As of 1 September 2019, there are 49 professors working at the Faculty of Medicine.
On this page, we will introduce you to the new professors of the Faculty of Medicine who have assumed this esteemed position on 1 September 2019. The professors will introduce their research field and its importance in society through answering three questions.
Professor of Andrology, Margus Punab
Margus Punab, a Professor of Andrology at the Institute of Clinical Medicine, explores male fertility and infertility. He is one of the most cited scietists in the world, belonging to the top 1% by citations for his field. He is the professor on Andrology since February 1st, 2020.
The topic of my PhD thesis was male fertility and infertility in Estonia. The same topics remain the centre of my research activities to this day. However, thanks to new colleagues and international collaboration networks our field of study has expanded to related subjects like hypogonadism, prostate diseases and disorders of gonadal development. My doctoral students have defended their theses on subjects covering the connection between male fertility and general health and weight, chronic genital infections, prostate diseases and aging. In collaboration with our international partners, we have studied male hypogonadism and aging.
My current PhD students are studying cryptorchidism and acute genitourinary tract infections and the late effects of these disorders on male reproductive function. We are on the brink of a breakthrough regarding understanding the genetic causes of severe male infertility. During the recent years we have also collected a unique data set on male hypogonadism, but unfortunately, we have not managed to receive funding to realize the potential of this subfield of male reproductive disorders.
Low birth rate, which remains far lower than expected for replacement level fertility, is one of the largest and most complex problems of the last half-century in the Western societies and also in Estonia. The prevalence of unwanted couple infertility is around 15% and in about half of the cases the couple’s infertility is due to male infertility or subfertility. Better understanding of the causes of male infertility would help to better treat this condition or even, ideally, to prevent infertility.
The prevalence of male hypogonadism rises rapidly with age. Due to the fast increase of male life-expectancy in Estonia, the share of older men in our society also increases and with this also the role of hypogonadism increases in the overall burden of disease. Timely and preventive treatment of hypogonadism is exceedingly important to ensure good quality of life and reduce concomitant health risks.
Both severe male infertility and male hypogonadism have proven to be closely related to increased risk of mortality. Thus, there has been increasing focus on male general health in our andrology clinic. We have started a project, funded by Estonian Health Insurance Fund, in which we study the general and sex-specific health of 40-49 years old Estonian men.
Today we essentially live in a golden age of clinical andrology compared to the time when I started my work in this field. For all the major male specific diseases there have been developed informative guidelines for analysis and investigation of the problem and treatments for solving it. There are very effective medications for treatment of most male specific diseases. Thanks to the developments in genetics during recent years, we are beginning to understand the connections between genotype and phenotype that lay behind the diseases. For myself personally, the most interesting finding are those which help better understand accumulation of diseases, sometimes even originating from prenatal period, and lifestyle factors that affect the development of classical diseases of older age.
Of my interests outside of work I would highlight broader interest in the culture of health, which has also led me to develop an interest in Oriental culture and philosophy. My hobbies, such as collecting contemporary art and taking care of apple gardens, and most of all my family help balance my professional activities.
See the CV of professor Margus Punab.
Professor of Molecular Medicine, Ana Rebane
Ana Rebane, a Professor of Molecular Medicine at the Institute of Biomedicine and Translational Medicine, explores the mechanisms of chronic inflammatory skin diseases as well as asthma pathogenesis and exacerbation.
My research aims to explore the mechanisms of chronic inflammatory skin diseases as well as asthma pathogenesis and exacerbation. Our main focus has been the functions of microRNAs, small RNA molecules that have capacity to widely modify gene expression, in these diseases and the development of cell penetrating peptide (CPP) based miRNA delivery methods for various cell types in vitro and inflamed tissue in vivo. In addition, we are participating in collaborative projects that aim to explore how cellular and epigeneic memory develops in chronic inflammatory diseases.
Chronic inflammatory diseases, such as allergic and autoimmune diseases constitute a major proportion of all diagnoses in all health care settings and comprise one of the largest burdens of disease worldwide. Current treatment options for these diseases are not always effective as well as adverse effects, such as the resistance to the drugs and antibodies neutralizing the drugs may develop. Therefore, clarification of disease-related cellular mechanisms and studies that potentially can lead to novel types of treatments for controlling the inflammation are important.
