49 results on '"Foekje Stelma"'
Search Results
2. Harmonization of PCR-based detection of intestinal pathogens: experiences from the Dutch external quality assessment scheme on molecular diagnosis of protozoa in stool samples
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Foekje Stelma, Theo G Mank, Rob Koelewijn, Jaap J. van Hellemond, Bert Mulder, Lisette van Lieshout, Titia Kortbeek, Theo A Schuurs, Eric A. T. Brienen, and Medical Microbiology & Infectious Diseases
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Quality Control ,0301 basic medicine ,medicine.medical_specialty ,030106 microbiology ,030231 tropical medicine ,Clinical Biochemistry ,Dientamoeba fragilis ,Cryptosporidium ,external quality assessment scheme ,Biology ,medicine.disease_cause ,Polymerase Chain Reaction ,Sensitivity and Specificity ,Feces ,03 medical and health sciences ,Entamoeba histolytica ,0302 clinical medicine ,All institutes and research themes of the Radboud University Medical Center ,Internal medicine ,External quality assessment ,Parasitic Diseases ,medicine ,Animals ,Humans ,Giardia lamblia ,media_common.cataloged_instance ,Parasites ,European union ,Netherlands ,media_common ,intestinal protozoa ,Intralaboratory ,Biochemistry (medical) ,General Medicine ,DNA, Protozoan ,Laboratories, Hospital ,biology.organism_classification ,DNA extraction ,Gastrointestinal Tract ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,real-time PCR - Abstract
Background: Real-time PCR methods are increasingly used in routine patient care settings not only to determine the presence or absence of pathogens in patient materials, but also to obtain semiquantitative results to estimate the pathogen load. However, it is so far unknown how well these methods are harmonized among different laboratories. Methods: Sets of stool samples were distributed three to four times per year to ca. 25–40 participating laboratories within the European Union as part of an external quality assessment scheme (EQAS) for the detection of gastrointestinal protozoa. This paper presents the results obtained over a 3-year period for Entamoeba histolytica, Entamoeba dispar, Giardia lamblia, Cryptosporidium species and Dientamoeba fragilis. Results: Although both false-positive and false-negative results were reported, the overall sensitivity and specificity were high. The substantial differences in the quantitative output of the real-time PCR assays could be traced back to differences in DNA isolation procedures between different laboratories. Conclusions: Participation in an EQAS proved to be important as it provides information on how the real-time PCR methods used by the participant compares to the generally reported results and indicates how procedures could be improved. Semiquantitative results of real-time PCR methods are not exchangeable between laboratories as long as the diagnostic procedures are not harmonized. Intralaboratory comparison of semiquantitative real-time PCR results seems only possible by the use of calibration curves derived from well-validated standards in clinical material and not by spiking solutions with purified DNA.
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- 2018
3. Has CXCL13 an Added Value in Diagnosis of Neurosyphilis?
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Khutso M. Mothapo, C. Wim Ang, Peter P. Koopmans, Lieven B. J. van der Velden, André J. A. M. van der Ven, Marcel M. Verbeek, Foekje Stelma, Medical Microbiology and Infection Prevention, and Other Research
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Adult ,Male ,Microbiology (medical) ,medicine.medical_specialty ,HIV Infections ,Sensitivity and Specificity ,Gastroenterology ,Rapid plasma reagin ,Neurosyphilis ,Young Adult ,Cerebrospinal fluid ,Internal medicine ,medicine ,Humans ,CXCL13 ,Young adult ,Pleocytosis ,Aged ,Netherlands ,Aged, 80 and over ,medicine.diagnostic_test ,Diagnostic Tests, Routine ,business.industry ,Bacteriology ,Middle Aged ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,medicine.disease ,Chemokine CXCL13 ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Csf biomarkers ,Immunology ,Female ,Syphilis ,business ,Biomarkers - Abstract
In patients with syphilis, central nervous system (CNS) involvement is often difficult to determine. In patients who also are infected with human immunodeficiency virus (HIV), this is even more challenging, as cerebrospinal fluid (CSF) pleocytosis can be attributed to HIV, syphilis, or both. Hence, this study investigated (i) CSF chemokine (C-X-C motif) ligand 13 (CXCL13) as a potential marker to diagnose neurosyphilis in HIV-infected individuals and (ii) the added value of CSF CXCL13 to conventional CSF biomarkers, such as the rapid plasma reagin test (RPR), in diagnosing neurosyphilis. We included 103 syphilis patients from two centers in The Netherlands: 47 non-HIV-infected patients and 56 HIV-infected patients. A positive CSF-RPR was regarded as the gold standard for neurosyphilis. CSF CXCL13 levels were significantly higher in neurosyphilis patients when neurosyphilis was diagnosed by CSF-RPR ( P = 0.0002) than in the syphilis control group. The sensitivity and specificity of CSF CXCL13 (cutoff of 76.3 pg/ml) to diagnose neurosyphilis by using positive CSF-RPR as the gold standard were 50% and 90%, respectively. CSF CXCL13 had an added value to CSF-RPR positivity in 70% of HIV-positive patients and in 33% of HIV-negative patients. Our data show that CSF CXCL13 might be a potential additional marker in neurosyphilis when other markers are not conclusive. The added value of CSF CXCL13 measurement to the current neurosyphilis gold standard appears to benefit HIV-positive patients more than HIV-negative patients.
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- 2015
4. Humoral and cellular immune responses after influenza vaccination in patients with postcancer fatigue
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Hanneke W. M. van Laarhoven, Ruurd Torensma, Carla M.L. van Herpen, Foekje Stelma, Hetty Prinsen, Joannes F M Jacobs, Jeanette M. Pots, I. Jolanda M. de Vries, Sasja F. Mulder, Gijs Bleijenberg, Jan Willem H. Leer, Tjitske Duiveman-de Boer, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, Oncology, Graduate School, and Gastroenterology and Hepatology
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Male ,Cellular immunity ,medicine.medical_treatment ,Cancer development and immune defence Radboud Institute for Molecular Life Sciences [Radboudumc 2] ,Lymphocyte proliferation ,Lymphocyte Activation ,T-Lymphocytes, Regulatory ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,Cancer development and immune defence Radboud Institute for Health Sciences [Radboudumc 2] ,Influenza A Virus, H1N1 Subtype ,Neoplasms ,Immunology and Allergy ,Medicine ,Fatigue ,Immunity, Cellular ,Women's cancers Radboud Institute for Molecular Life Sciences [Radboudumc 17] ,Middle Aged ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,Vaccination ,Cytokine ,Influenza Vaccines ,Cytokines ,Female ,influenza ,Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5] ,medicine.drug ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] ,Research Paper ,Interleukin 2 ,Adult ,Adolescent ,Immunology ,Young Adult ,Immune system ,Immunity ,Influenza, Human ,cancer ,Humans ,HSP90 Heat-Shock Proteins ,Pharmacology ,business.industry ,Influenza A Virus, H3N2 Subtype ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,Hemagglutination Inhibition Tests ,vaccination ,immunity ,Immunity, Humoral ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Humoral immunity ,Interleukin-2 ,business - Abstract
The aim of this study was to compare humoral and cellular immune responses to influenza vaccination in cancer survivors with and without severe symptoms of fatigue. Severely fatigued (n = 15) and non-fatigued (n = 12) disease-free cancer survivors were vaccinated against seasonal influenza. Humoral immunity was evaluated at baseline and post-vaccination by a hemagglutination inhibition assay. Cellular immunity was evaluated at baseline and post-vaccination by lymphocyte proliferation and activation assays. Regulatory T cells were measured at baseline by flow cytometry and heat-shock protein 90 alpha levels by ELISA. Comparable humoral immune responses were observed in fatigued and non-fatigued patients, both pre- and post-vaccination. At baseline, fatigued patients showed a significantly diminished cellular proliferation upon virus stimulation with strain H3N2 (1414 ± 1201 counts), and a trend in a similar direction with strain H1N1 (3025 ± 2339 counts), compared to non-fatigued patients (3099 ± 2401 and 5877 ± 4604 counts, respectively). The percentage of regulatory T lymphocytes was significantly increased (4.4 ± 2.1% versus 2.4 ± 0.8%) and significantly lower amounts of interleukin 2 were detected prior to vaccination in fatigued compared to non-fatigued patients (36.3 ± 44.3 pg/ml vs. 94.0 ± 45.4 pg/ml with strain H3N2 and 28.4 ± 44.0 pg/ml versus 74.5 ± 56.1 pg/ml with strain H1N1). Pre-vaccination heat-shock protein 90 alpha concentrations, post-vaccination cellular proliferation, and post-vaccination cytokine concentrations did not differ between both groups. In conclusion, influenza vaccination is favorable for severely fatigued cancer survivors and should be recommended when indicated. However, compared to non-fatigued cancer survivors, fatigued cancer survivors showed several significant differences in immunological reactivity at baseline, which warrants further investigation.
