19 results on '"Krämer, U."'
Search Results
2. Partikelbelastung und allergische Erkrankungen bei Kindern: Welche Zusammenhänge zeigen sich in epidemiologischen Studien?
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Krämer, U.
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- 2004
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3. Haemoglobin adducts from aromatic amines in children in relation to area of residence and exposure to environmental tobacco smoke
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Richter, E., Rösler, S., Scherer, G., Gostomzyk, J. G., Grübl, A., Krämer, U., and Behrendt, H.
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- 2001
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4. Angeborene Erkrankungen des Hörvermögens bei Kindern Teil 1: Erworbene Hörstörungen: Teil 1: Erworbene Hörstörungen
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Gross, M., Finchk-Krämer, U., and Spormann-Lagodzinski, M.
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- 2000
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5. Internal lead and cadmium exposure in 6-year-old children from western and eastern Germany
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Begerow, J., Freier, I., Turfeld, M., Krämer, U., and Dunemann, L.
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- 1994
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6. Regional and socio-economic differences in food, nutrient and supplement intake in school-age children in Germany: results from the GINIplus and the LISAplus studies
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Sausenthaler, S., Standl, M., Buyken, A., Rzehak, P., Koletzko, S., Bauer, C.P., Schaaf, B., von Berg, A., Berdel, D., Borte, M., Herbarth, O., Lehmann, I., Krämer, U., Wichmann, H.-E., Heinrich, J., GINIplus Study Group (Heinrich, J., Schoetzau, A., Poescu, M., Mosetter, M., Schindler, J., Franke, K., Laubereau, B., Thaqi, A., Zirngibl, A., Zutavern, A.), LISAplus Study Group (Heinrich, J., Bolte, G., Belcredi, P., Jacob, B., and Höhnke, A.
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Male ,Parents ,Cross-sectional study ,Medicine (miscellaneous) ,Child Nutritional Physiological Phenomena ,Logistic regression ,Interviews as Topic ,Food Preferences ,Nutrient ,Germany ,Surveys and Questionnaires ,Environmental health ,Vegetables ,Humans ,Prospective Studies ,Child ,Prospective cohort study ,Nutrition and Dietetics ,Confounding ,Public Health, Environmental and Occupational Health ,Diet ,Children ,Regional differences ,Socio-economic determinants ,Feeding Behavior ,Cross-Sectional Studies ,Logistic Models ,Geography ,Socioeconomic Factors ,Fruit ,Dietary Supplements ,Population study ,Female ,Energy Intake ,Follow-Up Studies - Abstract
ObjectiveTo describe regional differences between eastern and western Germany with regard to food, nutrient and supplement intake in 9–12-year-old children, and analyse its association with parental education and equivalent income.DesignData were obtained from the 10-year follow-up of the two prospective birth cohort studies – GINIplus and LISAplus. Data on food consumption and supplement intake were collected using an FFQ, which had been designed for the specific study population. Information on parental educational level and equivalent income was derived from questionnaires. Logistic regression modelling was used to analyse the effect of parental education, equivalent income and region on food intake, after adjusting for potential confounders.SettingGermany.SubjectsA total of 3435 children aged 9–12 years.ResultsSubstantial regional differences in food intake were observed between eastern and western Germany. Intakes of bread, butter, eggs, pasta, vegetables/salad and fruit showed a significant direct relationship with the level of parental education after adjusting for potential confounders, whereas intakes of margarine, meat products, pizza, desserts and soft drinks were inversely associated with parental education. Equivalent income had a weaker influence on the child's food intake.ConclusionsNutritional education programmes for school-age children should therefore account for regional differences and parental education.
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- 2011
7. Exposure to lead and cadmium of children living in different areas of North-West Germany: results of biological monitoring studies 1982–1986
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Brockhaus, A., Collet, W., Dolgner, R., Engelke, R., Ewers, U., Freier, I., Jermann, E., Krämer, U., Manojlovic, N., Turfeld, M., and Winneke, G.
