| 1. |
- Adlerberth, Ingegerd, 1959, et al.
(författare)
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Gut microbiota and development of atopic eczema in 3 European birth cohorts.
- 2007
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Ingår i: The Journal of allergy and clinical immunology. - : Elsevier BV. - 0091-6749 .- 1097-6825. ; 120:2, s. 343-50
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Stimulation of the immune system by gut microbes might prevent allergy development. OBJECTIVE: The present study examined the hypothesis that sensitization to food allergens and atopic eczema are influenced by the infantile intestinal colonization pattern. METHODS: Infants were recruited perinatally in Göteborg (n = 116), London (n = 108), and Rome (n = 100). Commensal bacteria were identified to the genus or species level in rectal (3 days) and quantitative stool cultures (7, 14, and 28 days and 2, 6, and 12 months of age). At 18 months of age, atopic eczema and total and food-specific IgE levels were assessed. These outcomes were modeled in relation to time to colonization with 11 bacterial groups and to ratios of strict anaerobic to facultative anaerobic bacteria and gram-positive to gram-negative bacteria at certain time points. Study center, mode of delivery, parity, and infant diet were included as covariates. RESULTS: Neither atopic eczema nor food-specific IgE by 18 months of age were associated with time of acquisition of any particular bacterial group. Cesarean section delayed colonization by Escherichia coli and Bacteroides and Bifidobacterium species, giving way to, for example, Clostridium species. Lack of older siblings was associated with earlier colonization by Clostridium species and lower strict anaerobic/facultative anaerobic ratio at 12 months. CONCLUSIONS: This study does not support the hypothesis that sensitization to foods or atopic eczema in European infants in early life is associated with lack of any particular culturable intestinal commensal bacteria. CLINICAL IMPLICATIONS: The nature of the microbial stimulus required for protection from allergy remains to be identified.
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| 2. |
- Adlerberth, Ingegerd, 1959, et al.
(författare)
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Reduced enterobacterial and increased staphylococcal colonization of the infantile bowel: an effect of hygienic lifestyle?
- 2006
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Ingår i: Pediatric research. - : Springer Science and Business Media LLC. - 0031-3998 .- 1530-0447. ; 59:1, s. 96-101
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Tidskriftsartikel (refereegranskat)abstract
- The modern Western lifestyle may have altered the composition of the commensal microflora. Here, we investigated the first year's intestinal colonization pattern in 99 vaginally delivered Swedish infants and 17 delivered by cesarean section. Rectal swabs obtained at 3 d of age were cultured for aerobic bacteria and fecal samples obtained at 1, 2, 4, and 8 wk and at 6 and 12 mo of age were cultivated quantitatively for aerobic and anaerobic bacteria. Vaginally delivered infants more often had Escherichia coli compared with cesarean section-delivered infants, whereas the latter more frequently carried other enterobacteria, such as Klebsiella and Enterobacter. Independent of delivery mode, it took 2 mo until most infants were colonized by enterobacteria, traditionally the first colonizers. In contrast, coagulase-negative staphylococci colonized 99% of the infants from d 3 onwards. The poor adaptation of staphylococci to the gut was shown by declining population sizes after some weeks. Dominating anaerobes were initially bifidobacteria and clostridia, whereas Bacteroides initially colonized only 30% of vaginally delivered infants and increased very slowly in prevalence. Bacteroides colonization was delayed up to 1 y in cesarean section-delivered compared with vaginally delivered infants. Our results show that some "traditional" fecal bacteria are acquired late today especially in cesarean section-delivered infants, probably due to limited environmental circulation. In their absence, skin bacteria like staphylococci have become the first gut colonizers.
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| 3. |
- Adlerberth, Ingegerd, 1959, et al.
(författare)
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Toxin-producing Clostridium difficile strains as long-term gut colonizers of healthy infants.
- 2014
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Ingår i: Journal of clinical microbiology. - 1098-660X. ; 52:1, s. 173-179
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Tidskriftsartikel (refereegranskat)abstract
- Clostridium difficile is a colonizer of the human gut, and toxin-producing strains may cause diarrhea if infectious burden is heavy. Infants are more frequently colonized than adults, but rarely develop C. difficile disease. It is not known whether strains of C. difficile differ in capacity to colonize and persist in the human gut microbiota. Here, we strain-typed isolates of C. difficile colonizing 42 healthy infants followed from birth to ≥12 months of age, using PCR ribotyping of the 16S-23S rRNA intergenic spacer region. The isolates were also characterized regarding carriage of the toxin genes tcdA, tcdB and cdtA/B, and capacity to produce toxin B in vitro. Most strains (71%) were toxin-producers, and 51% belonged to the 001 or 014 ribotypes, that often cause disease in adults. These ribotypes were significantly more likely than other ones to persist for ≥6 months in the infant micobiota, and were isolated from 13/15 children carrying such long-term colonizing strains. Ribotype 001 strains were often acquired in the first week of life and attained higher population counts than other C. difficile ribotypes in newborn infants' faeces. Several toxin-negative ribotypes were identified, two of which (GI and GIII) were long-term colonizers, each in one infant. Our results suggest that the toxin-producing C. difficile ribotypes 001 and 014 have special fitness in the infantile gut microbiota. Toxin-producing strains colonizing young children for long time periods may represent a reservoir for strains causing disease in adults.
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| 4. |
- Ahrné, Siv, et al.
(författare)
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Lactobacilli in the intestinal microbiota of Swedish infants
- 2005
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Ingår i: Microbes and Infection. - : Elsevier BV. - 1286-4579 .- 1769-714X. ; 7:11-12, s. 1256-62
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Tidskriftsartikel (refereegranskat)abstract
- Lactobacillus colonisation was examined in 112 Swedish infants. Faecal samples obtained at 1, 2, 4 and 8 weeks and at 6, 12 and 18 months of age were cultivated quantitatively on Rogosa agar. Lactobacilli were speciated by PCR and typed to the strain level by randomly amplified polymorphic DNA (RAPD). Lactobacilli reached a peak at 6 months when 45% of the infants were colonised. L. rhamnosus and L. gasseri were the most common species in this period. Colonisation by lactobacilli in general (P < 0.01) and L. rhamnosus in particular (P < 0.05) was more common in breast-fed than in weaned infants at 6 months of age. Lactobacillus isolation reached a nadir of 17% by 12 months (P < 0.0001), but increased to 31% by 18 months of age P < 0.05). The food-related species L. paracasei, L. plantarum, L. acidophilus and L. delbrueckii dominated in this second phase. A single strain persisted for at least 3 weeks in 17% of the infants during the first 6 months, most commonly L. rhamnosus. Lactobacillus population counts in colonised infants increased from 10(6.4) cfu/g at 1 week to 10(8.8) cfu/g at 6 months, and then dropped to 10(5.4) cfu/g faeces at 12 months of age. Lactobacillus colonisation was not significantly related to delivery mode, or to presence of siblings or pets in the household. Our results suggest that certain Lactobacillus species, especially L. rhamnosus, thrive in the intestinal flora of breast-fed infants. After weaning they are replaced by other Lactobacillus species of types found in food.
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| 5. |
- Alves, Fabio de Abreu, et al.
(författare)
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Immunohistopathology of the Newly Discovered Giant Papillae Tongue Disorder in Organ-Transplanted Children
- 2017
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Ingår i: Transplantation. - : Lippincott Williams & Wilkins. - 0041-1337 .- 1534-6080. ; 101:6, s. 1441-1448
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Tidskriftsartikel (refereegranskat)abstract
- Background. Giant papillae tongue disorder (GRID) is a newly discovered, long-lasting clinical disorder that may develop in organ-transplanted pediatric recipients. The key feature of this disorder is the unique tongue lesion, which comprises swollen fungiform papillae. The aim of this study was to characterize the immunohistopathology of this novel inflammatory condition. Methods. Six organ transplanted children with GRID were included in the study. Routine histopathology and immunohistochemical stainings for CD3, CD4, CD8, CD25, FOXP3, CD20, CD138, CD68, CD1a, CD15, CD23, and mast cell tryptase were performed. Results. Immunohistochemical analyses of the oral lesions revealed a subepithelial infiltrate that was primarily composed of CD3- and CD4-positive T cells, CD20-expressing B cells, macrophages, and CD138-positive plasma cells. The CD20-positive cells did not display the typical B cell morphology, having in general a more dendritic cell-like appearance. The CD138-expressing plasma cells were distinctly localized as a dense infiltrate beneath the accumulation of T cells and B cells. Increased numbers of CD1a-expressing Langerhans cells were detected both in the epithelium and connective tissue. Because no granulomas were observed and only single lesional eosinophils were detected, GPTD does not resemble a granulomatous or eosinophilic condition. Conclusions. We describe for the first time the immunopathological characteristics of a novel inflammatory disorder of the oral cavity, which may develop after solid organ transplantation in children.
