Integrated Pathophysiological mechanisms

Until 2013, we focused on respiratory diseases and the impact of air quality on the health of the population in several contexts.

Since 2014, we study the integrated mechanisms of disease in multidisciplinary contexts:

  • Air quality and respiratory diseases: pathophysiologic mechanisms underlying the aggression of air pollutants (SAUDAR, ENVIRH, INSPIRAR, GERIA)
  • Aging and integrated mechanisms of disease: systematic comprehensive evaluation and referral approach of people aged >64 years old
  • Mechanisms of infection: respiratory infection biomarkers and targeted antibiotic therapies
  • Mechanisms of viral infection: clinical and biological consequences of respiratory viruses and bacteria in the upper respiratory tract
  • Biomarkers of disease: effects of air pollution in the health but also as a tool for antibiotic stewardship
  • Integrated mechanisms of cardiovascular disease
  • Cough mechanisms: new research area (EPICOUGH.PT and OSCAR)
  • Mechanisms of exercise-related diseases.
  • MINIVENT - Ventilador Minimalista para os Cuidados Intensivos da COVID19

The MiniVent aims to develop the evolution of the minimalist ventilator concept for intrusive mechanical ventilation, in pressure control mode, to COVID 19 emergency intensive clinical care with a unique architecture but with several alternatives in terms of the possible components to use, depending on its market availability or local production capacity

Project Sheet

  • EPICOUGH.PT

This project focuses on the epidemiology of chronic cough and the mechanisms of hypersensitivity of cough syndrome and is led by Nuno Neuparth and funded by MSD Portugal. Cough is an essential protective physiological mechanism that prevents food, liquids, dust, and chemicals from reaching the lower airways. The prevalence of chronic cough in Portugal is unknown. Cough is one of the most common respiratory symptoms that frequently leads people to seek medical care and can be a frustrating difficult problem for patients and clinicians. Whilst some patients cough daily over many years, for others the disease has a relapsing and remitting course making a definition based purely on a temporal basis difficult to sustain. The diagnosis of chronic cough should be made on a global clinical assessment, considering the other features of the phenotypes of cough. The main goal of the EPICOUGH.PT project is to study the prevalence of chronic cough in a set of primary care centers in Lisbon, Portugal using the Fujimura Cough Questionnaire. For that, this project will allow the study of the adult population registered in the different health care centers of ACES Lisboa Central, which serves about 244.000 people (30.000 ≥ 65 years old). The ACES database includes about 63.000 e-mails (13% of which ≥ 65 years old).

EPICOUGH.PT is a cross-sectional study, with two different Phases:

    • Phase 1: Assess the prevalence of chronic cough in the Lisbon area served by ACES Lisboa Central, using a tailored online survey (approved by the Ethics Committee). 60.000 individuals will be invited to answer it.
    • Phase 2: A random sample of participants with chronic cough, identified in Phase I, will be invited to perform a more detailed assessment at the Nova Medical School lung function lab (CHRC).

 

  • OSCAR - vOice Screening of CoronA viRus

This project was developed by a consortium including the NOVA Medical School, the Association Fraunhofer Portugal Research and the NOS iNovation, and funded by Portugal 2020. Chronic respiratory diseases can affect voice and present some voice-related sounds that are disease-characteristic. The study of the acoustic characteristics of patients’ voices allows the early diagnosis of respiratory diseases. It has been shown that COVID-19 infection can lead to severe respiratory disease, in which coughing is the main symptom. Indeed, we believe the analysis of the voice-related sounds could be used to diagnose people for COVID-19. OSCAR aims at developing an algorithm to identify suspect cases of COVID-19 through the analysis of the characteristics of the voice. Thus, the identification and development of tools to screen suspected cases of COVID-19 infection would be extremely relevant and useful, considering the need for rapid testing to contain this global pandemic. The goal of OSCAR is to develop a smart algorithm to screen for COVID-19, using the characteristics of the voice and epidemiological data collected by an online form and simple vocal tests, thus developing a service for the identification of suspected cases of COVID-19 based on NOS voice technology. Plus, we intend to provide a platform for epidemiological studies using voice data and improve algorithms for the investigation of respiratory diseases.

OSCAR is a cross-sectional study with 300 participants, with two phases:

    • Phase 1: Study of the characteristics of the voice of patients with COVID-19, confirmed by RT-PCR testing, to develop and validate the NOS algorithm.
    • Phase 2: Test and adjust the algorithm from Phase 1 to a bigger sample of the adults living in Portugal, for automatic report of the symptoms and COVID-19 diagnosis.