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- 1988
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8. Neuropsychological studies in children with elevated tooth-lead concentrations: II. Extended Study
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Winneke, G., Krämer, U., Brockhaus, A., Ewers, U., Kujanek, G., Lechner, H., and Janke, W.
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- 1983
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9. FADS gene cluster modulates the effect of breastfeeding on asthma. Results from the GINIplus and LISAplus studies
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Standl, M., Sausenthaler, S., Lattka, E., Koletzko, S., Bauer, C.-P., Wichmann, H.-E., von Berg, A., Berdel, D., Krämer, U., Schaaf, B., Lehmann, I., Herbarth, O., Klopp, N., Koletzko, B., Heinrich, J., GINIplus Study Group (Wichmann, H.-E., Zutavern, A., Chen, C.-M., Schnappinger, M., Rzehak, P.), LISAplus Study Group (Wichmann, H.-E., and Schnappinger, M.)
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Fatty Acid Desaturases ,Male ,Genotype ,Infant, Newborn ,Infant ,Polymorphism, Single Nucleotide ,Asthma ,Breast Feeding ,Delta-5 Fatty Acid Desaturase ,asthma ,breastfeeding ,children ,epidemiology ,FADS ,Child, Preschool ,Multigene Family ,Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ,Prevalence ,Humans ,Female ,Child - Abstract
BACKGROUND: The protective effect of breastfeeding (BF) on the development of asthma has been widely recognized, even if not all results have been consistent. Gene variants of the FADS gene cluster have a major impact on fatty acid composition in blood and in breast milk. Therefore, we evaluated the influence of the FADS1 FADS2 gene cluster polymorphisms on the association between BF and asthma. METHODS: The analysis was based on data (N=2245) from two German prospective birth cohort studies. Information on asthma and BF during the first 6 months was collected using questionnaires completed by the parents. Logistic regression modelling was used to analyse the association between exclusive BF and ever having asthma stratified by genotype. RESULTS: In the stratified analyses, BF for 3 or 4 months after birth had a protective effect for heterozygous and homozygous carriers of the minor allele (adjusted odds ratio between 0.37 (95% CI: 0.18-0.80) and 0.42 (95% CI: 0.20-0.88). Interaction terms of BF with genotype were significant and ranged from -1.17 (P-value: 0.015) to -1.33 (0.0066). Moreover, heterozygous and homozygous carriers of the minor allele who were exclusively breastfed for 5 or 6 months after birth had a reduced risk of asthma [0.32 (0.18-0.57) to 0.47 (0.27-0.81)] in the stratified analyses. For individuals carrying the homozygous major allele, BF showed no significant effect on the development of asthma. CONCLUSIONS: The association between exclusive BF and asthma is modified by the genetic variants of FADS genotypes in children.