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| 6. |
- Barman, Malin, 1983, et al.
(författare)
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Short-chain fatty acids (SCFA) in infants’ plasma and corresponding mother's milk and plasma in relation to subsequent sensitisation and atopic disease
- 2024
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Ingår i: EBioMedicine. - : Elsevier. - 2352-3964. ; 101
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Tidskriftsartikel (refereegranskat)abstract
- Background: Short-chain fatty acids (SCFAs) in intestinal contents may influence immune function, while less is known about SCFAs in blood plasma. The aims were to investigate the relation between infants’ and maternal plasma SCFAs, as well as SCFAs in mother's milk, and relate SCFA concentrations in infant plasma to subsequent sensitisation and atopic disease. Methods: Infant plasma (N = 148) and corresponding mother's milk and plasma were collected four months postpartum. Nine SCFA (formic, acetic, propionic, isobutyric, butyric, succinic, valeric, isovaleric, and caproic acid) were analysed by UPLC-MS. At 12 months of age, atopic disease was diagnosed by a pediatric allergologist, and sensitisation was measured by skin prick test. All families participated in the Swedish birth cohort NICE (Nutritional impact on Immunological maturation during Childhood in relation to the Environment). Findings: Infants with sensitisation, atopic eczema, or food allergy had significantly lower concentrations of five, three, and two SCFAs, respectively, in plasma at four months. Logistic regressions models showed significant negative associations between formic, succinic, and caproic acid and sensitisation [ORadj (95% CI) per SD: 0.41 (0.19–0.91); 0.19 (0.05–0.75); 0.25 (0.09–0.66)], and between acetic acid and atopic eczema [0.42 (0.18–0.95)], after adjusting for maternal allergy. Infants’ and maternal plasma SCFA concentrations correlated strongly, while milk SCFA concentrations were unrelated to both. Butyric and caproic acid concentrations were enriched around 100-fold, and iso-butyric and valeric acid around 3-5-fold in mother's milk, while other SCFAs were less prevalent in milk than in plasma. Interpretation: Butyric and caproic acid might be actively transported into breast milk to meet the needs of the infant, although mechanistic studies are needed to confirm this. The negative associations between certain SCFAs on sensitisation and atopic disease adds to prior evidence regarding their immunoregulatory potential. Funding: Swedish Research Council (Nr. 2013-3145 and 2019-0137 to A-S.S.), Swedish Research Council for Health, Working Life and Welfare FORTE, Nr 2018-00485 to A.W.), The Swedish Asthma and Allergy Association's Research Fund (2020-0020 to A.S.).
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| 7. |
- Bräutigam, Matilda, 1975, et al.
(författare)
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The Swedish PedsQL gastrointestinal symptoms scale and symptoms module showed good psychometric performance
- 2024
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Ingår i: ACTA PAEDIATRICA. - 0803-5253 .- 1651-2227.
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Tidskriftsartikel (refereegranskat)abstract
- AimThere is no validated symptom scale for Swedish children with gastrointestinal disorders. Our aim was to validate the Swedish version of the Paediatric Quality of Life Inventory (PedsQL) gastrointestinal symptoms scale and symptoms module. MethodsFamilies were recruited from two hospitals in Gothenburg, Sweden, from 1 March 2021 to 31 October 2022. The instruments were completed by 115 children with functional, congenital or organic acquired gastrointestinal disorders and 149 of their parents. These were the gastrointestinal symptoms scales, symptoms module and the 4.0 Generic core scale. Data were analysed for feasibility, construct validity and reliability, including internal consistency, re-test reliability and child-parent agreement. ResultsFeasibility was good, with a failure to respond of <= 5%. Construct validity showed strong correlation in the PedsQL gastrointestinal symptoms module. The known-group validity agreed with the expectations associated with the disease characteristics (p < 0.05). Cronbach's alpha was 0.96, which indicated excellent internal reliability. The intraclass correlation coefficient for the child self-report and parent-proxy report was 0.74, which indicated good agreement. ConclusionThe Swedish PedsQL Gastrointestinal Symptoms Scales, the symptoms module provided acceptable measurement properties and can be used to evaluate symptoms of gastrointestinal disorders and quality of life during clinical work or research projects.
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| 8. |
- Elfvin, Anders, 1971, et al.
(författare)
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Temporary percutaneous and permanent gastric electrical stimulation in children younger than 3 years with chronic vomiting.
- 2011
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Ingår i: Journal of pediatric surgery. - : Elsevier BV. - 1531-5037 .- 0022-3468. ; 46:4, s. 655-61
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate whether young children with drug-refractory nausea and vomiting can be treated with gastric electrical stimulation (GES) in a similar way as adults and to evaluate whether temporary percutaneous gastric electrical stimulation (TPGES) can be used in the pediatric population to select the patients who are responders to GES treatment. We report the clinical results in 3 children between 2 and 3 years of age. To the best of our knowledge, these are the youngest patients treated with GES.
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| 9. |
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| 10. |
- Gale, Gita, et al.
(författare)
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Does Crohn's Disease with Concomitant Orofacial Granulomatosis Represent a Distinctive Disease Subtype?
- 2016
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Ingår i: Inflammatory Bowel Diseases. - : Oxford University Press (OUP). - 1078-0998. ; 22:5, s. 1071-1077
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although orofacial granulomatosis (OFG) may present as a separate clinical entity, it often seems in conjunction with various systemic diseases, of which Crohn's disease (CD) is one of the most common. The aim of this study was to investigate whether CD with concomitant OFG represents a distinctive disease subtype. Methods: Twenty-one patients with CD and concomitant OFG (CD+OFG group) were included in the study. As the reference group, a cohort of 39 patients with CD but without OFG (CD-R group) was used. Demographic data and clinical characteristics were recorded at the time of diagnosis. The 2 groups were compared using multivariate analyses. Results: The percentage of patients with intestinal inflammation in the upper gastrointestinal tract was significantly higher in the CD+OFG group, as compared with the CD-R group (81% versus 33%; P < 0.001). Furthermore, ileocolonic inflammation was significantly more common in the CD+OFG patients (81% versus 46%; P = 0.013). In addition, perianal disease was more frequently observed in the CD+OFG group (48% versus 18%; P = 0.033). Significantly more patients showed evidence of granulomas in the primary endoscopy in the CD+OFG group than in the CD-R group (81% versus 38%; P = 0.003). Conclusion: The data from this study suggest that the presence of CD in conjunction with OFG represents a distinctive subphenotype of CD that is characterized by extensive inflammation, perianal disease, and pronounced granuloma formation in the intestine.
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| 11. |
- Gale, Gita, et al.
(författare)
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Immunophenotype in orofacial granulomatosis with and without Crohn's disease.
- 2014
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Ingår i: Medicina oral, patología oral y cirugía bucal. - : Medicina Oral, S.L.. - 1698-6946. ; 19:6
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this investigation was to characterise and compare the inflammatory infiltrates in patients with orofacial granulomatosis solely (OFG-S) and OFG with coexisting Crohn's disease (OFG+CD).
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| 12. |
- Gale, Gita, et al.
(författare)
-
Reply.
- 2016
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Ingår i: Inflammatory bowel diseases. - 1536-4844. ; 22:7
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 13. |
- Hesselmar, Bill, 1955, et al.
(författare)
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An index to predict asthma in wheezing young children produced promising initial results.