At the moment, it is very interesting to follow how clinical potential of RNA therapeutics has started to unwrap. In the development of RNA-based and targeting therapies, the main obstacle is to get the drug into the right cell of the right tissue without unwanted immunogenity. After years of work, now many novel chemically modified RNA-targeting oligos targeting specifically liver cells are in clinical trials. In 2018, also the first ever RNAi drug was approved by FDA to treat hereditary transthyretin amyloidosis, a rare and devastating disease mediated by the liver and causing polyneuropathy.
Professor of Vasology, Jaak KalsJaak Kals, a Professor of Vasology at the Institute of Clinical Medicine, is a renowned vascular surgeon, lecturer and researcher. He has combined the research field on one of the most serious clinical topics in the current international research area (research related to the endothelium, arterial stiffness and atherosclerosis) with a successful career as a vascular surgeon. He has made a substantial contribution to developing a close international cooperation network involving many preclinical and clinical subunits in Estonian medicine and the Faculty of Medicine at the University of Tartu for conducting modern cardiovascular studies and research.
What are your main research topics?
Vasology is a medical field involved in the prevention, diagnostics and treatment of vascular diseases (incl. surgical/endovascular treatment) as well as in education and research. The main task of a professor of vasology is to ensure the improvement of a research-based and complex approach to vascular diseases in Estonia. The plan is to combine various preclinical and clinical specialities more than ever, and to develop teaching and research at the pre- and post-diploma levels.
In 2004, together with the University of Tartu and Tartu University Hospital, we established a joint research unit – the Endothelial Centre. It is thus far the only scientific laboratory in Estonia focused on extensive translational vascular research. The main scientific focus of the research group led by me is directed at human vascular phenotype studies to identify pre-disease changes and to find out how arterial function is related to inflammation, oxidative stress and metabolomics.
Contacts with scientists from foreign universities and clinicians also enable me to strengthen the international cooperation network of vascular research.
Why are these topics important to study and how do they benefit society?
Cardiovascular diseases are the leading cause of death in the world – their prevention, early diagnostics and treatment is of utmost importance. The effectiveness of the treatment of these diseases does not only affect survival but also people’s quality of life. That’s why developing and implementing new, research-based diagnostics and treatment methods is critical.
In Estonia, mortality from cardiovascular diseases is beginning to decrease, but the situation should improve even further in the future to keep Estonia on the same level with European countries and other leading countries in the world. Ensuring such development requires teaching and research on vascular diseases to be taken to a new level, primarily by integrating preclinical and clinical specialities.What are the inspiring developments currently taking place in your research field?
There is an exciting study underway in collaboration with Uppsala University Hospital to describe the metabolomic profile of an abdominal aortic aneurysm. The long-term goal is to find low-molecular-weight biomarkers connected to the development and progression of an aneurysm to enable better planning of treatment in the future.
We intend to continue studies to assess the impact of the clinically easily performable, potentially protective remote ischaemic preconditioning phenomenon on arterial function, the metabolome and on organ damage after vascular surgery and subtraction angiography.
We are creating a unique biobank of patients with lower extremity atherosclerotic disease . This will become a high-quality storage place for biomaterial as well as a systematic database including the general clinical and socio-economic background of the subjects being studied and the information from biomaterial. The information stored in the biobank is intended to be applied mainly for studying the physiological and pathophysiological processes of the cardiovascular system, and also to determine new diagnostic and prognostic indicators and possible treatment targets.
Additionally, an interesting doctoral thesis project is commencing, where we will find out whether and to what extent local inflammation, oxidative stress and the levels of low-molecular-weight metabolites in ischaemic lower limbs are affected by atherosclerosis related to endothelium-dependent and -independent local vasomotor and hemodynamic changes.Did you know?
• In 2007, Jaak Kals defended his doctoral thesis “Endothelial Function and Arterial Stiffness in Patients with Atherosclerosis and in Healthy Subjects”.