Promotor | Responsible Center: Faculdade de Ciências Médicas | CHRC

Partners: NOS INovação, SA/Associação Fraunhofer Portugal Research/Universidade Politécnica de Madrid/Hospitais da Luz e Beatriz Ângelo/Centro Medicina Laboratorial Germano de Sousa

Authors: N.Neuparth/P.Martins/A.Rodrigues/R.Sousa/H.Canhão/J.Sousa/P.Paixão/MJ.Chasqueira/MJR.Sousa/A.Carreiro/F.Soares/I.Sousa/J.Ferreira/SJ.Braga

  • MSD Portugal: Multidisciplinary functional evaluation of cough. (2020-11 to 2022-10) – GRANT: Cough
  • Programa Operacional Temático Factores de Competitividade: OSCAR: vOice Screening of CoronA viRus. (2020-07 to 2022-02) – GRANT: 51277
  • FCT: Finnee - From spectra to formulas. (2018 - 2021/12) - PTDC/CCI-BIO/29702/2017
  • AstraZeneca Produtos Farmacêuticos Lda: OLDER - Obstructive Lung Diseases in Elders (2015 - 2018/05)
  • FCT: GERIA-Geriatric study in Portugal on Health Effects of Air Quality in Elderly Care Centers. (2012 - 2015/02) - PTDC/SAU-SAP/116563/2010
  • FCT: Is insulin a stimulus for carotid body activation? A new mechanism for insulin resistance and hypertension. (2011 - 2013/12) - PTDC/SAU-ORG/111417/2009
  • FCT: INSPIRAR - Air Quality Exposure and Human Health in Industrialized Urban Areas. (2010 - 2013/09/30) - PTDC/AAC-AMB/103895/2008
  • FCT: Environment and Health in children daycare centres (ENVIRH). (2010 - 2013/08) - PTDC/SAU-ESA/100275/2008 grant. Provided by PTCRIS: 100275
  • Fundação Calouste Gulbenkian: SaudAr - A Saúde e o Ar que Respiramos. (2004-2008) – GRANT: SaudAr
  • FCT: Mechanisms of lung hyperinflation in asthma (MELIA) (2004-2008)
  • FCT: Effect of inhaled steroids on bronchial inflammation in COPD patients (EISOBIC) (2004-2006)
  • FCT: Role of the bronchial inflammation on the pathogenesis of pulmonary hyperinflation in Asthma (1997-2000) – GRANT: PRAXIS/PSAU/P/SAU/92/96
  • iNOVA4Health – Translational Medicine Programme. (2015 - 2017/12/31) – CODE: UID/Multi/04462/2013 (in collaboration with iBET - Instituto de Biologia Experimental e Tecnológica; Universidade Nova de Lisboa CEDOC and Instituto Português de Oncologia de Lisboa Francisco Gentil EPE)
  • AstraZeneca Produtos Farmacêuticos Lda, Instituto Clínico de Alergologia, Portugal: STEP - Efficacy and safety of budesonide/formoterol single inhaler therapy versus a higher dose of budesonide in moderate to severe asthma - estudo multicêntrico internacional (2000 – 2003)
  • AstraZeneca Produtos Farmacêuticos Lda, Instituto Clínico de Alergologia, Portugal: FUN - A 12-month comparison of as-needed formoterol Turbuhaler® and terbutaline Turbuhaler in patients with asthma on an anti-inflammatory treatment - estudo multicêntrico internacional (2000 – 2002)
  • AstraZeneca Produtos Farmacêuticos Lda, Instituto Clínico de Alergologia, Portugal: Efficacy of Symbicort Turbuhaler compared with fluticasone diskus in asthmatic patients - estudo multicêntrico internacional (1999 – 2000)
  • AstraZeneca Produtos Farmacêuticos Lda, Instituto Clínico de Alergologia, Portugal: The effect of inhaled fluticasone was compared by using two different types of inhalers in asthmatic children - estudo multicêntrico internacional (1999 – 2000)
  • AstraZeneca Produtos Farmacêuticos Lda, Instituto Clínico de Alergologia, Portugal: Once daily administration of 200 mcg budesonide Turbuhaler and 200 mcg fluticasone propionate via diskus inhaler is stable asthmatics - estudo multicêntrico internacional (1998 – 2000)
  • AstraZeneca Produtos Farmacêuticos Lda, Instituto Clínico de Alergologia, Portugal: A placebo controled multicentre study comparing the efficacy of Rhinocort Aqua (budesonide) and Nasorex (mometasone furoate) administered to patients with perennial allergic rhinitis - estudo multicêntrico internacional (1993 – 2000)
  • AstraZeneca Produtos Farmacêuticos Lda, Instituto Clínico de Alergologia, Portugal: A double blind parallel group study in nebulisation treatment with budesonide suspension (1mg or 2mg per day) or placebo in moderate to severe asthmatic infants (1992 - 1996)
  • AstraZeneca Produtos Farmacêuticos Lda, Instituto Clínico de Alergologia, Portugal: Effect on hyperinflation in asthmatic children - estudo da iniciativa do investigador (1988 - 1994)
  • AstraZeneca Produtos Farmacêuticos Lda, Instituto Clínico de Alergologia, Portugal: Effect of inhaled budesonide in the bronchial response to metacoline in asthmatic children (1989 - 1993)