- 2017
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253. ; 106:9, s. 1532-1533
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Tidskriftsartikel (refereegranskat)abstract
- Diagnosing asthma is difficult in infants and preschool children because wheezing is common in this age group and it is not synonymous with asthma. Some children outgrow the tendency to wheeze during colds in a few years' time, whereas other develop asthma. Efforts have been made to find ways to identify the subgroup of preschool children with wheeze who are most likely to develop asthma (1,2). However, the different asthma predictive indexes mainly aim to predict children who will have a persistent wheeze or asthma, not necessarily the subgroup who will outgrow their symptoms. This article is protected by copyright. All rights reserved.
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| 14. |
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| 15. |
- Hesselmar, Bill, 1955, et al.
(författare)
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Pacifier Cleaning Practices and Risk of Allergy Development.
- 2013
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 1098-4275 .- 0031-4005. ; 131:6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:Immune stimulation through exposure to commensal microbes may protect against allergy development. Oral microbes may be transferred from parents to infants via pacifiers. We investigated whether pacifier cleaning practices affected the risk of allergy development.METHODS:A birth-cohort of 184 infants was examined for clinical allergy and sensitization to airborne and food allergens at 18 and 36 months of age and, in addition, promptly on occurrence of symptoms. Pacifier use and pacifier cleaning practices were recorded during interviews with the parents when the children were 6 months old. The oral microbiota of the infants was characterized by analysis of saliva samples collected at 4 months of age.RESULTS:Children whose parents "cleaned" their pacifier by sucking it (n = 65) were less likely to have asthma (odds ratio [OR] 0.12; 95% confidence interval [CI] 0.01-0.99), eczema (OR 0.37; 95% CI 0.15-0.91), and sensitization (OR 0.37; 95% CI 0.10-1.27) at 18 months of age than children whose parents did not use this cleaning technique (n = 58). Protection against eczema remained at age 36 months (hazard ratio 0.51; P = .04). Vaginal delivery and parental pacifier sucking yielded independent and additive protective effects against eczema development. The salivary microbiota differed between children whose parents cleaned their pacifier by sucking it and children whose parents did not use this practice.CONCLUSIONS:Parental sucking of their infant's pacifier may reduce the risk of allergy development, possibly via immune stimulation by microbes transferred to the infant via the parent's saliva.
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| 16. |
- Hesselmar, Bill, 1955, et al.
(författare)
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Pet-keeping in early life reduces the risk of allergy in a dose-dependent fashion.
- 2018
-
Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 13:12
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Tidskriftsartikel (refereegranskat)abstract
- Several studies have indicated that early pet keeping could protect the infant from later allergy development. Here, we investigate if there is a dose-dependent association between cat- and dog-keeping during the first year of life and subsequent allergy development.Two cohorts were investigated: a cross-sectional questionnaire-based study of 7- to 8-year-old children (N = 1029) from Mölndal and Kiruna, and a birth-cohort of children from the Västra Götaland county clinically evaluated for asthma and allergy by paediatricians up to the age of 8-9 years (N = 249). The cross-sectional study asked validated questions on asthma and allergy that had been used in two previous studies of children from the same areas. In the birth-cohort study, a diagnosis of asthma and allergy was based on predefined clinical criteria, and laboratory evaluation included blood eosinophils, skin-prick tests and specific immunoglobulin E analyses. Information on pets during first year of life was collected retrospectively in the Cross-Sectional Cohort and prospectively in the Birth Cohort.A dose-response association was seen, with less allergic manifestations (any of asthma, allergic rhinoconjunctivitis, or eczema) with increasing number of household cats and dogs during the first year of life. In the Cross-Sectional Cohort, allergy ever decreased from 49% in those with no pets to zero in those with five or more pets (P-value for trend 0.038), and from 32% to zero for allergy last year (P-value for trend 0.006). The same pattern was seen in Birth Cohort. Sensitization to animals, as well as pollens, also decreased with increasing number of animals in the household.The prevalence of allergic disease in children aged 7-9 years is reduced in a dose-dependent fashion with the number of household pets living with the child during their first year of life, suggesting a "mini-farm" effect, whereby cats and dogs protect against allergy development.
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| 17. |
- Kondori, Nahid, 1967, et al.
(författare)
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Candida species as commensal gut colonizers: A study of 133 longitudinally followed Swedish infants.
- 2020
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Ingår i: Medical mycology. - 1460-2709. ; 58:4, s. 485-92
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Tidskriftsartikel (refereegranskat)abstract
- The gut microbiota harbor a wide range of bacterial species, but also yeasts may be part of this ecosystem. Infants who are being treated in intensive care units are often colonized by Candida species. However, little is known regarding commensal yeast colonization of healthy infants and young children. Here the acquisition of yeast species was studied in a birth-cohort including 133 healthy Swedish infants. A rectal swab sample was obtained on day 3 of life, and fresh fecal samples were obtained at regular intervals up to 3 years of age; the samples were cultured quantitatively for yeasts. Colonization with yeasts increased rapidly in the first months of life, with 73/133 infants (55%) colonized at 6 months of age. The yeast numbers in positive samples decreased from an average of 105 cfu/g in infants aged 0-2 months to 103.5 cfu/g at 3 years of age. Candida albicans was the most frequently isolated species and reached higher population counts than the other species in culture-positive infants. The yeast colonization rate did not differ between infants who were delivered vaginally and those birthed via Caesarean section, whereas breastfed infants showed a lower colonization rate (p < 0.05 for 1 year of age compared to the other infants). The results demonstrate that yeasts, particularly C. albicans and C. parapsilosis (sensu lato), are common commensals in the gut microbiota of healthy infants and young children.
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| 18. |
- Kullberg-Lindh, Carola, 1959, et al.
(författare)
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Epstein-Barr viremia levels after pediatric liver transplantation as measured by real-time polymerase chain reaction.
- 2006
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Ingår i: Pediatric transplantation. - : Wiley. - 1397-3142 .- 1399-3046. ; 10:1, s. 83-9
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Tidskriftsartikel (refereegranskat)abstract
- Effective immunosuppression has improved the results following liver transplantation, but also increased the risk for opportunistic infections. Epstein-Barr virus (EBV) infection in transplant patients can cause various symptoms including the life-threatening premalignant condition, post-transplantation lymphoproliferative disorder (PTLD). Serum specimens from 24 consecutive children (mean 7.6 specimens/patient), who had undergone liver transplantation in Göteborg from January 1995 to May 2002, were analyzed retrospectively for EBV DNA by real-time TaqMan polymerase chain reaction (PCR). The results were related to clinical picture, immunosuppression, graft rejection and infections with other agents. Eleven patients (46%) developed primary EBV infection at a mean time of 4.8 months after transplantation, and six (25%) reactivated EBV infection at a mean of 4.0 months after transplantation. Four of the 11 patients with primary infection had symptomatic EBV infection: two had PTLD and two hepatitis. One patient in the group with reactivated infection developed PTLD. EBV DNA levels were significantly higher in the group with primary symptomatic infection compared with the patients with primary asymptomatic infection (mean 65 500 copies/mL; range 14 200-194 300 vs. 3700 copies/mL; range 100-9780). In patients with symptomatic infection EBV DNA levels did not differ between PTLD and hepatitis patients. The data suggest that quantitative analysis of EBV DNA in serum by real-time PCR is useful for identification of EBV-related disease.
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| 19. |
- Kullberg-Lindh, Carola, 1959, et al.
(författare)
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Epstein-Barr virus DNA monitoring in serum and whole blood in pediatric liver transplant recipients who do or do not discontinue immunosuppressive therapy
- 2017
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Ingår i: Pediatric Transplantation. - : Wiley. - 1397-3142 .- 1399-3046. ; 21:5
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Tidskriftsartikel (refereegranskat)abstract
- © 2016 John Wiley & Sons A/S.The rate of PTLD can be reduced by weaned IS guided by monitoring of EBV DNA. In this single-center retrospective case series study, we analyzed how reduction in IS influenced EBV DNA levels in whole blood and serum in 30 children during the first year after liver transplantation, and how these levels were related to symptoms putatively due to EBV. Primary and reactivated EBV infection was seen in 18 (60%) and eight patients (27%), respectively. Thirteen patients (42%) developed chronic high load the first year post-transplant. IS was successfully discontinued in six patients the first year post-transplant and in another two patients within 3 years. EBV DNA levels were reduced, but persisted long term in all the eight patients who had IS completely withdrawn. There was no case of PTLD. In summary, EBV DNAemia and chronic high load were very common after pediatric liver transplantation. Liver graft tolerance facilitates radical reduction in IS treatment, which may prevent PTLD, but EBV DNAemia may persist long term after discontinued IS.