• Since 2011, he has worked at Tartu University Hospital as a cardiovascular surgeon, and since 2004, at the University of Tartu as a research fellow, lecturer, senior research fellow and an associate professor.
• In 2012, he received the Young Scientist Award of the Cultural Foundation of the President of the Republic.
• Kals has published 53 category 1.1 articles (CC, WOS), and according to Google Scholar, he has 1,419 citations, h-index 20.
• He is currently the leading executor of a personal research grant (PUT, personaalne uurimistoetus) and is involved with two institutional research grants (IUT, institutsionaalne uurimistoetus)
• He has been the supervisor of four defended doctoral theses and one master’s thesis. Currently, he is supervising four doctoral theses.
Professor of Paediatric and Neonatal Intensive Care, Tuuli Metsvaht
A Professor of Paediatric and Neonatal Intensive Care at the Institute of Clinical Medicine, Tuuli Metsvaht, is a respected doctor in her field. She is convinced that clinical drug research in children is necessary for the safe and effective use of drugs. This is one of the research fields that Metsvaht is dedicated to.
As of 2006, I am a member of the Estonian Paediatric Research Group. Our main research directions are issues associated with safe and effective drug use in children and neonates; pharmacokinetics and pharmacodynamics of antibiotics and cardiovascular medicine in neonates; and development of the colonisation/microbioma of a neonate in intensive care unit.
Our research group has extensive international collaborations, participating also in international research projects funded by the EU Seventh Framework Programme and the “Horizon 2020” programme (NeoMero, NeoVanc, Mon4Strat, ALBINO, CloSed). In our most recent research projects, we have focused on individual dosing using the possibilities of pharmacokinetics and pharmacodynamics.Why are these topics important to study and how do they benefit society?
With drugs for adults, it is assumed that before placing the drugs on the market and putting them into clinical use, they have been put through clinical trials confirming their effectiveness and safety. However, up to two thirds of the drugs for children and neonates are being used without them having been studied in this population.
In regard to this matter, these are patients whose organism’s ability to cope with a drug (i.e., pharmacokinetics) and often also the effect of the drug on the organism (i.e., pharmacodynamics) is different from that of adults. There are also notable differences among the different age groups of children.
When necessary data is missing, the risk of developing side effects is higher, but the efficiency of the drug might also not be optimal. Therefore, it is very important to study the effect and safety of drugs in children. For example, in the European paediatric intensive care units, up to 63% of neonates receive medicines, which contain and/or have been produced using potentially harmful excipients. Toxicokinetic studies indicate that these substances may accumulate in the organism, primarily in extremely premature neonates. Poisonings caused by excipients have also been described, although for approximately two thirds of the cases, there are alternative pharmaceutical forms available on the European pharmaceuticals market that do not contain dangerous excipients. In recent years, the European Medicines Agency has also become interested in this issue. The results of our research group’s study were reported by the international news provider Reuters.
What are the inspiring developments currently taking place in your research field?
It might be said that we are studying the possibilities of personalised medicine perhaps from a bit of an unconventional viewpoint, i.e., through pharmacokinetics and pharmacodynamics. The realisation that one size does not fit all is becoming more and more widespread in medicine. In the context of medication, this means that the characteristics of a patient may significantly influence drug exposure and the medicine’s effect on the organism.
Currently, we are studying the individual dosing of medication to achieve its specific exposure (i.e., plasma concentration) using the Bayesian method. In order to do this, we have developed a software programme in cooperation with the University of Tartu’s Institute of Computer Science, which we are testing in the clinical trial. Such solutions are primarily necessary for medications in which the difference between effective and toxic concentrations is small, and in groups having a large inter-individual variability, like intensive care patients or neonates.
The next goal could be the individual dosing of a medication for producing a specific therapeutic effect. For example, if we know how the concentration of the medication affecting the functioning of the cardiovascular system is related to myocardial contractions, and which parameters of the patient affect this relationship between the concentration and effect, and how, then we will be able to calculate the dose of medication needed by a specific patient to achieve the intended effect.Did you know?
• In 2010, Metsvaht defended her doctoral thesis “Optimal Antibacterial Therapy of Neonates at Risk of Early Onset Sepsis” at the University of Tartu. The supervisors of the doctoral thesis were professor Irja Lutsar and professor Raul Talvik.
