Fighting cystic fibrosis at EPFL and across Lake Geneva

Tristan recently swam 14 kilometers – from St. Sulpice to Evian in 22-degree water – in 5 hours and 45 minutes. He pulled off this feat alongside his older brother, Corentin, and three friends from EPFL. The group trained for two and a half months, drawing inspiration from training routines used by professional open-water swimmers. “We used the main parts of the programs and adapted them,” says Tristan. “Our sessions were a combination of endurance and technical training. We also asked the Lake Geneva Swimming Association for advice, and they accompanied us during the swim.”

This was not Tristan’s first major sporting achievement, as he had previously competed at a high level. He won the youth sailing world championship in catamarans two times, when he was 14 and 16 years old. He also finished second in his category in the well-known AlpsMan Xtrem Triathlon in 2018. That event consisted of swimming 3.8km, cycling 180km with 4,500m of elevation across five mountain passes, and running a marathon.

“The more we move, the better we breathe”

Tristan, 24 years old, is a very driven person, and his condition plays a big part in that. When he was diagnosed with cystic fibrosis soon after birth, his parents followed the doctors’ advice and made sure that he grew up playing sports. “Sports are as important to me as the medication I take and the respiratory physiotherapy I do every day. I want to show people like me that we need to do sports to feel better!” he says.

Cystic fibrosis causes frequent lung infections in patients. These are treated with antibiotics, but they become ineffective in the long term as an individual’s response to the treatment weakens and the bacteria become resistant. Tristan adds that “there are many antibiotics available, and it is difficult for doctors to choose the right antibiotic for the right person.” Sports are so effective because they naturally improve the condition of the lungs and slow their gradual deterioration.

Using machine learning for personalized medicine

Tristan completed his Master’s degree in mechanical engineering, with a minor in computer science, at EPFL. He used his studies to better understand cystic fibrosis. While deciding on a project for his Master’s degree, he realized that machine learning could be applied to a variety of fields. “Since it is a new research tool, I thought it must be possible to use it to solve unanswered questions about medical conditions like cystic fibrosis. I contacted various laboratories specializing in cystic fibrosis around the world, as well as researchers and doctors,” he explains. The Department of Medicine at the University of Cambridge in England was exactly what Tristan was looking for. He started working with them and the Machine Learning and Optimization Laboratory at EPFL on a project that combined computer science and life sciences.

For two years, Tristan observed how 250 English patients responded to certain treatments. Every day, they recorded their health-related data, including lung function, weight, heart rate and oxygen saturation. He monitored the progress of these factors as patients took a course of antibiotics for 15 days. “My hypothesis was that, by examining certain biomarkers, we can determine how effective an antibiotic treatment is for a given patient. And with machine learning, we can help doctors choose an antibiotic that best suits their patient in order to maximize the effect of the treatment and minimize lung damage,” Tristan explains.

Tristan presented his results to the director of research for cystic fibrosis at the Necker–Enfants Malades Hospital in Paris and the cystic fibrosis center at the Royal Papworth Hospital in Cambridge. “They were very interested in this statistical approach, because I was able to corroborate findings that had been validated 20 years ago using a systemic method. I showed them that, by examining a patient’s treatment from the very start, it’s possible to quickly identify whether or not it will be effective,” Tristan says. “This is one of the first times that machine learning was used to try to better understand the condition – it’s really fascinating.”

A new life-altering drug

2021 has been a liberating and extremely productive year for Tristan. He has done many impressive things, such as incorporating cystic fibrosis into his Master’s degree and encouraging cystic fibrosis patients to take up sports and not be afraid of physical activity. However, the biggest news is that a new drug has been available to cystic fibrosis patients, and Tristan has been reaping its life-altering benefits for the past four months: “Since I started taking this new medication, I have absolutely no discomfort in my lungs, and I know that it will help prolong my life. Now, when I think about my plans for the future, I can see so much further ahead.”