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| 20. |
- Käppi, Timo, 1975, et al.
(författare)
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Collagenous Gastritis in Children: Incidence, Disease Course, and Associations With Autoimmunity and Inflammatory Markers.
- 2020
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Ingår i: Clinical and translational gastroenterology. - : Ovid Technologies (Wolters Kluwer Health). - 2155-384X. ; 11:8
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Tidskriftsartikel (refereegranskat)abstract
- Collagenous gastritis (CG), a rare disorder of unknown etiology, has been postulated to have immune-mediated mechanisms. We investigated (i) the incidence and prevalence of CG in a pediatric population; (ii) the clinical, endoscopic, and histologic characteristics of childhood-onset CG; and (iii) the evidence for autoimmunity and/or inflammatory activity in these patients.Clinical, endoscopic, and histologic data were reviewed longitudinally in a population-based Swedish cohort of 15 patients with childhood-onset CG diagnosed in the period 2008-2019. A set of 11 autoantibodies, 4 blood inflammatory biomarkers, and the human leukocyte antigen DQ2/DQ8 genotype was analyzed cross-sectionally.The incidence rate of childhood-onset CG was 0.25/100,000 person-years, with an incidence rate ratio of girls to boys of 4.2 (95% confidence interval, 1.2-15). The prevalence of CG was 2.1/100,000 in children aged younger than 18 years. The endoscopic and histologic findings remained pathologic in all the examined patients during a median follow-up of 4.4 years. Many patients had heredity for autoimmune disorders (47%) and/or tested positive for autoantibodies (40%) or human leukocyte antigen DQ2/DQ8 (53%). No associated autoimmune comorbidities were observed. The serum levels of calprotectin and amyloid A were increased in 10/15 (67%) and 5/15 (33%) of the patients, respectively, whereas plasma C-reactive protein levels were normal in all, but 1 patient.The results indicate that childhood-onset CG is rare and has a chronic disease course. Although signs of autoimmune predisposition are frequent, early development of autoimmune comorbidities seems seldom. Serum calprotectin and amyloid A represent novel candidate biomarkers of inflammatory activity in CG (see Visual Abstract, Supplementary Digital Content 4, http://links.lww.com/CTG/A349).
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| 21. |
- Käppi, Timo, 1975, et al.
(författare)
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High frequency of concomitant food allergy development and autoantibody formation in children who have undergone liver transplantation
- 2019
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Ingår i: Transplantation. - 1534-6080. ; 103:11, s. 2338-2346
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Tidskriftsartikel (refereegranskat)abstract
- Allergy and other immune-mediated diseases are more frequently reported in children who have undergone liver transplantation. Furthermore, autoantibodies are also prevalent, suggesting a state of immune dysregulation in these patients. Whether or not these processes occur simultaneously in the same individual has not been studied previously.A cohort of 43 children who had undergone liver transplantation for nonautoimmune liver disease at median age of 1.3 years was investigated for allergy and autoimmune disease. Sensitization to food and inhalant allergens was assessed and autoantibodies were measured.The prevalence of food allergy was 26% and that of respiratory allergy was 23%, while 33% and 26% of the subjects were sensitized to food and inhalant allergens, respectively. Autoimmune disease (i.e., autoimmune hepatitis) occurred in a single individual (2%), whereas autoantibodies were present in 44% of the children. Food allergy and autoantibodies occurred concomitantly in 19% of the children, which was almost twice the frequency expected by chance (11%, p=0.04). Respiratory allergy and the presence of autoantibodies were unrelated (12% concurrence vs the expected 10%, p = 0.73). In the logistic regression analysis, autoantibody formation was associated with discontinued immunosuppression and food allergy, with odds ratios of 13 (p=0.01) and 7.1 (p=0.03), respectively.In contrast to respiratory allergy, food allergy and autoantibody formation occurred together in the same children who underwent liver transplantation at a frequency higher than would be expected by chance. This may reflect an underlying immune dysregulation that impairs immune tolerance to both food allergens and autoantigens.
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| 22. |
- Lindberg, Erika, 1976, et al.
(författare)
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Effect of lifestyle factors on Staphylococcus aureus gut colonization in Swedish and Italian infants.
- 2011
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Ingår i: Clinical microbiology and infection. - : Elsevier BV. - 1469-0691 .- 1198-743X. ; 17:8, s. 1209-1215
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Tidskriftsartikel (refereegranskat)abstract
- Clin Microbiol Infect ABSTRACT: In recent years, Staphylococcus aureus has become a common bowel colonizer in Swedish infants. We aimed to identify host factors that determine such colonization. Stool samples from 100 Italian and 100 Swedish infants were obtained on seven occasions during the first year of life and cultured quantitatively for S.aureus. In a subgroup of infants in each cohort, individual strains were identified by random amplified polymorphic DNA analysis. Colonization at each time-point was related to delivery mode, siblings in family and antibiotic treatment. In total, 66% of the Italian and 78% of the Swedish infants had S.aureus in their stools on at least one time-point (p 0.08) and 4% of Italian and 27% of Swedish infants were positive on at least six of the seven time-points investigated (p0.0001). Most infants analysed regarding strain carriage harboured a single strain in their microbiota for several months. The S.aureus stool populations in colonized infants decreased from 10(7) to 10(4) colony-forming units/g between 1week and 1year of age in both cohorts. In multivariate analysis, the strongest predictor for S.aureus colonization was being born in Sweden (OR 3.4 at 1week of age, p0.002). Having (an) elder sibling(s) increased colonization at peak phase (OR 1.8 at 6months, p0.047). Antibiotic treatment was more prevalent among Italian infants and correlated negatively with S.aureus colonization at 6months of age (OR 0.3, p0.01). To conclude, S.aureus is a more common gut colonizer in Swedish than Italian infants, a fact that could not be attributed to feeding or delivery mode.
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| 23. |
- Lindberg, Erika, 1976, et al.
(författare)
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High rate of transfer of Staphylococcus aureus from parental skin to infant gut flora.
- 2004
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Ingår i: Journal of clinical microbiology. - 0095-1137. ; 42:2, s. 530-4
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Tidskriftsartikel (refereegranskat)abstract
- Many Swedish infants carry Staphylococcus aureus in their intestinal microflora. The source of this colonization was investigated in 50 families. Infantile S. aureus strains were isolated from rectal swabs and stool samples at 3 days and at 1, 2, 4, and 8 weeks of age. The strains were identified by using the random amplified polymorphic DNA method and compared to strains from swab cultures of the mothers' hands, nipples, and nares and from the fathers' hands and nares. Maternal stool samples were also obtained at a later stage to compare infant and adult intestinal S. aureus colonization. Although 60% of 1-month-old children had S. aureus in the stools, this was true of only 24% of the mothers. The median population numbers in colonized individuals also differed: 10(6.8) CFU/g of feces among infants at 2 weeks of age versus 10(3.2) CFU/g of feces in the mothers. Of S. aureus strains in the stools of 3-day-old infants, 90% were identical to a parental skin strain. A total of 96% of infants whose parents were S. aureus skin carriers had S. aureus in their feces and 91% had the same strain as at least one of the parents. In comparison, only 37% of infants to S. aureus-negative parents had S. aureus in the stool samples. Thus, infantile intestinal S. aureus colonization was strongly associated with parental skin S. aureus carriage (P = 0.0001). These results suggest that S. aureus on parental skin establish readily in the infantile gut, perhaps due to poor competition from other gut bacteria.
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| 24. |
- Lindfred, Helene, 1957, et al.
(författare)
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Inflammatory bowel disease and self-esteem in adolescence.