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- 2012
10. Association between attendance of day care centres and increased prevalence of eczema in the German birth cohort study LISAplus
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Cramer, C., Link, E., Bauer, C.P., Hoffmann, U., von Berg, A., Lehmann, I., Herbarth, O., Borte, M., Schaaf, B., Sausenthaler, S., Wichmann, H.-E., Heinrich, J., Krämer, U., LISAplus Study Group (Wichmann, H.-E., Bolte, G., Belcredi, P., Jacob, B., Schoetzau, A., Mosetter, M., Schindler, J., Höhnke, A., Franke, K., Laubereau, B., Thaqi, A., Zirngibl, A., Zutavern, A.), and Malden, USA
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Male ,Incidence ,Eczema ,Germany, West ,Infant ,children ,day care attendance ,East ,West comparison ,eczema ,regional patterns ,Child Day Care Centers ,Social Environment ,Cohort Studies ,Risk Factors ,Child, Preschool ,Health Care Surveys ,Surveys and Questionnaires ,Absenteeism ,Prevalence ,Humans ,Female ,Germany, East ,Child ,Life Style - Abstract
Day care centre attendance is much more common in East than in West Germany. Although there is evidence that early day care might be protective against atopic diseases, several studies have shown a higher prevalence of childhood eczema in East Germany compared to West Germany. To compare prevalence and cumulative incidence of eczema in a birth cohort study in East and West Germany and to identify risk factors that are associated with eczema, which might explain regional differences. We used data from the ongoing population-based birth cohort study Influence of Life-style factors on the development of the Immune System and Allergies in East and West Germany Plus the influence of traffic emissions and genetics. In 1997, 3097 children from study areas in East and West Germany were recruited. Cumulative incidence and 1-year prevalences of eczema up to the age of 6 years were determined from yearly questionnaires. Cox regression and generalized estimating equations/logistic regression were used to quantify regional differences and to identify risk factors that might explain them. Prevalence and incidence of eczema were higher in children living in East Germany than those living in West Germany. We identified 11 risk factors that showed significant regional differences. From these factors, only 'day care attendance during the first 2 years of life' was significantly associated with eczema (odds ratio 1.56, 95% confidence interval CI 1.31-1.86). The regional differences in eczema could be explained by differences in early day care utilization. Day care centre attendance is associated with an increased prevalence and incidence of eczema. Regional differences in eczema prevalence could be explained by regional differences in utilization of early day care.
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- 2010
11. Association of gas cooking with children's respiratory health: results from GINIplus and LISAplus birth cohort studies.
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Casas, L., Tischer, C., Tiesler, C., Brüske, I., Koletzko, S., Bauer, C.-P., Wichmann, H.-E., von Berg, A., Berdel, D., Krämer, U., Schaaf, B., Lehmann, I., Herbarth, O., and Heinrich, J.
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ASTHMA in children ,GAS cooking ,RESPIRATORY diseases ,NITROGEN dioxide ,WHEEZE - Abstract
Previous studies have found inconsistent results on the association between asthma in children and gas cooking emissions. We aimed to assess the effects of the long-term exposure to gas cooking on the onset of asthma and respiratory symptoms, focusing on wheezing, in children from two German birth cohorts: LISAplus and GINIplus. A total of 5078 children were followed until the age of 10 years. Asthma, wheezing, gas cooking, and exposure to other indoor factors were assessed through parental reported questionnaires administered periodically. Logistic and multinomial regressions adjusting for potential confounders were performed. The prevalence of asthma and persistent wheezing was higher among children exposed to gas cooking but the results were not statistically significant. Exposure to gas cooking was positively associated ( P-value < 0.05) with exposure to other indoor factors (dampness, environmental tobacco smoke, and pets). Our results did not show a statistically significant association between the exposure to gas cooking and children's respiratory health. Practical Implications These analyses are consistent with the assumption of no effect of the exposure to low doses of nitrogen dioxide. The strong positive associations found between gas cooking and other indoor factors highlight the importance of considering other indoor factors when assessing health effects of gas cooking. Low-dose exposure to indoor nitrogen dioxide through gas cooking might not contribute to increase the risk of asthma and respiratory symptoms in children. [ABSTRACT FROM AUTHOR]
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- 2012
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12. Association between attendance of day care centres and increased prevalence of eczema in the German birth cohort study LISAplus.
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Cramer, C., Link, E., Bauer, C.-P., Hoffmann, U., Von Berg, A., Lehmann, I., Herbarth, O., Borte, M., Schaaf, B., Sausenthaler, S., Wichmann, H.-E., Heinrich, J., and Krämer, U.