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- 2015
5. CD14/Toll-like receptors interact with bacteria and regulatory T-cells in the development of childhood asthma
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Quirijn Jöbsis, Ester M.M. Klaassen, Edward Dompeling, M. Soeteman, G. van Eys, Jan Damoiseaux, K.D.G. van de Kant, O C P van Schayck, Foekje Stelma, Marieke Quaak, Ellen E. Stobberingh, RS: CAPHRI School for Public Health and Primary Care, RS: NUTRIM - R4 - Gene-environment interaction, Genetica & Celbiologie, MUMC+: DA CDL Algemeen (9), Epidemiologie, RS: CAPHRI - Asthma and COPD, RS: CAPHRI - Public Health: Infectious diseases and antibiotic resistance, Farmacologie en Toxicologie, Moleculaire Genetica, Kindergeneeskunde, Interne Geneeskunde, Medische Microbiologie, and Family Medicine
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Pulmonary and Respiratory Medicine ,Allergy ,Genotype ,CD14 ,Buccal swab ,Lipopolysaccharide Receptors ,Single-nucleotide polymorphism ,T-Lymphocytes, Regulatory ,Immune system ,medicine ,Humans ,Genetic Predisposition to Disease ,Longitudinal Studies ,Prospective Studies ,Child ,Netherlands ,Respiratory Sounds ,Asthma ,Innate immune system ,Bacteria ,business.industry ,Toll-Like Receptors ,Genetic Variation ,Environmental Exposure ,Sequence Analysis, DNA ,Flow Cytometry ,medicine.disease ,Immunity, Innate ,TLR2 ,Phenotype ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Case-Control Studies ,Immunology ,business - Abstract
To the Editor: The susceptibility to asthma development in childhood is influenced by genetic as well as environmental factors, and interactions between these factors [1–3]. However, at present, their exact role is still largely undetermined. Genetic variations in the innate immune system may lead to different adaptive immune responses to bacteria and may therefore vary the development of asthma [2, 4, 5]. We performed a prospective longitudinal study in preschool children, in which we determined polymorphisms in Toll-like receptors ( TLR s) and CD14 , the presence of bacteria, and the proportion of regulatory T-cells (Treg) all in relation to an asthma diagnosis at 6 years of age. We hypothesise that specific genetic variants in genes that affect the innate immune system influence the response to bacteria and the recruitment of Treg in preschool children, leading to an increased likelihood of asthma at 6 years of age. The Asthma DEtection and Monitoring (ADEM) study is a long-term prospective case–control study. A detailed protocol of this study has previously been published [6]. A total of 202 children who had experienced at least two wheezing episodes during their lifetime (International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire) [7] and 50 children without wheezing episodes were included at 2–4 years of age. The children were randomly selected from a random population sample in Limburg, the Netherlands, based on the presence or absence of recurrent wheeze [6]. During the initial visit, saliva or buccal cells (DNA), nasal and throat swabs (bacterial cultures), and blood (Treg) were collected. Participants were genotyped for six single nucleotide polymorphisms in TLR2 , TLR4 , TLR9 and CD14 (Sequenom …
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- 2014
6. Absolute Lymphocyte Count Predicts the Response to New Influenza Virus H1N1 Vaccination in Pediatric Cancer Patients
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Peter M. Hoogerbrugge, Michiel van der Flier, Foekje Stelma, Coretta van Leer-Buter, Annelies M. C. Mavinkurve-Groothuis, and Frank Preijers
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Male ,Microbiology (medical) ,Adolescent ,medicine.medical_treatment ,Lymphocyte ,Clinical Biochemistry ,Immunology ,medicine.disease_cause ,Virus ,Decision Support Techniques ,Influenza A Virus, H1N1 Subtype ,Neoplasms ,Influenza, Human ,Influenza A virus ,medicine ,Humans ,Immunology and Allergy ,Lymphocyte Count ,Child ,Vaccines ,Chemotherapy ,business.industry ,Vaccination ,Absolute lymphocyte count ,H1n1 virus ,Pediatric cancer ,medicine.anatomical_structure ,Influenza Vaccines ,Child, Preschool ,Female ,business - Abstract
We measured the vaccination response to the new H1N1 virus in relation to the lymphocyte count prior to vaccination in pediatric cancer patients. The absolute lymphocyte count above the lower normal limits (LNL) for age prior to vaccination predicts the response to influenza vaccination in pediatric cancer patients treated with chemotherapy.
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- 2013
7. Soluble TLR2 and 4 concentrations in cerebrospinal fluid in HIV/SIV-related neuropathological conditions
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Khutso M. Mothapo, Peter P. Koopmans, A.J.A.M. van der Ven, Marcel M. Verbeek, Gerrit Koopman, J. ten Oever, M.G.M. Olde Rikkert, Saskia M. Burm, Foekje Stelma, J. Bajramovic, and Mihai G. Netea
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0301 basic medicine ,Male ,Chemokine ,Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1] ,Neurology ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,Simian Acquired Immunodeficiency Syndrome ,Gene Expression ,HIV Infections ,medicine.disease_cause ,chemistry.chemical_compound ,0302 clinical medicine ,Cerebrospinal fluid ,Medicine ,Chemokine CCL2 ,biology ,Neopterin ,Middle Aged ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,medicine.anatomical_structure ,Female ,Simian Immunodeficiency Virus ,Microglia ,Adult ,medicine.medical_specialty ,Central nervous system ,Neuropathology ,S100 Calcium Binding Protein beta Subunit ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Alzheimer Disease ,Virology ,Animals ,Humans ,Cognitive Dysfunction ,Neuroinflammation ,business.industry ,Interleukin-8 ,HIV ,Simian immunodeficiency virus ,Macaca mulatta ,Toll-Like Receptor 2 ,Toll-Like Receptor 4 ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,030104 developmental biology ,chemistry ,Solubility ,Astrocytes ,Case-Control Studies ,Immunology ,biology.protein ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Biomarkers - Abstract
Contains fulltext : 169827.pdf (Publisher’s version ) (Closed access) HIV in the central nervous system (CNS) mainly infects microglial cells which are known to express toll-like receptors (TLRs). This paper aimed to study the role of soluble TLR2 (sTLR2), sTLR4, and other inflammatory markers in cerebrospinal fluid (CSF) in HIV/Simian immunodeficiency virus (SIV)-related neurological sequelae. We determined sTLR2 and sTLR4 levels in CSF and serum/plasma of SIV-infected rhesus macaques with and without neurological sequelae, as well as in HIV-infected patients with and without cognitive impairments and Alzheimer's disease (AD) patients and matched controls. CSF cytokines and chemokines levels were analyzed in macaques as markers of neuroinflammation, while neopterin and S100B CSF concentrations were measured in HIV-infected patients as microglial and astrocyte marker, respectively. We found detectable levels of sTLR2 and sTLR4 in CSF of macaques and humans. Furthermore, CSF sTLR2 and sTLR4 concentrations were higher in SIV-infected macaques with neurological sequelae compared to those without neurological complications (p = 0.0003 and p = 0.0006, respectively). CSF IL-8 and monocyte chemoattractant protein-1 (MCP-1) levels were elevated in macaques with neurological sequelae, and a positive correlation was found between CSF levels of sTLR2/4 and IL-8 and MCP-1. Also in humans, elevated CSF sTLR4 levels were found in HIV-infected patients with cognitive impairments compared to HIV-infected patients with normal cognition (p = 0.019). Unlike CSF S100B levels, neopterin correlated positively with sTLR2 and sTLR4. No difference was found in plasma and CSF sTLR2 and sTLR4 levels between AD patients and control subjects (p = 0.26). In conclusion, CSF sTLR2 and sTLR4 may play a role in HIV/SIV-related neuroinflammation and subsequent neuropathology.