Araújo-Martins J; Brás-Geraldes C; Neuparth N. "The potential role of peak nasal inspiratory flow to evaluate active sinonasal inflammation and disease severity". Scientific Reports 10 1 (2020): 1-9. doi: 10.1038/s41598-020-69693-6

Erny G; Gomes R; Santos M; Santos L.; Neuparth N; Carreiro-Martins P; Gaspar-Marques J; Guerreiro A; Gomes-Alves P. "Mining for Peaks in LC-HRMS Datasets Using Finnee – A Case Study with Exhaled Breath Condensates from Healthy, Asthmatic, and COPD Patients". ACS Omega 5 26 (2020): 16089-16098. doi:10.1021/acsomega.0c01610

Mendes A, Papoila AL, Carreiro-Martins P, Aguiar L, Bonassi S, Caires I, Palmeiro T, Ribeiro ÁS, Neves P, Pereira C, Botelho A, Neuparth N, Teixeira JP (2017) The Influence of Thermal Comfort on the Quality of Life of Nursing Home Residents. J Toxicol Environ Health A. 2017 May 23:1-11. doi: 10.1080/15287394.2017.1286929

Sousa H, Branco P, de Sousa Almeida M, de Araújo Gonçalves P, Gaspar A, Dores H, Mesquita J, Andrade MJ, Neuparth N, Aleixo A, Mendes M, Barata JD (2017) Changes in albumin-to-creatinine ratio at 12-month follow-up in patients undergoing renal denervation. Rev Port Cardiol. 2017 May;36(5):343-351. doi: 10.1016/j.repc.2016.09.019

Marques IJ, Moura MM, Cabrera R, Pinto AE, Simões-Pereira J, Santos C, Menezes FD, Montezuma D, Henrique R, Teixeira MR, Leite V, Cavaco BM (2017) Identification of somatic TERT promoter mutations in familial non-medullary thyroid carcinomas (FNMTC). Clin Endocrinol (Oxf). 2017 May 14. doi: 10.1111/cen.13375

Rodrigues G, de Araújo Gonçalves P, Moscoso Costa F, Campante Teles R, Hélder D, Mariano L, Brito J, Mesquita Gabriel H, Almeida M, Mendes M. (2017) Low previous cardiovascular risk of patients with ST-elevation myocardial infarction. Coron Artery Dis. 2017 Apr 20. doi: 10.1097/MCA.0000000000000502

Bousquet J, Bewick M, Arnavielhe S, Mathieu-Dupas E, Murray R, Bedbrook A, Caimmi DP, VandenPlas O, Hellings PW, Bachert C, Anto JM, Bergmann KC, Bindslev-Jensen C, Bosnic-Anticevitch S, Bouchard J, Canonica GW, Chavannes NH, Cruz AA, Dahl R, Demoly P, De Vries G, Devillier P, Fink-Wagner A, Fokkens WJ, Fonseca J, Guldemond N, Haahtela T, Hellqvist-Dahl B, Just J, Keil T, Klimek L, Kowalski ML, Kuna P, Kvedariene V, Laune D, Larenas-Linnemann D, Mullol J, Pereira AM, Carreiro-Martins P, Melén E, Morais-Almeida M, Nogueira-Silva L, O'Hehir RE, Papadopoulos NG, Passalacqua G, Portejoie F, Price D, Ryan D, Samolinski B, Sheikh A, Simons FE, Spranger O, Bom AT, Tomazic PV, Triggiani M, Valero A, Valovirta E, Valiulis A, van Eerd M, Wickman M, Young I, Zuberbier T (2017) Work productivity in rhinitis using cell phones: The MASK pilot study. Allergy. 2017 Apr 7. doi: 10.1111/all.13177