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ECZEMA ,DAY care centers ,DISEASE risk factors ,GENETICS ,IMMUNOLOGIC diseases ,COHORT analysis - Abstract
Background: Day care centre attendance is much more common in East than in West Germany. Although there is evidence that early day care might be protective against atopic diseases, several studies have shown a higher prevalence of childhood eczema in East Germany compared to West Germany. Objectives: To compare prevalence and cumulative incidence of eczema in a birth cohort study in East and West Germany and to identify risk factors that are associated with eczema, which might explain regional differences. Methods: We used data from the ongoing population-based birth cohort study Influence of Life-style factors on the development of the Immune System and Allergies in East and West Germany Plus the influence of traffic emissions and genetics. In 1997, 3097 children from study areas in East and West Germany were recruited. Cumulative incidence and 1-year prevalences of eczema up to the age of 6 years were determined from yearly questionnaires. Cox regression and generalized estimating equations/logistic regression were used to quantify regional differences and to identify risk factors that might explain them. Results: Prevalence and incidence of eczema were higher in children living in East Germany than those living in West Germany. We identified 11 risk factors that showed significant regional differences. From these factors, only 'day care attendance during the first 2 years of life' was significantly associated with eczema (odds ratio 1.56, 95% confidence interval CI 1.31-1.86). The regional differences in eczema could be explained by differences in early day care utilization. Conclusion: Day care centre attendance is associated with an increased prevalence and incidence of eczema. Regional differences in eczema prevalence could be explained by regional differences in utilization of early day care. [ABSTRACT FROM AUTHOR]
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- 2011
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13. Prospective association between food sensitization and food allergy: results of the LISA birth cohort study.
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Schnabel, E., Sausenthaler, S., Schaaf, B., Schäfer, T., Lehmann, I., Behrendt, H., Herbarth, O., Borte, M., Krämer, U., von Berg, A., Wichmann, H.-E., and Heinrich, J.
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FOOD allergy in children ,REGRESSION analysis ,PHENOTYPES ,IMMUNOLOGIC diseases ,GENETICS - Abstract
Background Food allergy is common, especially in childhood, where 6–8% of children are affected. Identification of early and efficient markers for later development of food allergy is very important. Objective We examined the ability of repeated measurements of food sensitization in early childhood to predict doctor-diagnosed food allergy (DDFA) at the age of 6 years. Methods The analysis was based on data from a prospective birth cohort study. Information was collected by parental questionnaires, and blood samples were obtained at 2 and 6 years of age. Children with repeated determination of sensitization to food allergens at 2 and 6 years of age were categorized into the sensitization phenotypes: no, early onset, late onset and persistent sensitization. The association between sensitization phenotypes and DDFA was prospectively investigated using multiple logistic regression analyses. Results Of 3097 children recruited at birth, a complete follow-up of IgE measurements and questionnaires at 1.5, 2 and 6 years were available for 1082 children. Early food allergen sensitization (fx5) was a strong risk for DDFA at 6 years [odds ratio (OR)=4.7; 95% confidence intervals (95% CI) 2.0–11.2] and for a new onset of DDFA at 6 years (OR=4.1; 95% CI 1.5–11.3). Additionally, persistent food allergen sensitization increased the risk of DDFA at 6 years (OR=6.1; 95% CI 2.7–13.7). Early sensitized children with a history of parental atopy showed the highest risk for DDFA at 6 years. Conclusion Food-sensitized children during the first 2 years of life, especially with a family history of atopy, might be considered as a susceptible subgroup that requires specific attention concerning the development of food allergy-related symptoms. >Cite this as: E. Schnabel, S. Sausenthaler, B. Schaaf, T. Schäfer, I. Lehmann, H. Behrendt, O. Herbarth, M. Borte, U. Krämer, A. von Berg, H.-E. Wichmann, J. Heinrich, and for the LISA Study Group, Clinical & Experimental Allergy, 2010 (40) 450–457. [ABSTRACT FROM AUTHOR]
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- 2010
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14. Differences in allergy trends between East and West Germany and possible explanations.
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Krämer, U., Oppermann, H., Ranft, U., Schäfer, T., Ring, J., and Behrendt, H.