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- 2016
8. The diagnostic accuracy of serological tests for Lyme borreliosis in Europe: a systematic review and meta-analysis
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F. Verduyn-Lunel, H.A. Bijlmer, Ram Benny Dessau, Mariska M.G. Leeflang, A.P. van Dam, Benoît Jaulhac, Volker Fingerle, Joppe W. Hovius, C. W. Ang, J. Berkhout, N. D. Van Burgel, W. Van Pelt, B. Meijer, Joop F. P. Schellekens, Gerold Stanek, Foekje Stelma, Herve Zeller, A.H. Brandenburg, René Spijker, W. Van Bortel, Hein Sprong, APH - Amsterdam Public Health, Epidemiology and Data Science, AII - Amsterdam institute for Infection and Immunity, Infectious diseases, Other departments, Graduate School, Gastroenterology and Hepatology, AII - Infectious diseases, and Medical Microbiology and Infection Prevention
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0301 basic medicine ,medicine.medical_specialty ,Databases, Factual ,030106 microbiology ,MEDLINE ,serology ,Enzyme-Linked Immunosorbent Assay ,Sensitivity and Specificity ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Lyme disease ,Internal medicine ,medicine ,Humans ,Serologic Tests ,030212 general & internal medicine ,Borrelia burgdorferi ,GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries) ,Lyme borreliosis ,Lyme Disease ,biology ,business.industry ,medicine.disease ,biology.organism_classification ,Checklist ,meta-analysis ,Europe ,Infectious Diseases ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,ROC Curve ,Meta-analysis ,Area Under Curve ,Immunology ,business ,Neuroborreliosis ,Acrodermatitis chronica atrophicans ,Research Article - Abstract
Background: Interpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe. Methods: We searched EMBASE en MEDLINE and contacted experts. Studies evaluating the diagnostic accuracy of serological assays for Lyme borreliosis in Europe were eligible. Study selection and data-extraction were done by two authors independently. We assessed study quality using the QUADAS-2 checklist. We used a hierarchical summary ROC meta-regression method for the meta-analyses. Potential sources of heterogeneity were test-type, commercial or in-house, Ig-type, antigen type and study quality. These were added as covariates to the model, to assess their effect on test accuracy. Results: Seventy-eight studies evaluating an Enzyme-Linked ImmunoSorbent assay (ELISA) or an immunoblot assay against a reference standard of clinical criteria were included. None of the studies had low risk of bias for all QUADAS-2 domains. Sensitivity was highly heterogeneous, with summary estimates: erythema migrans 50 % (95 % CI 40 % to 61 %); neuroborreliosis 77 % (95 % CI 67 % to 85 %); acrodermatitis chronica atrophicans 97 % (95 % CI 94 % to 99 %); unspecified Lyme borreliosis 73 % (95 % CI 53 % to 87 %). Specificity was around 95 % in studies with healthy controls, but around 80 % in cross-sectional studies. Two-tiered algorithms or antibody indices did not outperform single test approaches. Conclusions: The observed heterogeneity and risk of bias complicate the extrapolation of our results to clinical practice. The usefulness of the serological tests for Lyme disease depends on the pre-test probability and subsequent predictive values in the setting where the tests are being used. Future diagnostic accuracy studies should be prospectively planned cross-sectional studies, done in settings where the test will be used in practice.
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- 2016
9. Timing of infection and development of wheeze, eczema, and atopic sensitization during the first 2 yr of life: The KOALA Birth Cohort Study
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Monique Mommers, John Penders, Marion Koopmans, Foekje Stelma, Carel Thijs, Ronald van Ree, and Johan Reimerink
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Pediatrics ,medicine.medical_specialty ,Pregnancy ,medicine.diagnostic_test ,business.industry ,Immunology ,Common cold ,medicine.disease ,Atopy ,Wheeze ,Pediatrics, Perinatology and Child Health ,medicine ,Immunology and Allergy ,Respiratory sounds ,medicine.symptom ,Age of onset ,business ,Cohort study ,Asthma - Abstract
To investigate if infections in pregnancy and very early in life present a risk for wheezing, eczema, or atopic sensitization in later infancy. A total of 2319 children enrolled before birth in the KOALA Birth Cohort Study were followed during their first 2 yr of life using repeated questionnaires. Information was obtained on common colds, fever, and diarrhea with fever as well as on wheeze and eczema at ages 3 and 7 months and 1 and 2 yr, respectively. Blood samples were collected from 786 children at age 2 yr for specific immunoglobulin E analyses. Children with a common cold [adjusted odds ratio (aOR) 2.03 95% CI 1.21-3.41] or fever episode (aOR 1.81 95% CI 1.10-2.96) in the first 3 months of life had a higher risk of new onset wheeze in the second year of life compared to children who had not. For children with diarrhea with fever in the first 3 months of life, the aOR for new onset wheeze in the second year of life was 3.94 (95% CI 1.36-11.40) compared to children without diarrhea. Infections becoming clinically manifest during the first 3 months of life may be a general marker for a wheezy phenotype.