Schultz MJ, Dunser MW, Dondorp AM, Adhikari NK, Iyer S, Kwizera A, Lubell Y, Papali A, Pisani L, Riviello BD, Angus DC, Azevedo LC, Baker T, Diaz JV, Festic E, Haniffa R, Jawa R, Jacob ST, Kissoon N, Lodha R, Martin-Loeches I, Lundeg G, Misango D, Mer M, Mohanty S, Murthy S, Musa N, Nakibuuka J, Serpa Neto A, Nguyen Thi Hoang M, Nguyen Thien B, Pattnaik R, Phua J, Preller J, Povoa P, Ranjit S, Talmor D, Thevanayagam J, Thwaites CL, Global Intensive Care Working Group of the European Society of Intensive Care Medicine (2017) Current challenges in the management of sepsis in ICUs in resource-poor settings and suggestions for the future. Intensive Care Med. 2017 Mar 27. doi: 10.1007/s00134-017-4750-z

Khan F, Owens MB, Restrepo M, Povoa P, Martin-Loeches I. (2017) Tools for outcome prediction in patients with community acquired pneumonia. Expert Rev Clin Pharmacol. 2017 Feb;10(2):201-211. doi: 10.1080/17512433.2017.1268051

Caroça C, Vicente V, Campelo P, Chasqueira M, Caria H, Silva S, Paixão P, Paço J.(2017) Rubella in Sub-Saharan Africa and sensorineural hearing loss: a case control study. BMC Public Health. 2017 Feb 1;17(1):146. doi: 10.1186/s12889-017-4077-2

  • 2020 - Prémio SPAIC-ASTRAZENECA melhor projeto de investigação original sobre asma - trabalho intitulado “PASMA 20-30 Painel online de doentes para vigilância do controlo da ASMA 2020-2030". Sociedade Portuguesa de Alergologia e Imunologia Clínica, Portugal
  • 2019 - 2º Prémio Melhor Poster SPAIC - trabalho intitulado "Sobreposição Asma-Doença Pulmonar Obstrutiva Crónica: Pior Função Pulmonar e Maior Utilização de Recursos de Saúde". Sociedade Portuguesa de Alergologia e Imunologia Clínica, Portugal
  • 2018 - Melhor poster - A proposal to score concepts maps used in pathophysiology teaching based on current experience and critical literature review. International Society for Pathophysiology, Albânia
  • 2017 - 2º Prémio Melhor Comunicação Oral SPAP e SPC - trabalho intitulado "Indução da expetoração para contagem celular como biomarcador celular na asma". Sociedade Portuguesa de Anatomia Patológica, Portugal. Sociedade Portuguesa de Citologia , Portugal.
  • 2017 - 1º Prémio Melhor Poster SPAIC - trabalho intitulado "Função respiratória e percepção do controlo da doença respiratória alérgica em idosos". Sociedade Portuguesa de Alergologia e Imunologia Clínica, Portugal
  • 2017 - 1º Prémio Melhor Comunicação Oral do Dia do Jovem Investigador INSA - trabalho intitulado "Geriatric study in Portugal on health effects of air quality in elderly care centers". Instituto Nacional de Saúde Doutor Ricardo Jorge, Portugal
  • 2017 - 1º Prémio Melhor Comunicação Oral APTEC - trabalho intitulado "Caracterização da avaliação espirométrica numa população muito idosa - Que equações de referência utilizar?". Associação Portuguesa de Cardiopneumologistas, Portugal
  • 2017 - Prémio Melhor Poster na área de citologia SPAP e SPC - trabalho intitulado "Contagem celular em amostras de expetoração induzida: Otimização de um protocolo de processamento". Sociedade Portuguesa de Anatomia Patológica, Portugal. Sociedade Portuguesa de Citologia , Portugal
  • 2016 - 1º prémio Comité Olímpico de Portugal / Fundação Millennium BCP - Medicina do desporto - trabalho intitulado “Alteração da resposta fisiológica pelo efeito da altitude simulada”. Comité Olímpico de Portugal.
  • 2016 - Prémio Arnaldo Sampaio, promovido pela APPSP - "Projeto GERIA Estudo Geriátrico dos Efeitos na Saúde da Qualidade do Ar Interior em Lares da 3ª Idade de Portugal". Associação Portuguesa para a Promoção da Saúde Pública, Portugal
  • 2016 - Prémio de Mérito Científico do Departamento de Pediatria Médica da Reunião do Anuário do Hospital Dona Estefânia com a publicação intitulada "Effect of indoor air quality of day care centers in children with different predisposition for asthma". Hospital Dona Estefânia, Portugal
  • 2015 - Prémio de Comunicação em Poster daEAACI - trabalho intitulado "Asthma and quality of life in the elderly". European Academy of Allergy and Clinical Immunology, Suiça
  • 2014 - 1º Prémio de Melhor Comunicação Oral APTEC- trabalho intitulado "Taxa de sucesso da espirometria em idosos residentes em lares de Lisboa (dados preliminares) – Estudo GERIA". Associação Portuguesa de Cardiopneumologistas, Portugal
  • 2014 - 2º Prémio de Melhor Poster da SPAIC - trabalho intitulado "Qualidade de Vida e Doença Respiratória no Idoso.". Sociedade Portuguesa de Alergologia e Imunologia Clínica, Portugal
  • 2013 - 2º Prémio Melhor Poster da SPAIC/MSD - trabalho intitulado "Exposição a ácaros do pó doméstico em infantários: associação a episódios de sibilância com necessidade de recurso ao serviço de urgência". Sociedade Portuguesa de Alergologia e Imunologia Clínica, Portugal
  • 2011 - 1º Prémio ex-aequo SPAIC/Bial Aristegui - trabalho intitulado “Efeito conjunto da exposição à poluição do ar e aos ácaros do pó, sobre as vias aéreas”. Sociedade Portuguesa de Alergologia e Imunologia Clínica, Portugal
Paulo Paixão in new doc series about virus on RTP