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ALLERGIES , *ASTHMA , *ATOPY , *ECZEMA , *ASTHMA in children - Abstract
Background At the time of the German reunification in 1990, manifestations of most allergic diseases were less prevalent in East than in West Germany. It was hypothesized that these East–West differences would diminish with lifestyle and pollution changes in East Germany. Objective To investigate whether changes in the prevalence of asthma, hayfever, eczema or allergic sensitization in East Germany approached the levels seen in West Germany and to identify possible lifestyle or environmental factors that may influence this. Methods Between 1991 and 2000, 6-year-old children from four areas in East Germany participated in an annual survey. Every 3rd year, a parallel survey was performed in four areas of West Germany. In total, 31 903 children were included. Parents completed a questionnaire regarding lifestyle factors and diagnoses and symptoms of asthma, hayfever and eczema. In sub-areas, eczema was clinically assessed by a dermatologist. Specific IgE sensitization was determined for 6121 children. Logistic regression was used to analyse differences in time trends and the influence of lifestyle and pollution changes. Results Lifestyle and pollution changed significantly differently between East and West Germany. The trends in hayfever and in strong (specific IgE >3.5) sensitization against pollen, and particularly birch pollen, were steeper in East than in West Germany. The trend towards marked pollen sensitization was four times stronger (95% confidence interval 1.2–13.9) in East than in West Germany. Increasing numbers of only children, less single-room heating with fossil fuels and increasing importance of traffic-related pollution in East Germany partly explained these differences in time trends. Conclusions Hayfever and sensitization against pollen were the most sensitive allergic manifestations to changes experienced specifically in East Germany. Influences of lifestyle (single-room heating, living as a single child) were important in explaining different trend developments. Cite this as: U. Krämer, H. Oppermann, U. Ranft, T. Schäfer, J. Ring and H. Behrendt, Clinical & Experimental Allergy, 2010 (40) 289– 298. [ABSTRACT FROM AUTHOR]
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- 2010
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15. Association between suppressors of cytokine signalling, T-helper type 1/T-helper type 2 balance and allergic sensitization in children.
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Daegelmann, C., Herberth, G., Röder, S., Herbarth, O., Giese, T., Krämer, U., Behrendt, H., Borte, M., Heinrich, J., Emmrich, F., and Lehmann, I.
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ALLERGIES ,TRANSFER factor (Immunology) ,IMMUNE response ,JUVENILE diseases ,GENE expression ,CYTOKINES ,T cells - Abstract
Background Suppressors of cytokine signalling (SOCS) family members have been shown to play an important role in the balance of cytokines that determine the onset of T-helper type 1 (Th1)- and Th2-mediated immune responses. In particular, for cytokine-induced Src-homology 2 protein (CIS), SOCS1, SOCS3 and SOCS5, a role in the regulation of T cell differentiation has been discussed. However, only few data exist so far in the human system. Objectives The aim of the present study was to analyse the relationship between these suppressors and Th1/Th2 regulation as well as allergic sensitizations within a population-based study. Methods Within the Lifestyle–Immune system–Allergy plus cohort study, mRNA was prepared from blood samples of 6-year-old children for the analysis of cytokines, transcription factors for T cell regulation and SOCS molecule expression by quantitative real-time polymerase chain reaction. In addition, total and specific IgE concentrations have been measured by the Pharmacia CAP System. A complete data set from 248 children was available. Results Among the SOCS molecules investigated, only SOCS1 showed a strong positive correlation to allergic sensitizations. In addition, an up-regulated SOCS1 expression correlated with down-regulated T-box expressed in T cells (Tbet) and higher expression levels of GATA-binding protein 3 (GATA-3) and IL-4. No association between SOCS1 and forkhead box P3 (FOXP3) was observed. For SOCS3, SOCS5 and CIS, a contradictory picture was found. The expression of these SOCS molecules was positively correlated with Tbet and FOXP3 and (with the exception of CIS) negatively with IL-4. Conclusions Our data suggest that SOCS3, SOCS5 and CIS, which correlate with an up-regulated Th1 and regulatory T cell activity, are without relevance for the allergic status. In contrast, SOCS1 might be involved in the development of a Th2-skewed immune response and subsequent allergic sensitizations. [ABSTRACT FROM AUTHOR]
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- 2008
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16. Association of neuropeptides with Th1/Th2 balance and allergic sensitization in children.