• Metsvaht is a member of several organisations and supervisory boards. She is a member of the Ethics Committee of Tartu University Hospital; the European Society for Paediatric Infectious Diseases; the Estonian Perinatal Society; the supervisory board of the Anaesthesiology and Intensive Care Clinic at Tartu University Hospital; a member of the Estonian Society of Anaesthesiologists and board member since 2018, and a member of the Estonian Medical Association.
• She is the head of the Paediatric Intensive Care Unit at the Anaesthesiology and Intensive Care Clinic of Tartu University Hospital.
• Metsvaht has been the supervisor of two defended doctoral theses. She is currently supervising four doctoral theses.
• Metsvaht has published 124 scientific publications, 62 of these in category 1.1. More than 30 of these have been published within the last five years. Total number of citations is >1,200 (Google scholar), h-index 23.
• In 2012, Metsvaht received the Neinar Seli grant for scientific publications of the last five years in Tartu University Hospital, and in 2008, she was awarded the Tartu University Hospital research grant.
Professor of Neurology, Janika Kõrv
A professor of clinical neurology at the Institute of Clinical Medicine, Janika Kõrv, has dedicated her whole scientific career on studying stroke. This has made her a renowned physician in her field in Estonia and internationally. In addition to doing research, Kõrv has also often talked about stroke in the media. Her goal is to raise people’s awareness about this common neurological disease and about helping people who have suffered a stroke.
What are your main research topics?
My entire career has been focused on one of the most common neurological diseases – stroke. I have mainly studied the epidemiology, causes and long-term outcomes of stroke in young adults, but I have also conducted other stroke-related clinical research.
I am participating as a national coordinator in several international academic clinical stroke studies and othercollaborative projects. Besides finding new treatment options, the implementation of evidence-based knowledge in clinical practice is also very important. Furthermore, I am associated with projects dealing with the quality of care for stroke patients. I have also been interested in other neurological diseases – traumatic spinal cord injuries, the post-polio syndrome and others.Why are these topics important to study and how do they benefit society?
Stroke is a common neurological disease, which is the second most common cause of death among all diseases and the most frequent cause of disability. It is understandable that all over the world great attention is being paid on preventing stroke as well as on treatments aiming to improve the quality of life of those affected. Compared to other European countries, the incidence of stroke in Estonia is moderate, however, it is higher among young adults and its long-term outcomes are worse than several other countries.
We are trying to find the causes for this and what we could do to improve the quality of life of stroke patients. Academic clinical trials help broaden treatment options and the indications for medications already in use.What are the inspiring developments currently taking place in your research field?
In recent decades, there has been a massive breakthrough in stroke treatment. Briefly, it means that stroke has become a treatable disease. The results of preclinical and clinical studies have proved that irreversible damage to nerve cells can be avoided by the fast recovery of blood flow. We are able to dissolve clots occluding the blood vessels in the brain and how to mechanically remove them.
We can successfully treat more and more people. The scientifically proven methods should be implemented into everyday clinical practice and their performance should be analysed. Estonia is among the leaders in Europe to implement new treatment methods in acute stroke. The other side of this is disease prevention, for which possibilities have also broadened. Proven treatment methods are in use, which help reduce the risk of stroke considerably.
Despite studies, the cause of stroke in young adults often remains unclear. Even more thorough studies are being conducted to try to find new risk factors. Our research is related to the topics mentioned above, and we are conducting it in cooperation with international research groups.Did you know?
• Kõrv has published 250 publications of which 59 appear in peer-reviewed journals.
• She has been the supervisor for two defended doctoral theses and two master’s theses. Currently, she is supervising three doctoral students.
• Kõrv has been part of the working groups for several international and Estonian treatment guidelines.
• Between 2015 and 2019, she was the chairman of the Nordic Stroke Society. Currently, she is the board member of the Estonian Ludvig Puusepp Society of Neurologists and Neurosurgeons and chair of the Stroke Initiative Group.
• In 2014, she was awarded the University of Tartu Badge of Distinction.