Professor Paulo Paixão, clinical researcher at Integrated Pathophysiological Mechanisms, is a guest on the documentary series on RTP1, Vírus - Parasitas Obrigatórios.

Have you had a COVID-19 diagnostic test? Participate in the OSCAR project!

Project partners include NOVA Medical School, CHRC, NOS Innovation, Fraunhofer Portugal and Polytechnic University of Madrid

  • António Artigas, Sabadell Hospital – Universidade Autonoma de Barcelona, Spain
  • Ignacio Martin Loeches, St James’s University Hospital, Ireland
  • Jose Miguel Martins, Instituto Superior Técnico, University of Lisbon (IST-UL), Portugal
  • Paulo Ribeiro, Faculty of Sciences and Technology, New University of Lisbon (FCT – UNL), Portugal.

Principal Investigator

Nuno Manuel Barreiros Neuparth
Vice-dean, President of the Pedagogical Council, Immunoallergologist, Clinical Director

Team

Catarina Pedro
Luís Bento
MD, PhD
Paulo Paixão
MD, PhD
Pedro Carreiro Martins
Immunoallergologist
Pedro Póvoa
MD, PhD
José Araújo Martins
MD, MSc
Paula Leiria Pinto
MD, MSc
Iolanda Caires
Cardiopulmonology Technician
Maria Manuela Correia
Psychologist, MSc
Maria Amália Botelho
MD, PhD
António Bugalho de Almeida
MD, PhD
Hélder Dores
MD, PhD
Joana Logrado Belo Costa
Cardiopulmonology Technician, PhD
Joana Silvestre
MD, PhD
João Beckert
MD PhD
João Gonçalves Pereira
MD, PhD
Manuel de Sousa Almeida
MD, PhD
Maria de Jesus Chasqueira
Biologist, PhD
Pedro Araújo Gonçalves
MD, PhD
Sara Simões Dias
MD, PhD
João Gaspar Marques
MD
José Araújo Martins
MD, MSc
Luis Coelho
MD
Marta Fonseca
Tiago Rodrigues
MD
Augusta Marques
Clinical Analysis Technician, BSc
Iolanda Caires
Cardiopulmonology Technician
Lúcia Rodrigues
Clinical Analysis Technician, BSc
Miguel Ferreira
MD
António Pais Pereira
MD, PhD
Carlos Robalo Cordeiro
MD, PhD
César Magro
Cláudia Lopes
Cardiopulmonology Technician, BSc
Lina Maria Carvalho
MD, PhD
Teresa Palmeiro
Cardiopulmonology Technician, BSc