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Herberth, G., Daegelmann, C., Weber, A., Röder, S., Giese, T., Krämer, U., Schins, R. P. F., Behrendt, H., Borte, M., and Lehmann, I.
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NEUROPEPTIDES ,ALLERGY in children ,IMMUNE system ,SOMATOSTATIN ,CYTOKINES ,IMMUNOGLOBULIN E - Abstract
Background Among neurogenic factors, the neuropeptides have an important regulatory influence on immune system activity and may lead to allergic sensitization. Objective The aim of our study was to investigate the relationship of the neuropeptides vasoactive intestinal peptide (VIP), somatostatin (SOM) and substance P (SP) on modulation of Th1/Th2 balance and allergic sensitization in children. Methods Within the LISAplus (Life style–Immune system–Allergy) study, blood samples of 321 six-year-old children were analysed for concentration of neuropeptides, Th1 and Th2 cytokines, transcription factors for T cell regulation and suppressors of cytokine signalling. In addition, samples were screened for specific IgE against inhalant and food allergens. Results Children with high SOM values showed a Th2 polarization and a reduced expression of FOXP3, the marker for regulatory T cells. High (VIP) levels correlated inversely with the expression of T cell transcription factors (Tbet and SOCS3). In contrast, elevated levels of SP were associated with reduced GATA3 and SOCS3 expression and with increased IFN-γ concentrations. Allergic sensitization was more prevalent in children with higher SOM and VIP concentrations but not associated with SP levels. Conclusion Our data reveal an association between neuropeptides and modulatory effects on immune cells in vivo, especially on Th1/Th2 balance with a correlation to allergic sensitization in children. We suggest that elevated SOM and VIP concentrations and the inducing factors should be considered as allergy risk factors. [ABSTRACT FROM AUTHOR]
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- 2006
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17. Current eczema in children is related to Der f 1 exposure but not to Der p 1 exposure.
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Krämer, U., Lemmen, C., Bartusel, E., Link, E., Ring, J., and Behrendt, H.
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ECZEMA , *SKIN inflammation , *RESPIRATORY allergy , *ALLERGENS , *DISEASE risk factors , *ENZYME-linked immunosorbent assay - Abstract
Background Mite allergen exposure is an important risk factor for specific IgE production and is associated with asthma, hay fever and eczema. Whether these associations are independent of mite species has not been investigated so far. Objectives To investigate the influence of exposure to the major house dust mite (HDM) allergens Der p 1 and Der f 1 on sensitization, respiratory symptoms, and especially on eczema and related skin symptoms in 6–7-year-old children. Methods In a cross-sectional study in Augsburg (Bavaria, Germany) 1669 school beginners (mean age 6·5 years) were investigated in 1996. The concentrations of Der p 1 and Der f 1 were measured in dust samples from mattresses of 1081 children by enzyme-linked immunosorbent assay. The prevalence of atopy-related health outcomes was assessed by questionnaire, dermatological examination, skin prick testing and determination of specific serum IgE concentrations by radioallergosorbent test. Information about covariates was taken from questionnaires and interview data. Logistic regression was used to adjust for confounding. Results The mean concentrations of Der p 1 and Der f 1 were 0·68 and 0·79 µg g−1 dust, respectively. The relationship between the two species-specific allergens in individual homes was poor (Pearson correlation 0·2). Influencing variables were bedroom-sharing (Der p 1) and social status of the parents (Der f 1). Respiratory diseases were positively associated with both allergen concentrations [odds ratio (OR) between 1·1 and 2·6]. These associations were significant for sneezing attacks (Der p 1 and Der f 1). Reported prevalence of current (in the last 12 months) itchy skin rash was significantly associated with exposure to Der f 1 only (OR 2·4, P < 0·003); also a diagnosis of atopic eczema on the day of investigation was positively associated with Der f 1 only (OR 1·8, P = 0·14). Conclusions Studies on the effects of HDM exposure on eczema and allergies should consider specific effects of different mite species. This might have implications on assessment of allergen exposure and consecutive prevention or therapeutic measures. [ABSTRACT FROM AUTHOR]
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- 2006
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18. Heart transplantation in children and infants: Short-term outcome and long-term follow-up.