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- 2010
10. TLR-related pathway analysis: novel gene-gene interactions in the development of asthma and atopy
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C.P. van Schayck, Bert Brunekreef, Dirkje S. Postma, Henriette A. Smit, Carel Thijs, Gerard H. Koppelman, Naomi E. Reijmerink, R. W. B. Bottema, Jorrit Gerritsen, Marjan Kerkhof, Foekje Stelma, Groningen Research Institute for Asthma and COPD (GRIAC), Medische Microbiologie, Epidemiologie, Family Medicine, and RS: NUTRIM - R2 - Gut-liver homeostasis
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Hypersensitivity, Immediate ,Male ,Allergy ,Genotype ,BACTERICIDAL/PERMEABILITY-INCREASING PROTEIN ,Immunology ,atopy ,IL1RL1 ,Single-nucleotide polymorphism ,Polymorphism, Single Nucleotide ,Atopy ,Geneeskunde ,Gene interaction ,CELL-SURFACE ,cohort study ,Immunology and Allergy ,Medicine ,Humans ,genetics ,Child ,SOLUBLE ST2 ,Asthma ,gene-gene interaction ,Genetics ,TOLL-LIKE RECEPTORS ,Multifactor dimensionality reduction ,business.industry ,Haplotype ,Infant ,ASSOCIATION ,Immunoglobulin E ,asthma ,medicine.disease ,CROHNS-DISEASE ,Pathogenesis and modulation of inflammation [N4i 1] ,gene–gene interaction ,Child, Preschool ,SINGLE NUCLEOTIDE POLYMORPHISMS ,T-CELLS ,INTERLEUKIN-1 RECEPTOR ,Female ,TH2 CELLS ,business ,Infection and autoimmunity [NCMLS 1] ,Signal Transduction - Abstract
P>Background:The toll-like receptor (TLR)-related pathway is important in host defence and may be crucial in the development of asthma and atopy. Numerous studies have shown associations of TLR-related pathway genes with asthma and atopy phenotypes. So far it has not been investigated whether gene-gene interactions in this pathway contribute to atopy and asthma development.Methods:One hundred and sixty-nine haplotype tagging single nucleotide polymorphisms (SNPs) of 29 genes (i.e. membrane and intracellular receptors, TLR4 or lipopolysaccharide-binding/facilitating proteins, adaptors, interleukin-1 receptor associated kinases, kinases, chaperone molecules, transcription factors and inhibitors) were analysed for single- and multilocus associations with atopy [total and specific immunglobulin E (IgE) at 1-2 and 6-8 years] and asthma (6-8 years). A total of 3062 Dutch children from the birth cohorts PIAMA, PREVASC and KOALA (Allergenic study) were investigated. Chi-squared test, logistic regression and the data mining approach multifactor dimensionality reduction method (MDR) were used in analysis.Results:Several genes in the TLR-related pathway were associated with atopy and/or asthma [e.g. IL1RL1, BPI, NOD1, NOD2 and MAP3K7IP1]. Multiple, single associations were found with the phenotypes under study. MDR analysis showed novel, significant gene-gene interactions in association with atopy and asthma phenotypes (e.g. IL1RL1 and TLR4 with sIgE to indoor allergens and IRAK1, NOD1 and MAP3K7IP1 with asthma). Interestingly, gene-gene interactions were identified with SNPs that did not have an effect on their own.Conclusion:Our unbiased approach provided suggestive evidence for interaction between several TLR-related pathway genes important in atopy and/or asthma development and pointed to novel genes.
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- 2010
11. X-chromosome Forkhead Box P3 polymorphisms associate with atopy in girls in three Dutch birth cohorts
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Naomi E. Reijmerink, Foekje Stelma, Henriette A. Smit, R. W. B. Bottema, C.P. van Schayck, Marjan Kerkhof, Gerard H. Koppelman, Carel Thijs, Bert Brunekreef, and Dirkje S. Postma
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Allergy ,biology ,Immunology ,Single-nucleotide polymorphism ,Immunoglobulin E ,medicine.disease ,biology.organism_classification ,Atopy ,Cohort ,Genotype ,biology.protein ,medicine ,Mite ,Immunology and Allergy ,Asthma - Abstract
BACKGROUND: The Forkhead Box P3 (FOXP3) gene, located on the X-chromosome, encodes a transcription factor that directs T cells toward a regulatory phenotype. Regulatory T cells may suppress development of atopy. We evaluated whether single-nucleotide polymorphisms (SNPs) of FOXP3 are associated with atopy development in childhood. METHODS: Seven SNPs in FOXP3 were genotyped in 3062 children (51% boys) participating in the Allergenic study, which consists of three Dutch birth cohorts (PIAMA, PREVASC and KOALA). Association of FOXP3 SNPs with total serum IgE and sensitisation (presence of specific serum IgE to egg, milk, and indoor, i.e. house-dust mite, cat, and/or dog allergens) was investigated at ages 1, 2, 4, and 8. Analysis of variance and logistic regression were performed, stratified for gender. RESULTS: Our most consistent finding was observed for sensitisation to egg and indoor allergens. In girls, five FOXP3 SNPs (rs5906761, rs2294021, rs2294019, rs6609857 and rs3761548) were significantly associated with sensitisation to egg at ages 1 and 2 and with sensitisation to indoor allergens at age 2 (P < 0.05), but not at 4 and 8, a finding that was observed across the three cohorts. Rs5906761 and rs2294021 were associated with remission of sensitisation to food allergens in boys, as tested in the PIAMA cohort. CONCLUSION: This is the first study showing across three cohorts that X-chromosomal FOXP3 genotypes may contribute to development of sensitisation against egg and indoor allergens in girls in early childhood. In addition, an association with remission of sensitisation to food allergens existed in boys only.
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- 2009
12. CD14 polymorphisms in mother and infant, soluble CD14 in breast milk and atopy development in the infant (KOALA Study)
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Ronald van Ree, Naomi E. Reijmerink, Jan Damoiseaux, Piet A. van den Brandt, Gerrit van der Steege, Bianca E. P. Snijders, Foekje Stelma, Dirkje S. Postma, Gerard H. Koppelman, and Carel Thijs
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business.industry ,Immunology ,Breastfeeding ,Maternal effect ,Single-nucleotide polymorphism ,Odds ratio ,Atopic dermatitis ,Breast milk ,medicine.disease ,Atopy ,Pediatrics, Perinatology and Child Health ,medicine ,Immunology and Allergy ,business ,Breast feeding - Abstract
Different CD14 polymorphisms have been associated with atopic phenotypes in infants. In addition, CD14 genotypes of breastfeeding mothers have been associated with soluble CD14 (sCD14) levels in breast milk. The role of CD14 genotypes of infant and mother and their interaction with sCD14 levels in breast milk in atopy development remain to be established. We aimed to study the associations of CD14 single nucleotide polymorphisms (SNPs), and their interaction with breast milk sCD14, with atopy development until age two. In addition, we assessed whether levels of sCD14 in breast milk associated with SNPs in CD14. Four SNPs in CD14 gene were investigated in 698 infants and 188 mothers. Associations between these SNPs, sCD14 and atopy development were analyzed in multiple logistic or linear regression models. The CD14/-1619 SNP was associated with eczema. CC homozygotes showed a lower risk of eczema vs. TT homozygotes (adjusted odds ratio = 0.56, 95% confidence interval 0.33-0.96) in a co-dominant model. Breast milk sCD14 levels did not significantly modify the effect of the child's CD14 genotype on atopy development (p interaction > or =0.10). Maternal CD14 SNPs were not significantly associated with sCD14 levels in breast milk (anova, p > or = 0.48). We found only an association between CC homozygozity of SNP CD14/-1619 and eczema. Our data did not support a modifying role of breast milk sCD14 levels on the relationship between CD14 genotype and atopy development until age 2 yr.