- 2008
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Ingår i: Acta paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 97:2, s. 201-5
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Forskningsöversikt (refereegranskat)abstract
- AIM: To compare the self-esteem of adolescents suffering from inflammatory bowel disease (IBD) with that of healthy adolescents, and to identify factors affecting self-esteem in the presence of IBD. METHODS: A self-assessment questionnaire, 'I think I am' (ITIA), was completed by 71 (41 boys) out of 77 adolescents (10-16 years) with IBD. Of the participating adolescents, 23 had Crohn's disease, 44 had ulcerative colitis and 4 had indeterminate colitis. The self-esteem of adolescents with IBD was compared with that of 1037 school children. RESULTS: In this population-based study, children with IBD estimated their self-esteem in the same range as healthy adolescents. Using a multiple regression analysis, the self-esteem of adolescents with IBD was related to disease course severity and cohabitation status of parents. Children with severe disease and children of single parents were found to be most at risk of low self-esteem. CONCLUSION: This study shows that, as a group, adolescents with IBD have self-esteem in the same range as their healthy peers, but that there are some adolescents with IBD who are at risk of low self-esteem. Special attention should be given to adolescents with a severe disease course and to those with separated parents.
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| 25. |
- Lindfred, Helene, 1957, et al.
(författare)
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Parents' views of their child's health and family function in paediatric inflammatory bowel disease.
- 2010
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Ingår i: Acta paediatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 99:4, s. 612-617
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract Aim: The aim of this study was to explore parents' views and agreement of their child's current and future health, as well as the family's functioning in daily life with inflammatory bowel disease (IBD). Methods: In this study, 119 parents (65 mothers and 54 fathers) of 66 adolescents (11-16 years) with IBD completed a questionnaire regarding their views of their child's IBD and health-related behaviour. Results: The majority of the parents held a positive view of their child's current health status. However, the parents voiced a range of worries about their children's future health and life situation such as fear about the side effects of medication, concerns for future schooling, social life and employment options. Within the families, the parental pairs had more similar views about their child's current health status than about their future health. Factors that affected the parents' views consisted of cohabitation status, i.e. parents not living together, and severe disease course, both correlated with a more negative view of the child's current health and family functioning. Conclusion: The majority of the parents in this study had a largely positive view of their child's current health status, but they expressed concerns about their child's future health. Knowledge about parents' thoughts may be of importance for healthcare teams supporting families with IBD.
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| 26. |
- Lindfred, Helene, 1957, et al.
(författare)
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Self-reported health, self-management, and the impact of living with inflammatory bowel disease during adolescence.
- 2012
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Ingår i: Journal of pediatric nursing. - : Elsevier BV. - 1532-8449 .- 0882-5963. ; 27:3, s. 256-64
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Tidskriftsartikel (refereegranskat)abstract
- Perceptions of living with inflammatory bowel disease (IBD) during adolescence were explored in a cross-sectional study with a multimethod design. The adolescents as a group described general well-being and ability to handle the disease, which was related to their self-reported self-esteem. However, a subgroup of adolescents with a severe disease course reported a more negative view of the impact of IBD in their daily lives. Encouraging adolescents to communicate in different ways may help professionals to identify vulnerable subgroups with impaired health and to provide more appropriate support and treatment for those most in need.
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| 27. |
- Lingblom, Christine, 1984, et al.
(författare)
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Differences in eosinophil molecular profiles between children and adults with eosinophilic esophagitis.
- 2017
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Ingår i: Allergy. - : Wiley. - 1398-9995 .- 0105-4538. ; 72:9, s. 1406-1414
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Tidskriftsartikel (refereegranskat)abstract
- Eosinophilic esophagitis (EoE) afflicts both children and adults. It has been debated whether pediatric and adult EoE represent different disease entities. The objectives of this study were to determine if the blood eosinophil molecular pattern of children with EoE is: 1) distinct from that of healthy children; and 2) different from that of adults with EoE.Blood eosinophils from children and adults with EoE, and healthy controls, were analyzed with flow cytometry regarding levels of CD23, CD44, CD54, CRTH2, FOXP3 and galectin-10. Eosinophil FOXP3 and galectin-10 mRNA levels were determined by qPCR. The data was analyzed by using a multivariate method of pattern recognition.An eosinophil molecular pattern capable of distinguishing children with EoE from control children was identified. A smaller fraction of eosinophils from children with EoE expressed CD44 and a larger fraction expressed CRTH2 than the controls. Eosinophils from children with EoE also had higher levels of galectin-10 mRNA and lower levels of FOXP3 mRNA. The eosinophils from children with EoE had lower levels of surface CD54 and of FOXP3 mRNA compared with the eosinophils from the adult patients. A key finding was the detection in healthy individuals of age-related differences in the levels of several eosinophil markers.Children with EoE can be distinguished from healthy children based on the molecular patterns of their blood eosinophils. Age-related physiologic differences in eosinophil molecular patterns may partly explain the different blood eosinophil phenotypes in children versus adults with EoE. This article is protected by copyright. All rights reserved.
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| 28. |
- Lingblom, Christine, 1984, et al.
(författare)
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Eosinophils from eosinophilic oesophagitis patients have T cell suppressive capacity and express FOXP3.
- 2017
-
Ingår i: Clinical and Experimental Immunology. - : Oxford University Press (OUP). - 1365-2249 .- 0009-9104. ; 187:3, s. 455-465
-
Tidskriftsartikel (refereegranskat)abstract
- Eosinophilic esophagitis (EoE) is an antigen-driven T cell-mediated chronic inflammatory disease where food and environmental antigens are thought to have a role. Human eosinophils express the immunoregulatory protein galectin-10 and have T cell suppressive capacity similar to regulatory T cells (Tregs ). We hypothesized that one function of eosinophils in EoE might be to regulate the T cell-driven inflammation in the oesophagus. This was tested by evaluating the suppressive capacity of eosinophils isolated from the blood of adult EoE patients in a mixed lymphocyte reaction. In addition, eosinophilic expression of forkhead box protein 3 (FOXP3), the canonical transcription factor of Tregs , was determined by conventional and imaging flow cytometry, quantitative polymerase chain reaction (qPCR), confocal microscopy and immunoblotting. It was found that blood eosinophils from EoE patients had T cell suppressive capacity, and that a fraction of the eosinophils expressed FOXP3. A comparison of EoE eosinophils with healthy control eosinophils indicated that the patients' eosinophils had inferior suppressive capacity. Furthermore, a higher percentage of the EoE eosinophils expressed FOXP3 protein compared with the healthy eosinophils, and they also had higher FOXP3 protein and mRNA levels. FOXP3 was found in the cytosol and nucleus of the eosinophils from both the patients and healthy individuals, contrasting with the strict nuclear localization of FOXP3 in Tregs . To conclude, these findings suggest that the immunoregulatory function of eosinophils may be impaired in EoE.
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| 29. |
- Lundell, Anna-Carin, 1976, et al.
(författare)
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High circulating immunoglobulin A levels in infants are associated with intestinal toxigenic Staphylococcus aureus and a lower frequency of eczema.
- 2009
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Ingår i: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. - : Wiley. - 1365-2222. ; 39:5, s. 662-70
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Intestinal bacteria trigger IgA production and delayed maturation of mucosal IgA response is linked to allergy development. OBJECTIVE: Our aim was to investigate if plasma levels of IgA or APRIL (a proliferation inducing ligand), an important factor for IgA class switch recombination, in infancy correlates with intestinal colonization by any specific bacteria or yeast. We also examined if plasma IgA or APRIL levels are related to sensitization and the development of eczema. METHODS: IgA was quantified in plasma obtained from infants at birth and at 4 and 18 months of age and APRIL was measured at 4 months of age. Colonization by major bacterial groups and yeast was followed in the first 8 weeks of life by quantitative culture of stool samples. A clinical evaluation regarding the presence of allergen-specific IgE or eczema and eosinophil counts in blood was performed at 18 months of age. RESULTS: In multiple linear regression analysis, only colonization by Staphylococcus aureus strains producing toxins with superantigen function (SEA-D or TSST-1) made an independent contribution to plasma IgA levels at 4 months of age. Further, increased levels of APRIL in plasma at 4 months were negatively associated with sensitization while IgA plasma levels were inversely correlated to eczema development and blood eosinophil counts at 18 months of age. CONCLUSION: Early intestinal colonization by toxigenic S. aureus strains seems to promote systemic IgA responses. Furthermore, high levels of APRIL and IgA in the circulation at 4 months of age seem to correlate negatively with allergy development.
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| 30. |
- Lundell, Anna-Carin, 1976, et al.