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Bauer, J., Thul, J., Krämer, U., Hagel, K. J., Akintürk, H., Valeske, K., Schindler, E., Bohle, R. M., and Schranz, D.
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HEART transplantation ,CONGENITAL heart disease diagnosis - Abstract
Abstract: Since 1988, 82 heart transplants have been performed in 80 infants and children. Diagnoses pretransplant were: hypoplastic left heart syndrome (HLHS) (n = 43); cardiomyopathy (n = 19); endocardial fibroelastosis (n = 6); and other complex congenital heart diseases (n = 12). Age at transplantation was < 1 yr in 61 patients. Overall survival rate was 79% at 1 yr and 73% at 5 and 10 yr. To date, 20 patients have died after transplantation. Causes of death were: rejection (eight patients); right ventricular failure (four patients); transplant coronary artery disease (TCAD) (two patients); and other causes (six patients). In the majority of patients somatic growth is not impaired, and renal function is reduced (but stable) in all patients. Two patients developed post-transplant lymphoproliferative disease, which was treated successfully. Major long-term morbidity is neurologic deficit – severe in three patients and minor in six. TCAD was present or suspected in six surviving patients. We conclude that heart transplantation in infants and children can be performed with good early and late results. Quality of life is excellent in most patients. TCAD, however, will become an increasing problem in the long term. [ABSTRACT FROM AUTHOR]
- Published
- 2001
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19. Cardiac troponin I: A marker of acute heart rejection in infant and child heart recipients?
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Siaplaouras, J., Thul, J., Krämer, U., Bauer, J., and Schranz, D.
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GRAFT rejection ,HEART transplantation ,INFANT mortality - Abstract
Abstract: Acute rejection of the donor heart is a major cause of mortality in infant heart transplant recipients. The early diagnosis of acute cardiac rejection (ACR) is crucial. Non-invasive methods have shown poor sensitivity in detecting rejection when compared to endomyocardial biopsies (EMB). We assessed troponin I as a new marker to diagnose cardiac rejection. Serum cardiac troponin I (cTNI) levels were retrospectively analysed in 25 heart transplant patients (ages, 2 wk to 13 yr; mean age, 3 months) presenting 36 acute rejections. In early post-operative rejection and initially elevated cTNI levels, rejection was associated with a second increase of serum cTNI concentrations in 21% of the patients (p = 0.15). If cTNI levels were in normal range before ACR an elevation was monitored in 59% of the rejection periods (p < 0.05). In 25% of the cases (n = 9) cTNI levels remained in normal range during the rejection episode (<0.6 ng/mL), in 22% (n = 8) cTNI levels did not exceed pathological values from 0.6 to 1.5 ng/mL and in 53% (n = 19) the measured levels went beyond 1.5 ng/mL. Maximum concentrations of cTNI were measured mostly 12 d from the moment rejection was suspected (day 1) in patients (median day 3). However, cTNI levels were elevated for 2–43 d after ACR was diagnosed (median 10 d). Twenty per cent of the patients with grade 3 rejection (ISHLT) and 75% of the patients with grade 4 rejection had a corresponding elevated cTNI level (p = 0.013). No false-positive elevations of cTNI were documented. The present data demonstrate that cTNI is a not a sensitive but a specific marker of ACR in children. [ABSTRACT FROM AUTHOR]
- Published
- 2003
- Full Text
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