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- 2009
13. Early-life rotavirus and norovirus infections in relation to development of atopic manifestation in infants
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Marion Koopmans, Monique Mommers, Foekje Stelma, Carel Thijs, R. van Ree, D.A. Brouwer, Barry Rockx, Edward Dompeling, Ellen E. Stobberingh, Johan Reimerink, Other departments, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Experimental Immunology, Medische Microbiologie, Kindergeneeskunde, Epidemiologie, RS: CAPHRI School for Public Health and Primary Care, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, and RS: NUTRIM - R2 - Gut-liver homeostasis
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Male ,Pediatrics ,medicine.medical_specialty ,Immunology ,Antibodies, Viral ,medicine.disease_cause ,Rotavirus Infections ,Dermatitis, Atopic ,Atopy ,Risk Factors ,Seroepidemiologic Studies ,Wheeze ,Rotavirus ,Hypersensitivity ,Odds Ratio ,medicine ,Humans ,Immunology and Allergy ,Risk factor ,Antigens, Viral ,Caliciviridae Infections ,Netherlands ,Respiratory Sounds ,Asthma ,business.industry ,Incidence (epidemiology) ,Norovirus ,Infant ,Odds ratio ,Allergens ,Immunoglobulin E ,medicine.disease ,Pathogenesis and modulation of inflammation [N4i 1] ,Child, Preschool ,Female ,medicine.symptom ,business ,Cohort study - Abstract
Item does not contain fulltext BACKGROUND: The increase in incidence of atopic diseases (ADs) in the developed world over the past decades has been associated with reduced exposure of childhood infections. OBJECTIVE: To investigate the relation between early intestinal viral infections in relation to the development of atopic symptoms (eczema, wheeze and atopic sensitization) in the first and second year(s) of life. METHODS: In the KOALA Birth Cohort Study, we assessed IgG seropositivity for rota- and norovirus (GGI.1 and GGII.4) at 1 year of age. This was related to allergic sensitization [specific immunoglobulin E (IgE)] at 1 and 2 years, and parent reported eczema and wheeze in the first 2 years, using logistic regression analysis adjusted for confounders. RESULTS: Rotavirus seropositivity (39%) was associated with an unexpected higher risk of recurrent wheeze in the first and second year of life [adjusted odds ratio (OR) 3.1 and 95% confidence intervals (CI) 1.1-9.1] and persistent and new recurrent wheeze (adjusted OR 2.7 and 95% CI 1.1-6.2). No further associations were found between intestinal viral seropositivity and atopic manifestations. CONCLUSION: Our data did not show a clear protection by enteric viral infections in young children on development of IgE response to allergens, but rotavirus infection in the first year was a risk factor for wheeze. However, this needs to be followed up to older ages in order to establish the true importance of intestinal viral infections and especially cumulative effects in AD aetiology. Exposure to rotavirus may offer a new and interesting focus on infant wheeze and later asthma development.
- Published
- 2009
14. Occupational risk of human Cytomegalovirus and Parvovirus B19 infection in female day care personnel in the Netherlands; a study based on seroprevalence
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Cathrien A. Bruggeman, V. J. Goossens, A. Smismans, Foekje Stelma, and Christian J. P. A. Hoebe
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Adult ,Microbiology (medical) ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Congenital cytomegalovirus infection ,Cytomegalovirus ,Day care ,Antibodies, Viral ,Occupational safety and health ,Parvoviridae Infections ,Occupational medicine ,Risk Factors ,Seroepidemiologic Studies ,Occupational Exposure ,Epidemiology ,Parvovirus B19, Human ,medicine ,Humans ,Seroprevalence ,Analysis of Variance ,Chi-Square Distribution ,biology ,business.industry ,Parvovirus ,Parvovirus infection ,Age Factors ,virus diseases ,Child Day Care Centers ,General Medicine ,medicine.disease ,biology.organism_classification ,Occupational Diseases ,Logistic Models ,Infectious Diseases ,Cytomegalovirus Infections ,Immunology ,Female ,business - Abstract
Cytomegalovirus (CMV) and Parvovirus B19 infections acquired during pregnancy may result in developmental disabilities of the foetus. This study evaluates the occupational risk of these infections in female day care personnel. IgG seroprevalence was determined in 310 Dutch day care workers and 158 nursing school students. CMV seroprevalence was age-related, starting at 21% in those20 years and reaching 65% in those35 years. Between the ages of 20 and 24 years the CMV prevalence was higher in day care personnel than in controls, 50% versus 31% (p = 0.03). In the first 2 years of employment the risk of attracting CMV was significantly increased (OR(adj) = 3.80; p0.001) and the occupational risk was also increased (OR(adj) 2.19; p0.001). Parvovirus seropositivity (71-77%) was not related to age or working at a day care centre. In conclusion, an occupational risk was observed for CMV, but not for Parvovirus infection in female day care personnel.
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- 2008
15. Interleukin 13, CD14, pet and tobacco smoke influence atopy in three Dutch cohorts: the allergenic study
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Naomi E. Reijmerink, Marjan Kerkhof, Jorrit Gerritsen, Carel Thijs, Foekje Stelma, Dirkje S. Postma, R. W. B. Bottema, Bert Brunekreef, C.P. van Schayck, Gerard H. Koppelman, Groningen Research Institute for Asthma and COPD (GRIAC), Epidemiologie, Huisartsgeneeskunde, RS: NUTRIM - R2 - Gut-liver homeostasis, and RS: CAPHRI School for Public Health and Primary Care
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Male ,Allergy ,Lipopolysaccharide Receptors ,atopy ,environmental tobacco smoke ,CHILDREN ,Tobacco smoke ,Cohort Studies ,Atopy ,Prospective Studies ,Child ,Prospective cohort study ,POPULATION ,Netherlands ,education.field_of_study ,Interleukin-13 ,BIRTH COHORT ,Interleukin ,ASSOCIATION ,Air Pollution, Indoor ,Child, Preschool ,Female ,pets ,CD14 ,Cohort study ,Pulmonary and Respiratory Medicine ,Population ,SERUM IGE LEVELS ,Polymorphism, Single Nucleotide ,Dogs ,medicine ,Animals ,Humans ,Genetic Predisposition to Disease ,education ,POLYMORPHISMS ,Asthma ,business.industry ,Infant ,CHILDHOOD ASTHMA ,Immunoglobulin E ,medicine.disease ,GENE-ENVIRONMENT INTERACTIONS ,PREVENTION ,Haplotypes ,Immunology ,Cats ,interleukin 13 ,Tobacco Smoke Pollution ,business ,IMMUNOGLOBULIN-E - Abstract
Studying gene-environment interactions may elucidate the complex origins of atopic diseases but requires large study populations. Pooling data from several cohort studies may help but may also obscure findings. Gene-environment interactions in atopy development were studied and the benefits of pooling data were evaluated.Haplotype-tagging polymorphisms in the genes interleukin (IL)13 and CD14 were genotyped in 3,062 children from the following birth cohorts: the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study; the Prevention of Asthma in Children (PREVASC) study; and the Child, Parent, Health, Focus on Lifestyle and Predisposition (KOALA) study, and tested for association with total and specific immunoglobulin (Ig)E and interaction with tobacco smoke and pet exposure at ages 1, 2, 4 and 8 yrs by analysis of variance, Chi-squared tests and regression analyses.At all ages, in IL13, minor alleles of rs1295685 and rs20541 were significantly associated with elevated IgE levels in pooled analyses. In CD14, the rs2569190-TT and rs2569191-CC genotypes associated with lower IgE and decreased risk of sensitisation at 4 and 8 yrs in children exposed to pets, with an opposite effect in nonexposed children. Findings for IL13 and CD14 were comparable in separate cohorts.The present study indicates that atopy is importantly influenced by interleukin 13 at age 1-8 yrs and by CD14 in interaction with pet exposure at ages 4 and 8 yrs. Additionally, pooled data improved effect estimates and genetic effects could be detected in interaction with important environmental factors.