(författare)
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Increased levels of circulating soluble CD14 but not CD83 in infants are associated with early intestinal colonization with Staphylococcus aureus
- 2007
-
Ingår i: Clin Exp Allergy. ; 37:1, s. 62-71
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Soluble forms of the monocyte marker CD14 and the mature dendritic cell marker CD83 are plasma proteins with immunoregulatory functions. The physiological stimulus for their production is unclear and their possible role in allergy development is unknown. METHODS: We measured the plasma levels of soluble CD14 (sCD14) and soluble CD83 (sCD83) in 64 Swedish children in relation to intestinal bacterial colonization pattern in a prospective birth cohort. Soluble CD14 and sCD83 levels were quantified by enzyme linked immunosorbent assay in plasma obtained at birth and at 4, 18 and 36 months of age. All major aerobic and anaerobic bacteria were quantified in faecal samples obtained regularly over the first 8 weeks of life. Clinical allergy and IgE levels were evaluated at 18 months of age. RESULTS: Soluble CD14 in plasma increased during the first 18 months of life while sCD83 peaked at 4 months of age. Children who were perinatally colonized with Staphylococcus aureus had significantly higher levels of sCD14 in plasma at 4 months of age relative to non-colonized children. The levels of sCD14 were unrelated to colonization with Escherichia coli, other enterobacteria, enterococci, clostridia, Bacteroides, bifidobacteria or lactobacilli. Further, children with food allergy by 18 months tended to have lower levels of sCD14 than healthy children. Plasma levels of sCD83 were not related to either bacterial colonization pattern or allergy development. CONCLUSIONS: Perinatal colonization with S. aureus may trigger the occurrence of sCD14 in plasma, which may influence development of the infantile immune system and risk of allergy development.
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| 31. |
- Malmquist, Marianne, 1961, et al.
(författare)
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Frequent Occurrence of Perianal Disease and Granuloma Formation in Patients with Crohn's Disease and Coexistent Orofacial Granulomatosis
- 2023
-
Ingår i: Digestive Diseases and Sciences. - : Springer Science and Business Media LLC. - 0163-2116 .- 1573-2568. ; 68:7, s. 3129-3138
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundOrofacial granulomatosis (OFG) is an inflammatory disorder of the perioral region and oral cavity. Crohn's disease (CD) in conjunction with OFG (CD-OFG), has been suggested to constitute a phenotype of CD with distinct features at diagnosis.AimsThe aim of this project was to investigate whether the distinct phenotypic features of CD-OFG persist in the years following the initial diagnosis of CD.MethodsClinical data were extracted from medical records covering the first 5 years post-diagnosis for a cohort of patients with CD-OFG, and were compared to those of references with CD without OFG.ResultsThe clinical characteristics of our cohort of patients with CD-OFG (N = 25) were evaluated in comparison to references with CD without OFG (ratio 1:2). Five years post-diagnosis, more patients with CD-OFG had a phenotype with perianal disease (cumulative incidence: 16/25, 64% vs 13/50, 26%, P = 0.002) and intestinal granulomas (cumulative incidence: 22/25, 88% vs 24/50, 48%, P = 0.0009) than patients in the CD reference group. The patients with CD-OFG were also more likely to have undergone perianal surgery (12/25, 48% vs 4/50, 8%, P = 0.0002). At the end of the observation period, more of the patients with CD-OFG were receiving combination therapy, i.e., immunomodulators and tumor necrosis factor antagonists, than those in the CD reference group (9/25, 36% vs 5/50, 10%, P = 0.01).ConclusionThe results support the notion that CD in conjunction with OFG represents a specific phenotype of CD that is characterized by frequent perianal disease, pronounced intestinal granuloma formation and a need for extensive therapy.
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| 32. |
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| 33. |
- Marthinsen, Lars, et al.
(författare)
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Kolonspiroketos - behandlingsbart och värt att uppmärksamma : Erfarenheter från pediatrisk praktik
- 2006
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 103:46, s. 3600-3602
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Forskningsöversikt (refereegranskat)abstract
- This article is written to raise awareness among clinicians and pathologists regarding the existence of colonic spirochetosis. Whether this is of clinical significance is still a matter of debate. We report a series of sixteen randomly selected patients, all of paediatric age; eight of them have been reported in a previous publication (10). In one patient, spirochetes were found both in the colon and in the liver. The colon organisms were Brachyspira aalborgi, documented by antigen test; however, due to lack of material, the spirochetes in the liver could not be typed. As 10 of 13 patients recovered or improved after antibiotic treatment with clarythromycin or metronidazole, our conclusion is that Brachyspira may be pathogenic. We suggest that when a rectosigmoidoscopy/colonoscopy is performed, colonic spirochetosis should be considered, especially in the differential diagnosis to microscopic colitis.
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| 34. |
- Mattsson, Ulf, 1955, et al.
(författare)
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Recidiverande aftös stomatit
- 2004
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Ingår i: Tandläkartidningen. ; 96:3, s. 48-54
-
Forskningsöversikt (refereegranskat)
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| 35. |
- Mellgren, Karin, 1962, et al.
(författare)
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Liver transplantation after stem cell transplantation with the same living donor in a monozygotic twin with acute myeloid leukemia
- 2005
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Ingår i: Ann Hematol. - : Springer Science and Business Media LLC. - 0939-5555. ; 84:11, s. 755-7
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Tidskriftsartikel (refereegranskat)abstract
- Two monozygotic twins from a Swedish, nonconsanguine family-with concordant acute myeloid leukemia and similar morphological and cytogenetic changes, but with additional changes in one twin, suggestive of clonal evolution-are described. Twin I relapsed 4 months after completion of treatment, while twin II was still on treatment and was transplanted with stem cells from the human leukocyte antigen-identical father. An early relapse after transplantation was treated with donor lymphocyte infusions, but twin I relapsed again and died 8 months after stem cell transplantation (SCT). On relapse of twin I, treatment of twin II was reconsidered and consolidation was intensified with SCT in CR1 with peripheral blood stem cells from the father. Due to irreversible liver failure caused by severe venoocclusive disease, a living, related liver transplantation from the father was performed on day +84 post-SCT. Minimal immunosuppression was required, and graft rejection did not occur. The patient was in complete remission 29 months after SCT and 25 months after liver transplantation.
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| 36. |
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| 37. |
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| 38. |
- Nowrouzian, Forough, 1957, et al.
(författare)
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Adhesin and superantigen genes and the capacity of Staphylococcus aureus to colonize the infantile gut.
- 2011
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Ingår i: The Journal of infectious diseases. - : Oxford University Press (OUP). - 1537-6613 .- 0022-1899. ; 204:5, s. 714-21
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Tidskriftsartikel (refereegranskat)abstract
- Staphylococcus aureus is a pathogen and a skin commensal that is today also common in the infant gut flora. We examine the role of S. aureus virulence factors for gut colonization. S. aureus isolated from quantitative stool cultures of 49 Swedish infants followed from birth to 12 months of age were assessed for 30 virulence-associated genes, spa type, and agr allele by serial polymerase chain reaction (PCR) assays. Strains carrying genes encoding collagen-binding protein, and the superantigens S. aureus enterotoxin O/M (SEO/SEM) had higher stool counts than strains lacking these genes, whereas genes for S. aureus enterotoxin A (SEA) were associated with low counts. A cluster of strains belonging to agr allele I and the spa clonal cluster 630 (spa-CC 630) that carried genes encoding SEO/SEM, SEC, collagen-binding protein, and elastin-binding protein were all long-time colonizers. Thus, certain S. aureus virulence factors might promote gut colonization.
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| 39. |
- Nowrouzian, Forough, 1957, et al.
(författare)
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Escherichia coli in infants' intestinal microflora: colonization rate, strain turnover, and virulence gene carriage.
