Michael Marks-Hultström

Our research explores the mechanisms of organ failure and recovery in critical illness, spanning the full translational continuum from experimental physiology and molecular discovery to genetic epidemiology and patient outcomes.

Working within both the Unit for Integrative Physiology at the department of Medical Cell Biology and the Anaesthesiology and Intensive Care group at the Department of Surgical Sciences, we combine mechanistic experimental research, multi-omics, and population-level studies to understand and mitigate life-threatening disease processes.

1. Experimental Physiology and Mechanisms of Organ Failure

Our experimental work investigates hemodynamic and microvascular mechanisms of organ failure in sepsis, shock, and decompensated heart failure. This translational framework connects clinical observations, GWAS findings, and physiological mechanisms, providing a bidirectional bridge from bedside to bench.

At the Unit for Integrative Physiology, we work with rodent models to investigate renal, cardiac, and vascular physiology, focusing on mechanisms of organ perfusion, oxygen handling, muscle function and neurohumoral regulation during shock and heart failure. These models are also used to explore metabolic adaptations and muscle wasting that accompany prolonged critical illness.

At the Hedenstierna Laboratory, we use advanced instrumentation in porcine models to study renal oxygen metabolism, circulatory function, and the physiological impact of resuscitation strategies.

At the DanioReadout core facility we perform mechanistic screening and exploration to validate genomic findings before moving to more advanced animals.

Project members:
Michael Marks-Hultström, docent
Mediha Becirovic Agic, researcher
Henrik Isackson, researcher
Esin Özcelebi, postdoc
Fernando Ribeiro, postdoc
Annelie Barrueta Tenhunen, postdoc
Miklós Lipcsey, Professor

2. Pathophysiology of Fluid, Electrolyte, and Renal Function

A central theme in our research is the integration of fluid, electrolyte, and circulatory physiology in critical illness. We study how osmotic stress, dehydration, and fluid therapy influence kidney perfusion, myocardial performance, and metabolic regulation. Our work has contributed to defining new physiological endotypes of acute kidney injury (AKI) and to developing individualized fluid and electrolyte management strategies for the critically ill.

Project members:
Michael Marks-Hultström, docent
Robert Frithiof, Professor
Miklós Lipcsey, Professor
Rasmus Mossberg, PhD-student
Mikael Eriksson, researcher
Annelie Barrueta Tenhunen, postdoc
Mediha Becirovic Agic, researcher
Arash Emami, PhD-student

3. Translational Omics and Biobanking in Critical Care

We bridge molecular discovery and clinical translation through extensive biobanking and multi-omics approaches in both experimental animals and patients. The Uppsala Intensive Care COVID-19 Biobank has provided key insights into host response, coagulation, and inflammatory mechanisms during the pandemic. Building on this foundation, we are establishing the Swedish Intensive Care Biobank (SWIC-B) for nationwide translational studies in infectious, cardiovascular, and renal critical illness.

We integrate proteomic, metabolomic, and transcriptomic data from patients and experimental models to identify pathways driving organ failure and recovery. Our studies include endotype characterization in sepsis, pulmonary embolism, and acute pancreatitis, based on both local biobanks and international collaborations. These efforts aim to define molecular signatures that predict disease course, therapeutic response, and long-term outcomes.

Project members:
Michael Marks-Hultström, docent
Miklós Lipcsey, Professor
Mediha Becirovic Agic, postdoc
Annelie Barrueta Tenhunen, postdoc
Jaap van der Heijden, PhD-student
Henrik Isackson, researcher

4. Clinical and Genetic Epidemiology of Critical Illness

We investigate determinants of critical illness using large-scale registry and genomic data. Within the Anaesthesiology and Intensive Care group, we conduct epidemiology and genetic epidemiology to identify risk factors for sepsis, acute respiratory failure, and cardiovascular collapse. We lead the Merged Anaesthesiology and Intensive Care Cohorts in Sweden (MAICS) and contribute to the COVID-19 Host Genetics Initiative (HGI) and the Global Burden of Disease (GBD) collaborations, extending our analyses to Long-COVID and post-critical illness disability.

Project members:
Michael Marks-Hultström, docent
Miklós Lipcsey, Professor
Robert Frithiof, Professor
Karl Stattin, docent
Björn Ahlström, researcher
Mikael Eriksson, researcher
Mohamad Nasir, PhD-student
Rasmus Mossberg, PhD-student
Peter Halvorsen, PhD-student
Bram Burger, Bioinformatician

5. Long-term Outcomes and Recovery after Critical Illness

Beyond the acute phase, we investigate the trajectory of recovery and long-term outcomes after critical illness, in particular muscle weakness and fatigue. By linking biobank, registry, and high-granularity patient management system data, we identify predictors of persistent organ dysfunction, fatigue, and reduced quality of life following sepsis, ARDS, and COVID-19. This research forms the basis for strategies to improve rehabilitation and survivorship after intensive care.

Project members:
Michael Marks-Hultström, docent
Fernando Ribiero, postdoc
Miklós Lipcsey, Professor
Robert Frithiof, Professor
Björn Ahlström, researcher
Peter Halvorsen, PhD-student
Ewa Wallin, lektor
Ing-Marie Larsson, lektor