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- 2008
16. Consumption of organic foods and risk of atopic disease during the first 2 years of life in the Netherlands
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Foekje Stelma, Lucy van de Vijver, Piet A. van den Brandt, Ischa Kummeling, Carel Thijs, Bianca E. P. Snijders, Ronald van Ree, John Penders, Pieter C. Dagnelie, Machteld Huber, Epidemiologie, RS: NUTRIM - R2 - Gut-liver homeostasis, RS: CAPHRI School for Public Health and Primary Care, Other departments, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, and Experimental Immunology
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Hypersensitivity, Immediate ,Male ,Pediatrics ,medicine.medical_specialty ,Organic product ,Allergy ,Eczema ,Medicine (miscellaneous) ,Logistic regression ,Atopy ,Wheeze ,medicine ,Respiratory Hypersensitivity ,Humans ,Respiratory sounds ,Risk factor ,Netherlands ,Respiratory Sounds ,Nutrition and Dietetics ,medicine.diagnostic_test ,business.industry ,Confounding ,Infant, Newborn ,Feeding Behavior ,Immunoglobulin E ,medicine.disease ,Female ,Food, Organic ,Infant Food ,Dairy Products ,medicine.symptom ,business ,Epidemiologic Methods - Abstract
We prospectively investigated whether organic food consumption by infants was associated with developing atopic manifestations in the first 2 years of life. The KOALA Birth Cohort Study in the Netherlands (n 2764) measured organic food consumption, eczema and wheeze in infants until age 2 years using repeated questionnaires. Diet was defined as conventional ( 90 % organic). Venous blood samples taken from 815 infants at 2 years of age were analysed for total and specific IgE. Multivariate logistic regression models were fitted to control for potential confounding factors. Eczema was present in 32 % of infants, recurrent wheeze in 11 % and prolonged wheezing in 5 %. At 2 years of age, 27 % of children were sensitised against at least one allergen. Of all the children, 10 % had consumed a moderately organic diet and 6 % a strictly organic diet. Consumption of organic dairy products was associated with lower eczema risk (OR 0·64 (95 % CI 0·44, 0·93)), but there was no association of organic meat, fruit, vegetables or eggs, or the proportion of organic products within the total diet with the development of eczema, wheeze or atopic sensitisation. Further studies to substantiate these results are warranted.
- Published
- 2008
17. Diphtheria, Pertussis, Poliomyelitis, Tetanus, and Haemophilus influenzae Type b Vaccinations and Risk of Eczema and Recurrent Wheeze in the First Year of Life: The KOALA Birth Cohort Study
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Piet A. van den Brandt, Carel Thijs, Foekje Stelma, Ischa Kummeling, Pieter C. Dagnelie, M. Huber, Epidemiologie, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, RS: NUTRIM - R2 - Gut-liver homeostasis, RS: GROW - School for Oncology and Reproduction, and RS: CAPHRI School for Public Health and Primary Care
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Male ,Down syndrome ,Pediatrics ,medicine.medical_specialty ,Vaccination schedule ,Eczema ,Recurrence ,Risk Factors ,medicine ,Humans ,Prospective Studies ,Vaccines, Combined ,Diphtheria-Tetanus-Pertussis Vaccine ,Haemophilus Vaccines ,Respiratory Sounds ,business.industry ,Tetanus ,Incidence (epidemiology) ,Diphtheria ,Infant, Newborn ,Gestational age ,Infant ,medicine.disease ,Poliomyelitis ,Vaccination ,Poliovirus Vaccine, Inactivated ,Pediatrics, Perinatology and Child Health ,Female ,Drug Eruptions ,business - Abstract
OBJECTIVES. Among potential etiologic factors for atopic manifestations, infant vaccinations have recently been discussed. We evaluated in a prospective design whether infants who were unvaccinated or vaccinated according to incomplete vaccination schedules in the first 6 months of age were at decreased risk for eczema and recurrent wheeze in the first year of life. METHODS. Information on vaccinations against diphtheria, pertussis, poliomyelitis, tetanus; Haemophilus influenzae type b vaccine; and eczema and recurrent wheeze was collected by repeated questionnaires in 2764 families participating in the KOALA Birth Cohort Study in the Netherlands. A standard vaccination schedule referred to 3 diphtheria, pertussis, poliomyelitis, tetanus, and Haemophilus influenzae type b vaccinations in the first 6 months with the first given in months 1 to 3; an incomplete vaccination schedule was defined as any other vaccination schedule. Exclusion criteria were prematurity (gestational age RESULTS. During the first year of life, the incidence of eczema was 23% (584 of 2537 infants) and of recurrent wheeze, the incidence was 8.5% (203 of 2402 infants). At age 6 months, 1969 (77%) of 2545 infants had been vaccinated according to a standard schedule, 393 (15%) vaccinated according to an incomplete schedule, and 182 (7%) never vaccinated. Compared with infants with standard vaccination schedules, infants with incomplete schedules did not differ significantly in eczema risk or recurrent wheeze. This was also true for infants who had never been vaccinated. CONCLUSION. This study shows that the risk of eczema or recurrent wheeze at 1 year of age does not differ between infants with different vaccination status at the age of 6 months.
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- 2007
18. Early life exposure to antibiotics and the subsequent development of eczema, wheeze, and allergic sensitization in the first 2 years of life: the KOALA Birth Cohort Study
- Author
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John Penders, Piet A. van den Brandt, Foekje Stelma, Machteld Huber, Pieter C. Dagnelie, Bianca E. P. Snijders, Ronald van Ree, Ischa Kummeling, Carel Thijs, Other departments, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Experimental Immunology, Epidemiologie, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, RS: NUTRIM - R2 - Gut-liver homeostasis, RS: GROW - School for Oncology and Reproduction, and RS: CAPHRI School for Public Health and Primary Care
- Subjects
Hypersensitivity, Immediate ,Pediatrics ,medicine.medical_specialty ,medicine.drug_class ,Antibiotics ,Breastfeeding ,Eczema ,Allergic sensitization ,Cohort Studies ,Risk Factors ,Wheeze ,medicine ,Humans ,Respiratory sounds ,Respiratory Sounds ,medicine.diagnostic_test ,business.industry ,Infant ,Immunoglobulin E ,Anti-Bacterial Agents ,Breast Feeding ,Pediatrics, Perinatology and Child Health ,Etiology ,Female ,medicine.symptom ,business ,Breast feeding ,Cohort study - Abstract
OBJECTIVES. Antibiotic exposure in early life may be associated with atopic disease development either by interfering with bacterial commensal flora or by modifying the course of bacterial infections. We evaluated early life exposure to antibiotics and the subsequent development of eczema, wheeze, and allergic sensitization in infancy. METHODS. Information on antibiotic use in the first 6 months and eczema and wheeze until age 2 was collected by repeated questionnaires in 2764 families participating in the KOALA (Child, Parent and Health: Lifestyle and Genetic Constitution [in Dutch]) Birth Cohort Study in the Netherlands. Antibiotic intake was evaluated both as maternal antibiotic use during breastfeeding and infant oral medication. Venous blood samples taken from 815 infants at 2 years of age were analyzed for total and specific immunoglobulin E against common food and inhalant allergens using a radioallergosorbent test. Multivariate logistic regression analysis was used to adjust for confounding factors. RESULTS. During the first 2 years, eczema was present in 32% of all infants, recurrent wheeze in 11%, and prolonged wheezing in 5%. At 2 years old, 27% of children were sensitized against ≥1 allergen. At 6 months old, 11% had been exposed to antibiotics through breast milk and 20% directly through medication. The risk for recurrent wheeze, and prolonged wheeze was higher in infants directly exposed to antibiotics through medication, also after excluding from the analyses children who wheezed in the same period as an antibiotic had been used (avoiding reverse causation). Antibiotic use through breastfeeding was associated with recurrent wheeze, but prolonged wheeze was not. Eczema and sensitization were not associated with antibiotic exposure. CONCLUSIONS.We demonstrated that early antibiotic use preceded the manifestation of wheeze but not eczema or allergic sensitization during the first 2 years of life. Different biological mechanisms may underlie the etiology of wheeze compared with eczema or sensitization. Antibiotic exposure through breastfeeding enhanced the risk for recurrent wheeze, but this needs further confirmation.