- 2003
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Ingår i: Pediatric research. - 0031-3998. ; 54:1, s. 8-14
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Tidskriftsartikel (refereegranskat)abstract
- Colonization by Escherichia. coli in infants might have decreased in the last decades, owing to changes in hospital routines and family lifestyle. In this study, the E. coli flora was characterized in 70 healthy Swedish infants followed for the first year of life. E. coli was isolated from rectal swabs obtained at 3 d of age and quantified in fecal samples collected at 1, 2, 4, and 8 wk of age and at 6 and 12 mo of age. Strains were typed using random amplified polymorphic DNA, and their virulence factor genes were identified by multiplex PCR. Colonization by E. coli occurred late; only 61% of the infants were positive by 2 mo of age. The turnover of individual strains in the microflora was slow (1.5 strains per infant during 6 mo, 2.1 during 1 y). Environmental factors, such as siblings, pets, or feeding mode, did not influence colonization kinetics or strain turnover rate. Genes encoding type 1 fimbriae, P fimbriae, and hemolysin were significantly more common in E. coli strains persisting for at least 3 wk in the microflora than in transient strains. The P-fimbrial class III adhesin gene was more common in E. coli from children who had a cat in their homes than in E. coli from children without pets (p = 0.01); this adhesin type is common in E. coli from cats. The late colonization and low E. coli strain turnover rate suggest limited exposure of Swedish infants to E. coli. Our results confirm that P fimbriae and other virulence factors facilitate persistence of E. coli in the human colonic microflora.
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| 40. |
- Nowrouzian, Forough, 1957, et al.
(författare)
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Superantigens and adhesins of infant gut commensal Staphylococcus aureus strains and association with subsequent development of atopic eczema.
- 2017
-
Ingår i: The British journal of dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 176:2, s. 439-445
-
Tidskriftsartikel (refereegranskat)abstract
- According to the hygiene hypothesis, insufficient immune activation by microbes increases the risk of allergy development. Staphylococcus aureus, which is part of the skin and gut microbiota of infants in Western countries, produces a variety of T-cell-activating enterotoxins, called superantigens.To investigate whether early (0-2 months of age) gut colonization by S. aureus strains that carry specific superantigens and adhesins was related to subsequent development of atopic eczema in a Swedish birth cohort.Staphylococcus aureus was isolated from rectal swabs and cultured quantitatively from faecal samples, with individual strains being tested for carriage of genes for superantigens and adhesins. Atopic eczema was diagnosed at onset of symptoms and at 18 months of age.Although the frequency of early gut colonization by S. aureus was not related to subsequent eczema development, the S. aureus strains that were found to colonize those infants who developed atopic eczema were less likely to carry the gene encoding the superantigen SElM (P = 0·008) and the gene for elastin-binding protein (P = 0·03), compared with strains that were isolated from infants who had not developed atopic eczema by 18 months of age.Gut colonization by S. aureus strains carrying a certain combination of superantigen and adhesin genes was negatively associated with subsequent development of atopic eczema. Such strains may provide stimulation and promote maturation of the infant immune system.
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| 41. |
- Olausson, Michael, 1956, et al.
(författare)
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In vivo application of tissue-engineered veins using autologous peripheral whole blood: A proof of concept study
- 2014
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Ingår i: EBioMedicine. - : Elsevier BV. - 2352-3964. ; 1:1, s. 72-79
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Tidskriftsartikel (refereegranskat)abstract
- Vascular diseases are increasing health problems affecting >25 million individuals in westernized societies. Such patients could benefit fromtransplantation of tissue-engineered vascular grafts using autologous cells. One challenge that has limited this development is the need for cell isolation, and risks associated with ex vivo expanded stem cells. Herewe demonstrate a novel approach to generate transplantable vascular grafts using decellularized allogeneic vascular scaffolds, repopulatedwith peripheralwhole blood (PWB) in vitro in a bioreactor. Circulating, VEGFR-2+/CD45+ and a smaller fraction of VEGFR-2+/CD14+ cells contributed to repopulation of the graft. SEMmicrographs showed flat cells on the luminal surface of the grafts consistentwith endothelial cells. For clinical validation, two autologous PWBtissue-engineered vein conduits were prepared and successfully used for bypass procedures in two pediatric patients. These results provide a proof of principle for the generation of transplantable vascular grafts using a simple autologous blood sample, making it clinically feasible globally.
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| 42. |
- Rabe, Hardis, et al.
(författare)
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Distinct patterns of naive, activated and memory T and B cells in blood of patients with ulcerative colitis or Crohn’s disease
- 2019
-
Ingår i: Clinical and Experimental Immunology. - : Oxford University Press (OUP). - 0009-9104 .- 1365-2249. ; 197:1, s. 111-129
-
Tidskriftsartikel (refereegranskat)abstract
- Both major subcategories of inflammatory bowel disease (IBD), ulcerative colitis and Crohn’s disease are characterized by infiltration of the gut wall by inflammatory effector cells and elevated biomarkers of inflammation in blood and feces. We investigated the phenotypes of circulating lymphocytes in the two types of IBD in treatment-naive pediatric patients by analysis of blood samples by flow cytometry. Multivariate analysis was used to compare the phenotypes of the blood lymphocytes of children with ulcerative colitis (n=17) or Crohn’s disease (n=8) and non-IBD control children with gastrointestinal symptoms, but no signs of gut inflammation (n=23). The two IBD subcategories could be distinguished based on the results from the flow cytometry panel. Ulcerative colitis was characterized by activated T cells, primarily in the CD8+ population, as judged by increased expression of human leukocyte antigen D-related (HLA-DR) and the β1-integrins [very late antigen (VLA)] and a reduced proportion of naive (CD62L+) T cells, compared with the non-IBD controls. This T cell activation correlated positively with fecal and blood biomarkers of inflammation. In contrast, the patients with Crohn’s disease were characterized by a reduced proportion of B cells of the memory CD27+ phenotype compared to the non-IBD controls. Both the patients with ulcerative colitis and those with Crohn’s disease showed increased percentages of CD23+ B cells, which we demonstrate here as being naive B cells. The results support the notion that the two major forms of IBD may partially have different pathogenic mechanisms.
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| 43. |
- Reichenberg, Kjell, et al.
(författare)
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Adolescents with inflammatory bowel disease feel ambivalent towards their parents' concern for them
- 2007
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Ingår i: Scandinavian Journal of Caring Sciences. - 1471-6712 .- 0283-9318. ; 21:4, s. 476-481
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Tidskriftsartikel (refereegranskat)abstract
- This is a grounded theory study to identify concepts for describing how adolescents with inflammatory bowel disease (IBD) respond to their parents' concern for them. Ten adolescent boys and seven girls were interviewed. In the analysis four main categories emerged: ambivalence, ability/inability, compliance/resistance and trust/distrust. We found ambivalence to be the most distinctive theme to appear in the way in which these young people described how they felt about their parents' response to their disease. The core category ambivalence was expressed as an oscillation between seeking close contact with one's parents or, sometimes, staving them off, one moment feeling anxiously dependent upon them or turning to them for protection and support and the next, trying to achieve a dialogue with them. The core category comprised three subcategories, ability/inability, compliance/resistance and trust/distrust. The clinical support for young individuals with IBD should include an awareness of the simultaneous existence of conflicting attitudes, reactions and emotions.
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| 44. |
- Saalman, Robert, 1952, et al.
(författare)
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ADCC-mediating capacity in children with cow's milk protein intolerance in relation to IgG subclass profile of serum antibodies to beta-lactoglobulin.
- 1995
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Ingår i: Scandinavian journal of immunology. - 0300-9475. ; 42:1, s. 140-6
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Tidskriftsartikel (refereegranskat)abstract
- In a previous study sera from children with cow's milk protein intolerance (CMPI) exhibiting gastrointestinal symptoms were found to efficiently induce antibody-dependent cell-mediated cytotoxicity (ADCC) to beta-lactoglobulin-coated cells. In contrast, sera from children with coeliac disease showed a low ADCC-mediating capacity, despite high levels of IgG anti-beta-lactoglobulin antibodies. The study described here was undertaken to evaluate whether differences in IgG subclass profile of anti-beta-lactoglobulin antibodies could explain the observed variations in the ADCC-mediating capacity. Forty-eight sera from the following groups of children were investigated: CMPI with predominantly gastrointestinal symptoms, CMPI with skin symptoms of immediate-onset, children with untreated coeliac disease and healthy references. Absorption experiments indicated that primarily IgG1 antibodies were responsible for the ADCC-mediating capacity of the sera. Accordingly, the ADCC reactivity of individual sera correlated with their IgG1 antibody levels. Sera from CMPI children with gastrointestinal symptoms, most of which had a high ADCC reactivity, also demonstrated a distinctive subclass pattern of their anti-beta-lactoglobulin antibodies with higher relative proportions of IgG1 (ratios: IgG1/IgG, IgG1/IgG3 and IgG1/IgG4) than those from the other diagnostic groups. Using logistic regression analysis, the diagnostic potential of ADCC as well as of different IgG subclass variables for the recognition of gastrointestinal symptoms caused by CMPI was evaluated. The ADCC reactivity of sera was found to be the best predictor in this model.
