krüger, principal investigator at the CHL clinical site in Luxembourg and Director of Transversal Translational Medicine (TTM) at LIH.

Deconstructing Parkinson’s cell by cell

Beating some of society’s toughest illnesses is a challenge that relies as much on novel treatments as it does on identifying risk factors and enacting effective preventative strategies. In their work on Parkinson’s Disease, researchers at the LIH are picking apart the complex web of mechanisms underlying the development and propagation of the condition. The more they can learn, the closer we come to being able to tackle this and potentially many other destructive illnesses.

The central nervous system, composed of the brain and spinal cord, is the body’s main processing centre, helping to control every aspect of the way we interpret and interact with the world around us. Such an important system requires some serious protection, a role played largely by specialist immune cells called ‘microglia’. These rapid responders account for 10-15% of all the cells found within the brain, and act as the first and main form of active immune defense against pathological stimuli such as invading viruses or bacteria.

Supporting Alzheimer’s disease research: IBBL develops assay to assess the quality of cerebrospinal fluid samples

The Integrated BioBank of Luxembourg (IBBL) plays a major role in the LIH’s strategy to carry out translational research and patient-centred healthcare. Samples are not only collected, processed, analysed and stored, but these stages are also researched in order to optimise sample quality and therefore results obtained. This has a profound impact on a large variety of research projects and their findings.

In August, the Biospecimen Science Research Group and the Translational Biomarker Group at IBBL researchers broke the mould, with a brand new method of assessing quality in samples of cerebrospinal fluid (CSF) to be used for Alzheimer’s research.

New insights into the genetic risk factors of Lewy body dementia

At the beginning of the year, the department of Transversal Translational Medicine at the LIH, demonstrated its role in the international research and healthcare community, by contributing to a major study aiming to shed light into the genetic determinants of Lewy body dementia (LBD).

LBD is a common yet understudied neurodegenerative disease characterised by progressive cognitive decline, parkinsonism and visual hallucinations. There are currently no effective treatments available to slow its progression, with therapeutic approaches being limited to mitigating the symptoms. The distinguishing feature of this disorder is the accumulation in the brain of pathologically altered forms of the protein ‘α-synuclein’ in aggregates known as Lewy bodies, which are coincidentally also a hallmark of Parkinson’s disease. Moreover, most LBD patients also report neuropathological traits of Alzheimer’s disease, suggesting that LBD could be genetically related to both Parkinson’s and Alzheimer’s.

In order to confirm this hypothesis and shed light into the genetic basis of LBD, the research team performed a cutting-edge genome sequencing technique, known as whole-genome sequencing, in a large cohort of 2,981 LBD patients and 4,391 neurologically healthy controls, which also included the participants recruited within the Luxembourg study ‘National Center for Excellence in Research on Parkinson’s disease’ (NCER-PD).

LIH scientists distinguished by research excellence awards

FNR Awards 2021: LIH researchers shine at centre-stage

Among numerous applications and noteworthy projects, it was an immense accomplishment when this year, in the presence of the Luxembourg research community, the award for ‘Outstanding Scientific Achievement’ was presented to Dr Golebiewska and Prof Dr Niclou for their ground-breaking translational research in neuro-oncology.

The success of the LIH researchers at the FNR Awards did not end there. Following a nomination by his peers, Dr Morande of the Tumor Stroma Interactions group was conferred the FNR Outstanding Mentor award.

©Olivier_Minaire_FNR_Awards_2021
Excellent Thesis Award for Hannah Wurzer

Back in December, the University of Luxembourg held its annual PhD graduation Ceremony with over 150 doctoral candidates graduating from the University’s four doctoral schools in 2021. Of these, only a few were handpicked for their outstanding thesis, one being Postdoctoral Fellow Hannah Wurzer, who was conferred the Excellent Thesis Award for doctoral graduates who demonstrated excellence, originality and depth of knowledge in their thesis.

2021 Career Launchpad Award for LIH researcher

May 2021 saw the LIH proudly award Dr Martyna Szpakowska, a scientist within the Immuno-Pharmacology and Interactomics group of the Department of Infection and Immunity (DII) and the Tumor Immunotherapy and Microenvironment group of the Department of Cancer Research (DoCR), a EUR 10,000 grant under the Wolfgang Baertz Career Launchpad Award (Legs W. Baertz). The funding will allow her to further develop her work targeting tumours with an innovative antibody that has the potential to significantly advance cancer immunotherapies.

LIH scientist in the royal spotlight

The Grand Duke of Luxembourg has besowed Dr Torsten Bohn, Group leader of the Nutrition and Health Research team, the esteemed title of ‘Chevalier de l’Ordre de Mérite du Grand-Duché de Luxembourg’, for his contributions to the culture of Luxembourg.

Additional 2021 highlights

More news, events, awards and nominations

January

> LIH appoints new Director of the Department of Precision Health

February

> The i2TRON PhD Training Programme kicks off

> TIME group consolidates collaboration with Pharma company Sprint Bioscience

> FNR 2020 CORE Call funds three DoCR projects

> The GLASS-LUX project receives funding from the FNR and the Fondation Cancer

March

> LIH Ph.D. candidates contribute to new edition of LUX:ploration comic

>Two LIH Ph.D. scholars awarded the Pelican Grant

> Predi-COVID study extended to children

April

> LIH leukaemia research further supported by Plooschter Projet donation

> Think Pink Lux ‘Marian Aldred Award’ awarded to LIH researchers

May

> Luxembourg and Canada researchers join forces under AUDACE programme

> LIH cancer research supported by Schëfflenger Kriibshëllef donation

> Luxembourg hosts international flagship cancer epidemiology conference

June

> LIH contributes to new era of healthcare digitalisation with FNR PEARL Chair support

> The international Colive Voice study kicks off

July

> Innovative up-cycling venture generates political interest

> LIH establishes the Translational Medicine Operations Hub (TMOH) to support translational medicine research

August

> ParkinsonNet Luxembourg celebrates 5 years

September

> LIH scientist at the forefront of European nutritional health

> The EATRIS Luxembourg Node receives the Node Reward Framework award

> ORCHESTRA study launched

October

> LIH leukaemia project to be supported by “Marie Sklodowska-Curie Individual Fellowships”

> EU-funded SPIDIA4P project wins CEN/CENELEC Standards+Innovation Award

> LIH joins forces with Advanced BioDesign to improve cancer immunotherapy

> EU-CardioRNA COST action: LIH plays leading role in international collaborative research on heart disease

> LIH revamps its visual identity

November

> COVID-19 research boosted by private funding

> Project “Young50#Stay Healthy – Cardiovascular Risk Prevention” launched in Luxembourg

December

> LIH contributes to international COVID-19 research

Organigram

LIH in numbers

Collection statistics

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