- Published
- 2007
19. Breast-feeding duration and infant atopic manifestations, by maternal allergic status, in the first 2 years of life (KOALA study)
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John Penders, Carel Thijs, Foekje Stelma, Piet A. van den Brandt, Bianca E. P. Snijders, Ischa Kummeling, Monique Mommers, Ronald van Ree, Pieter C. Dagnelie, Epidemiologie, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, RS: NUTRIM - R2 - Gut-liver homeostasis, RS: GROW - School for Oncology and Reproduction, RS: CAPHRI School for Public Health and Primary Care, Other departments, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, and Experimental Immunology
- Subjects
Risk ,Pediatrics ,medicine.medical_specialty ,Allergy ,Time Factors ,Eczema ,Mothers ,Lower risk ,Dermatitis, Atopic ,Atopy ,Pregnancy ,Recurrence ,Hypersensitivity ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Netherlands ,Respiratory Sounds ,Asthma ,business.industry ,Infant, Newborn ,Infant ,Odds ratio ,Immunoglobulin E ,medicine.disease ,Breast Feeding ,Logistic Models ,Pediatrics, Perinatology and Child Health ,Female ,business ,Breast feeding - Abstract
Objective To investigate the potential effect of modification by maternal allergic status on the relationship between breast-feeding duration and infant atopic manifestations in the first 2 years of life. Study design Data from 2705 infants of the KOALA Birth Cohort Study (The Netherlands) were analyzed. The data were collected by repeated questionnaires at 34 weeks of gestation and 3, 7, 12, and 24 months postpartum. Total and specific immunoglobulin E measurements were performed on venous blood samples collected during ionic visits at age 2 years. Relationships were analyzed using logistic regression analyses. Results Longer duration of breast-feeding was associated with a lower risk for eczema in infants of mothers without allergy or asthma (P-trend = .01) and slightly lower risk in those of mothers with allergy but noasthma(P-trend =.14). There was no such association for asthmatic mothers (P-trend =.87). Longer breast-feeding duration decreased the risk of recurrent wheeze independent of maternal allergy (P-trend =.02) or asthma status See editorial, p 331 and (P-trend =.06). related articles, p 352 Conclusions Our findings show that the relationship between breast-feeding and and p 359 infant eczema in the first 2 years of life is modified by maternal allergic status. The protective effect of breast-feeding on recurrent wheeze may be associated with protection against respiratory infections
- Published
- 2007
20. A Dutch nationwide evaluation of serological assays for detection of Borrelia antibodies in clinically well-defined patients
- Author
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F. Verduyn Lunel, A.H. Brandenburg, T. Herremans, C.W. Ang, Foekje Stelma, H.A. Bijlmer, N.D. van Burgel, A.P. van Dam, Medical Microbiology and Infection Prevention, CCA - Disease profiling, and Academic Medical Center
- Subjects
retrospective study ,serology ,Serology ,immunology ,antibody detection ,Lyme disease ,acrodermatitis chronica atrophicans ,cross reaction ,Netherlands ,serology, Antibodies, Bacterial ,Lyme Disease ,Bacterial ,clinical trial ,General Medicine ,Antibodies, Bacterial ,LYME ,Infectious Diseases ,priority journal ,validation study ,Antibody ,medicine.symptom ,Neuroborreliosis ,prospective study ,Microbiology (medical) ,Immunoblotting ,Enzyme-Linked Immunosorbent Assay ,Biology ,Sensitivity and Specificity ,Antibodies ,Article ,immunoglobulin M antibody ,bacterium antibody ,evaluation study ,blood ,Borrelia ,medicine ,Humans ,controlled study ,False Positive Reactions ,Serologic Tests ,human ,procedures ,Borrelia burgdorferi ,laboratory diagnosis ,Retrospective Studies ,bacterium detection ,nonhuman ,erythema chronicum migrans ,case control study ,medicine.disease ,biology.organism_classification ,major clinical study ,enzyme linked immunosorbent assay ,multicenter study ,bacterium antibody, acrodermatitis chronica atrophicans ,Immunology ,biology.protein ,Erythema chronicum migrans ,disease duration - Abstract
Numerous tests for the detection of antibodies against Borrelia burgdorferi are commercially available. Manufacturer-derived data invariably report a high sensitivity and specificity, but comparative studies demonstrate large differences in clinical practice, especially with regard to specificity. We retrospectively collected data from validation studies for B. burgdorferi antibody assays from 8 laboratories in the Netherlands. The total number of samples was 809. Samples were selected based on clinical and laboratory parameters. We included samples from patients with erythema migrans, acrodermatitis chronicum atrophicans, and neuroborreliosis; cross-reactivity controls; and healthy controls. Data are presented from 10 enzyme-linked immunosorbent assays and 5 immunoblots. For manifestations of B. burgdorferi infection with short disease duration, the positivity rate of the assays varied significantly. In patients with long disease duration, the positivity rate differed only marginally. In cross-reactivity controls, there was significant variation in the reactivity rate. The majority of false-positive reactions are of the IgM isotype. © 2015 Elsevier Inc..
- Published
- 2015
21. Amyloid beta-42 (Aß-42), neprilysin and cytokine levels: A pilot study in patients with HIV related cognitive impairments
- Author
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Khutso M. Mothapo, S. Miners, Foekje Stelma, Marcel M. Verbeek, Marloes A. M. Janssen, Peter P. Koopmans, A.J.A.M. van der Ven, and Roy P. C. Kessels
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Adult ,Male ,Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1] ,Amyloid ,medicine.medical_treatment ,Immunology ,Human immunodeficiency virus (HIV) ,HIV Infections ,Pilot Projects ,Neuropsychological Tests ,medicine.disease_cause ,Proinflammatory cytokine ,Amyloid Beta 42 ,Young Adult ,medicine ,Immunology and Allergy ,Dementia ,Humans ,Neprilysin ,Neuro- en revalidatiepsychologie ,Amyloid beta-Peptides ,Neuropsychology and rehabilitation psychology ,Cognition ,Plasticity and Memory [DI-BCB_DCC_Theme 3] ,Middle Aged ,Viral Load ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,medicine.disease ,Peptide Fragments ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Cytokine ,Neurology ,Linear Models ,Cytokines ,Female ,Neurology (clinical) ,Psychology ,Cognition Disorders - Abstract
HIV-associated dementia (HAD) is associated with amyloid-beta (Aβ) deposition. This study measured CSF and plasma amyloid beta-42 (Aβ-42), neprilysin (NEP) and cytokine levels in HIV-related cognitive impairments (HCI), HIV normal cognitive functioning (NF) and non-HIV controls. Our data showed a trend towards detectable plasma Aβ-42 levels more frequently in HCI (67%), when compared to NF (29%) and controls (10%). We showed elevated IL-8 levels in CSF of HCI compared to NF, although not significant values. The data from this pilot study indicates that CSF IL-8 and plasma Aβ-42 may be interesting biomarkers for the presence of HCI.
