The department Pediatric Hematology, Infectious Diseases, Immunology & Rheumatology covers the domain of non-malignant hematology and infectious and immunological disease s. Red cells, white cells and platelets all stem from the bone marrow and normal function is together with a intact plasma protein composition for normal child development. Within these domains we focus on fundamental and translational clinical research addressing the genetic and molecular pathophysiology of disease mechanisms with the aim to identify targets for therapeutic interventions that are subsequently addressed in well-designed clinical studies. Collaborations with national and international research partners from Europe, USA, Canada and developing countries make our research orientation global and connected and provide access to large (inter)national cohorts, employing sophisticated state of the art research methods. Below we describe the different themes covered by our department, indicating its full diversity and broad applicability.
Research lines (lead: Prof Karin Fijnvandraat, Dr Marjolein Peters)
2) SickleCell Disease
4) Pediatric transfusion
5) Bone marrow failure
the pediatric hematology team consists of 5 pediatric hematologists, a fellow, a nurse practitioner in training, 4 specialized nurses and a supportive care team encompassing a physiotherapist, social worker and pediatric psychologist, 2 postdocs, 6 PhD students (mostly MDs) and a changing group of Bachelor and Master students.
Recent accomplishments: the successful INSIGHT consortium (34 hospitals in 10 European countries and Australia) has identified genetic risk factors for inhibitor development and addressed preventive and eradication strategies for this complication. In Sickle Cell Disease we have identified clinical and genetic risk factors for allo-immunization and evaluated novel treatments to prevent sickle cell related pain. We have a leading role in several (inter)national consortia, SCORE, STARRING (national Sickle Cell Disease research networks), PLANET (international neonatal transfusion trial that included 660 extreme premature neonates)with the aim to provide robust, meaningful results in our clinical and translational research studies. Sanquin, ErasmusMC and the UK PLANET network are strong partners. Interdisciplinary research projects focus on bone marrow failure (combining hematological and immunological research) and long-term complications of chronic arthritis in hemophilia (linking hematological and pediatric rheumatology research).
Immunology - Rheumatology
Research lines (leads: Prof Taco Kuijpers & Dr Merlijn van den Berg):
1) Immunodeficiencies and immune dysregulation
2) Complement activation in infection and immunity
3) Kawasaki disease and systemic vasculitis
4) Juvenile idiopathic arthritis (JIA) and systemic disease (SLE)
the core group consists of four pediatric specialists in clinical care, 1 postdoc and 10 PhD students (about half of which are MDs), assisted by parttime research technicians, and a varying number of Bachelor and Master students.
Recent accomplishments: we have identified and characterized two novel Primary Immunodeficiencies (PIDs) and have learnt to understand their immunopathology in depth. Our collaboration with Sanquin and the Cambridge group has led to the creation of full epigenomes and eQTL maps of white blood cell types (Cell papers) that we can use to find rare genetic variants that may be linked to various blood diseases.
A recent accomplishment is the recent start of a Dutch-Canadian multicenter international research collaboration (UCAN-DO consortium) that was granted in 2016 by the Canadian and Ducth Arthritis foundations to delineate the immunopathology and best monitoring strategies in rheumatic disease. Drug monitoring and radiological imaging form an integral part of our evaluation of our monitoring strategies.
Infectious diseases - Immunology
Research lines (leads: Dr Dasja Pajkrt, Prof Michael Boele van Hensbroek, Prof Taco Kuijpers)
1) Viral infections (congenital infections , HIV, CMV, picornavirusinfections, meningo-encepahilitis in children)
2) Lyme disease: diagnostics, treatment and long term outcomes.
3) Treatment adherence in chronically ill children and adolescents
4) Biomarker analysis to diagnose early infection (bacterial versus viral) and non-infectious auto-inflammation
the Pediatric Infectious Disease research group focuses on these research pillars with two pediatric HIV caregivers (pediatric ID specialists), two research nurses and a team of supporting members specialized in neuroradiology, psychology department and medical virology. There are 7-8 PhD students and several Master students involved in these ongoing studies.
Recent accomplishments: a perinatally HIV-infected case-control cohort, (inter)national pediatric HIV research line, innovative training program forAmsterdam University College )AUC) and University of Amsterdam medical (UVA) students. Results from CIPHER, PACEM, ORGANOVIR, NOVICE, “Wicked Problems in Health”)
As part of an EU-funded research consortium PERFORM we put effort in a research line to discriminate infection from (auto)inflammation by biomarker studies which forms another overlapping themes in our department (see above).
Global Child Health Group
Research lines (lead: Prof Michael Boele van Hensbroek)
The research focuses on several aspects of pediatric disease in the developing world.
1) Severe anemia in children in developing countries (etiology, treatment and prevention)
2) Critical care in the tropics (etiology of coma & convulsions and fluid management)
3) Epidemiology and etiology of Nodding Syndrome
4) Malnutrition in children (pathophysiology and management)
5) Research capacity building
to date four pediatric specialists in critical care, infectious diseases and nutrition and one general practitioner work together as a core group, supervising a varying group of 10-14 PhD students, some of which are trained as MD, of which about half originate from (and is based in) Africa.