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| 45. |
- Saalman, Robert, 1952, et al.
(författare)
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Antibody-dependent cell-mediated cytotoxicity to gliadin-coated cells with sera from children with coeliac disease.
- 1998
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Ingår i: Scandinavian journal of immunology. - 0300-9475. ; 47:1, s. 37-42
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Tidskriftsartikel (refereegranskat)abstract
- Antibody-dependent cell-mediated cytotoxicity (ADCC) has been suggested as a contributing immunological mechanism in the disease process of coeliac disease. In the present study, sera from coeliac children were examined for their capacity to mediate ADCC against gliadin-coated target cells. The ADCC-mediating efficacy of sera were tested using monocytes from healthy adults as effector cells and gliadin-coated erythrocytes from the same donor as targets. Using monocytes as effector cells, sera from children with active coeliac disease (untreated or challenged), demonstrated significantly higher ADCC-mediating capacity than sera from healthy and disease references as well as children with treated coeliac disease. A positive correlation was found between the ADCC-mediating capacity and serum IgG as well as IgA anti-gliadin antibody levels. The results suggest that an antibody-dependent monocyte/macrophage-induced cytotoxic reaction might be involved in the disease process of coeliac disease.
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| 46. |
- Saalman, Robert, 1952, et al.
(författare)
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Avidity progression of dietary antibodies in healthy and coeliac children
- 2003
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Ingår i: Clinical and Experimental Immunology. - : Oxford University Press (OUP). - 0009-9104 .- 1365-2249. ; 134:2, s. 328-34
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Tidskriftsartikel (refereegranskat)abstract
- In most individuals minute amounts of food proteins pass undegraded across the intestinal mucosa and trigger antibody formation. Children with coeliac disease have enhanced antibody production against gliadin as well as other dietary antigens, e.g. beta-lactoglobulin, in cow's milk. Antibody avidity, i.e. the binding strength between antibody and antigen, often increases during antibody responses and may be related to the biological effectiveness of antibodies. The aim of the present study was to determine the avidity of serum IgG antibodies against beta-lactoglobulin and gliadin in healthy children during early childhood and compare these avidities to those found in children with coeliac disease. The average antibody avidity was analysed using a thiocyanate elution assay, whereas the antibody activity of the corresponding sera was assayed by ELISA. The avidity of serum IgG antibodies against beta-lactoglobulin as well as gliadin increased with age in healthy children, even in the face of falling antibody titres to the same antigens. Children with untreated coeliac disease had IgG anti-beta-lactoglobulin antibodies of significantly higher avidity than healthy children of the same age, and the same trend was observed for IgG antigliadin antibodies. The present data suggest that the avidities of antibodies against dietary antigens increase progressively during early childhood, and that this process seems to be accelerated during active coeliac disease.
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| 47. |
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| 48. |
- Saalman, Robert, 1952, et al.
(författare)
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Orofacial granulomatosis in childhood-a clinical entity that may indicate Crohn's disease as well as food allergy.
- 2009
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 98:7, s. 1162-7
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Orofacial granulomatosis (OFG) is a rare clinical entity with orofacial swelling in association with oral lesions such as mucosal oedema, ulcerations and mucosal tags. The aim of this prospective study was to evaluate the connection between OFG in childhood and systemic disease. METHODS: During a 3-year period, eight children (9-16 years old) who had been referred to the clinic of oral medicine were diagnosed solely with OFG. Thus, none of them had any known systemic disease or gastrointestinal symptoms at the time of referral. The children were then medically examined and followed up for 6-8 years at the department of paediatrics for systemic disease with specific emphasis on inflammatory disorders elsewhere in the gastrointestinal tract. RESULTS: During follow-up, four patients were diagnosed with Crohn's disease (CD). Further, one girl was found to have a food allergy-induced OFG, with delayed-type hypersensitivity to oats. One boy developed both diabetes and celiac disease during the follow-up. Only two patients had no diagnosis of systemic disease at the end of the observation period. CONCLUSION: OFG in childhood seems to be frequently related to systemic disease, and children with OFG should be referred to a paediatrician for examination and follow-up.
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| 49. |
- Schmidt, Susanne, 1970, et al.
(författare)
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Familial Resemblance of Bone Mineral Density in Children With Inflammatory Bowel Disease.
- 2010
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Ingår i: Journal of pediatric gastroenterology and nutrition. - 1536-4801. ; 51:2, s. 146-150
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIM:: Low bone mineral density (BMD) has recently been recognized as a potential health problem in children with inflammatory bowel disease (IBD). Our aim was to investigate the familial resemblance of BMD in pediatric patients with IBD. PATIENTS AND METHODS:: In this population-based study from western Sweden, we assessed 144 children with IBD, 83 with ulcerative colitis, 45 with Crohn disease, 16 with indeterminate colitis, and their parents (136 mothers and 130 fathers) with dual-energy X-ray absorptiometry (DEXA). After adjustment for sex, age, weight, height, and parental IBD, we correlated the BMD of the patients to the BMD of their mothers, fathers, and the midparent value ([mother's BMD + father's BMD]/2) at different skeletal sites and calculated the Pearson correlation coefficient (r) to evaluate the extent of familial resemblance. RESULTS:: The BMD of the children with IBD was clearly related to the BMD of their parents. The strongest correlation was found in the femoral neck with r = 0.55 (P < 0.001, 95% CI 0.41-0.66) between BMD of the children and the midparent value. The group of children with IBD had an odds ratio of 5.96 for decreased BMD (lumbar spine z score < -1 standard deviation) given that decreased BMD was diagnosed in both parents. CONCLUSIONS:: We conclude that BMD in children and adolescents with IBD is significantly related to that of their parents. In a clinical setting, it may be helpful to assess the parents of children with IBD with DEXA to interpret the children's DEXA measurements.
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| 50. |
- Schmidt, Susanne, 1970, et al.
(författare)
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Longitudinal Assessment of Bone Mineral Density in a Population of Children and Adolescents with Inflammatory Bowel Disease.
- 2012
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Ingår i: Journal of pediatric gastroenterology and nutrition. - 1536-4801. ; 55:5, s. 511-518
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:: Low bone mineral density (BMD) is recognized as a potential problem in children with inflammatory bowel disease (IBD). We aimed to describe the longitudinal development of BMD in a population of Swedish pediatric patients with IBD. METHODS:: A total of 144 IBD patients (93 males; 83 with ulcerative colitis (UC), 45 with Crohn's disease (CD)) were examined with dual-energy X-ray absorptiometry (DXA) at baseline. At follow-up two years later, 126 of the initial 144 patients were re-examined. BMD values are expressed as Z-scores. RESULTS:: Children with UC and CD had significantly lower mean BMD Z-scores of the lumbar spine (LS) at baseline and after two years. The reduction in BMD was equally pronounced in UC and CD patients, and neither group improved their Z-score during the follow-up period. Furthermore, significantly lower mean BMD Z-scores LS were found at baseline in males (-1.1 SD,±2.7 SD, p<0.001), but not in females (-0.0 SD,±3.0 SD). This finding remained unchanged at follow-up. Subanalyses of the different age groups at baseline showed the lowest BMD values in the group of patients aged 17 to 19 years in males (mean Z-score LS -1.59 SD,±3.1 SD) and in females (mean Z-score LS -3.40 SD,±3.1 SD). However, at follow-up, these patients had improved their BMD significantly (mean change Z-score LS 1.00 SD, 95% CI 0.40-1.60; 1.90 SD, 95% CI 0.60-3.20). CONCLUSIONS:: In this longitudinal study, the entire group of pediatric IBD patients showed permanent decreases in their BMD Z-scores LS. However, our data indicate that afflicted children have the potential to improve their BMD by the time they reach early adulthood.
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