Paediatric Pulmonology (kinderlongziekgen MDP)

The pulmonary system is in constant development during childhood. During this period environmental exposures act upon genetic predisposition to set a child on a trajectory to pulmonary health or disease, processess that have been shown to track well into adulthood. Unfortunately the exact nature of these pathofysiological processes is poorly understood as they are heteregeneous and typically poorly described by symptoms. This limits our capabilities to target existing therapies effectively and slows down development of novel therapies.

The department of pediatric pulmonology at the Emma’s Children Hospital  performs research to increase our understanding of the development of airways disease. We approach this by focussing not only on those children that do develop disease but explicitely on what protects children despite being exposed to the same environment. In this context the primary focus of our research lies in pediatric asthma. We collaborate intensively with a wide range of departments to build collaborative research projects that help us identify novel preventive and therapeutic approaches in asthma along with biomarkers that help identify children most likely to benefit.

Research Topics

Early prediction of asthma development
Respiratory symptoms are the most frequent reason for parents to consult their physician. One third of children have symptoms suggestive of the development of asthma in early life. However only one third of these children continue to have respiratory symptoms and are diagnosed with asthma at school-age. Unfortunately symptoms very poorly discriminate between children whom do and do not develop asthma. There is however compelling evidence to suggest that the pathofysiological processes leading to asthma are already present at a young age.

The EUROPA-study cohort is a 1200 patient birth cohort that studies the potential of biomarkers to predict the early development of asthma. For 6 years the respiratory symptoms of these children were monitored and the potential of biomarkers in blood, breath, sputum en stool to predict asthma are under investigation. This study is sponsored by the dutch Lung Foundation.

Chief Investigator : M.P. van der Schee
PhD student: N.W. Rutjes

Endotyping of asthma

Recent years have seen the advent of many novel target therapies for asthma. These so-called biologicals have strongly improved the treatment of refractory asthma in adults. Unfortunately most of these therapies are unavailable to children with severe problematic asthma. The underlying reason is a lack of understanding whether the processes relevant tot he functioning of these drugs in adult are equally relevant in children.

In the EUROPA-2 study we aim to endotype children with (developing) severe asthma into phenotypes that are known to be associated with treatment respons to novel therapies in adults. Characterisation of these pathways would be an important step towards evaluating the potential of these drugs to eleviate the complaints of children with problematic asthma.

Chief Investigator : M.P. van der Schee
PhD student: N.W. Rutjes

MAPS-study

The collective microbes on our body (microbiome)  support the development of an immune response protective against the development of asthma. Evidence suggests lifestyle changes in westernized countries may increase asthma prevalence through a reduction of early life microbial exposures. Similarly early life exposure to beneficial microbiota was able to prevent asthma development in mice.

Our department recently found that children at increased risk for developing asthma showed a distinct and less diverse microbiome compared to controls. In the MAPS we therefore hypothesize that personalized microbial interventions aimed at restoring a balanced microbiome can provide protection against the development of asthma.

Through this study we aim to provide a comprehensive analysis of the potential of microbial strains to protect against the development of asthma by stimulating a beneficiary immune response. This will pave the road for novel intervention strategies aimed at shifting the microbiome of children towards a composition that is protective against the development of asthma.

Chief Investigator : M.P. van der Schee
PhD student: T. Smulders

Researchers Paediatric Pulmonology :

Professors
Dr. Suzanne Terheggen-Lagro

Staff Members
N.W. Rutjes
S.W. Ter Heggen-Lagro

Postdocs
M.P. van der Schee

PhD Students
N.W. Rutjes
T. Smulders

Others
A. A. van der Plas

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