- Published
- 2015
22. Factors influencing the composition of the intestinal microbiota in early infancy
- Author
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Carel Thijs, John Penders, Cornelis Vink, Piet A. van den Brandt, Bianca E. P. Snijders, Ischa Kummeling, Foekje Stelma, Ellen E. Stobberingh, Epidemiologie, Medische Microbiologie, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, and RS: CAPHRI School for Public Health and Primary Care
- Subjects
Adult ,Male ,Antifungal Agents ,Fever ,Gestational Age ,Gut flora ,Bacteroides fragilis ,Cohort Studies ,Feces ,Species Specificity ,Pregnancy ,Surveys and Questionnaires ,Escherichia coli ,medicine ,Humans ,Prospective Studies ,Home Childbirth ,Netherlands ,Bacteria ,biology ,Cesarean Section ,Clostridioides difficile ,business.industry ,Siblings ,Infant, Newborn ,Infant ,Gestational age ,food and beverages ,Clostridium difficile ,Delivery, Obstetric ,biology.organism_classification ,medicine.disease ,Anti-Bacterial Agents ,Hospitalization ,Intestines ,Lactobacillus ,Breast Feeding ,Pediatrics, Perinatology and Child Health ,Immunology ,Female ,Infant Food ,Bifidobacterium ,Bacteroides ,business ,Breast feeding - Abstract
OBJECTIVE: The aim of this study was to examine the contribution of a broad range of external influences to the gut microbiotic composition in early infancy. METHODS: Fecal samples from 1032 infants at 1 month of age, who were recruited from the KOALA Birth Cohort Study in the Netherlands, were subjected to quantitative real-time polymerase chain reaction assays for the enumeration of bifidobacteria, Escherichia coli, Clostridium difficile, Bacteroides fragilis group, lactobacilli, and total bacterial counts. Information on potential determinants of the gut microbiotic composition was collected with repeated questionnaires. The associations between these factors and the selected gut bacteria were analyzed with univariate and multivariate analyses. RESULTS: Infants born through cesarean section had lower numbers of bifidobacteria and Bacteroides, whereas they were more often colonized with C difficile, compared with vaginally born infants. Exclusively formula-fed infants were more often colonized with E coli, C difficile, Bacteroides, and lactobacilli, compared with breastfed infants. Hospitalization and prematurity were associated with higher prevalence and counts of C difficile. Antibiotic use by the infant was associated with decreased numbers of bifidobacteria and Bacteroides. Infants with older siblings had slightly higher numbers of bifidobacteria, compared with infants without siblings. CONCLUSIONS: The most important determinants of the gut microbiotic composition in infants were the mode of delivery, type of infant feeding, gestational age, infant hospitalization, and antibiotic use by the infant. Term infants who were born vaginally at home and were breastfed exclusively seemed to have the most "beneficial" gut microbiota (highest numbers of bifidobacteria and lowest numbers of C difficile and E coli). AD - Department of Epidemiology, Nutrition and Toxicology Research Institute Maastricht, Maastricht University, PO Box 616, 6200 MD Maastricht, Netherlands. j.penders@epid.unimaas.nl
- Published
- 2006
23. KIR and Human Leukocyte Antigen Genotype Associated Risk of Cytomegalovirus Disease in Renal Transplant Patients
- Author
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Luuk B. Hilbrands, Foekje Stelma, Henk J. Tijssen, Arnold van der Meer, Clive M. Michelo, Irma Joosten, and Ramona Zomer
- Subjects
Adult ,Graft Rejection ,Male ,Time Factors ,Human leukocyte antigen ,medicine.disease_cause ,Antiviral Agents ,Natural killer cell ,Immunocompromised Host ,Gene Frequency ,Receptors, KIR ,HLA Antigens ,Risk Factors ,Genotype ,medicine ,Humans ,Genetic Predisposition to Disease ,Risk factor ,Receptor ,Transplantation ,Kidney ,business.industry ,Incidence ,virus diseases ,Cytomegalovirus ,Middle Aged ,Kidney Transplantation ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,medicine.anatomical_structure ,Phenotype ,Treatment Outcome ,Immunology ,Cytomegalovirus Infections ,Drug Therapy, Combination ,Female ,Renal disorders Radboud Institute for Health Sciences [Radboudumc 11] ,business ,Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5] ,Immunosuppressive Agents - Abstract
BACKGROUND Cytomegalovirus(CMV) infections have a significant effect on morbidity and mortality in kidney transplants. We conducted a study to ascertain the association of natural killer cell killer immunoglobulin-like receptors and human leukocyte antigen (HLA) genotype with risk of CMV disease. METHODS The 90 CMV-negative patients receiving a first renal transplantation from a CMV-positive donor in this study received triple immunosuppressive therapy and prophylactic CMV treatment for up to 3 months after transplantation. RESULTS We observed a 43.3% incidence rate of CMV disease within the first year after transplantation. Twenty-seven recipients experienced a rejection episode, 14 of which had CMV disease, mostly after rejection, suggesting that in this group, CMV disease is not a risk factor for rejection. KIR gene or genotype distribution were similar between the CMV diseased and CMV disease-free group. Twenty-seven recipients (30%) carried KIR-AA genotype, of which nine (33%) had CMV disease. Of the remaining 63 (70%) recipients with KIR-BX genotype, 30 (48%) had CMV disease. There was no significant difference between the two genotype groups with regard to occurrence of CMV disease, although there was a trend toward a lower incidence of CMV disease in recipients carrying the KIR-AA genotype. For CMV disease, we found no significant risk associated with the number of activating or inhibitory KIRs. Neither was missing KIR ligands for the inhibitory KIRs (HLA-C1/C2/Bw4) in recipients associated with lower rates of CMV disease. CONCLUSION In CMV-negative recipients, genotypic analysis of KIR repertoire and HLA ligands does not provide risk factors for primary CMV disease after renal transplantation.
- Published
- 2014
24. A review on the design and reporting of studies on drug–gene interaction
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Martin H. Prins, Kim M. Smits, Jan S. A. G. Schouten, Luc J.M. Smits, Patty J. Nelemans, and Foekje Stelma
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Risk ,Selection bias ,Models, Statistical ,Study quality ,Genotype ,Operations research ,Epidemiology ,business.industry ,Patient Selection ,media_common.quotation_subject ,Prognosis ,Systematic review ,Gene interaction ,Risk analysis (engineering) ,Pharmacogenetics ,Research Design ,Humans ,Medicine ,Narrative review ,Quality (business) ,business ,Effect modification ,Randomized Controlled Trials as Topic ,media_common - Abstract
Objective Methodological standards for clinical pharmacogenetic studies should be developed to improve reporting of studies and facilitate their inclusion in systematic reviews. The essence of these studies lies within the concept of effect modification. Study Design and Setting A narrative review discussing methodological issues in the design and reporting of pharmacogenetic studies. Results Studying effect modification within a trial leads to the comparison of subgroups based on genotype. Differences in effect based on genotype should preferably be expressed in absolute terms (risk differences) to facilitate clinical decisions on treatment. Information on the distribution of potential effect modifiers or prognostic factors should be available to prevent a biased comparison of differences in effect between genotypes. The distribution of genotypes should also be presented and compared to Hardy–Weinberg equilibrium to check for selection bias. Additional points of interest include the possibility of selective nonavailability of biomaterial and the choice of a statistical model to study effect modification. Conclusion Additional methodological issues should be taken into account when designing and reporting pharmacogenetic studies, to ensure high study quality. We present several important issues for future studies investigating drug–gene interactions that can serve as a basis for further discussion on methodology in pharmacogenetics.
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- 2005
25. The impact of maternal stress on pregnancy outcome in a well-educated Caucasian population
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Luc J.M. Smits, Rob A. de Bie, Jim van Os, Foekje Stelma, Janneke M Bastiaanssen, Lydia Krabbendam, Psychiatrie en Neuropsychologie, Epidemiologie, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, and RS: CAPHRI School for Public Health and Primary Care
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Adult ,medicine.medical_specialty ,Epidemiology ,Outcome (game theory) ,Maternal stress ,Pregnancy ,Risk Factors ,Prevalence ,Medicine ,Humans ,Prospective Studies ,Caucasian population ,Prospective cohort study ,Netherlands ,business.industry ,Obstetrics ,Confounding ,Infant, Newborn ,Pregnancy Outcome ,medicine.disease ,Mental health ,Pregnancy Complications ,Pediatrics, Perinatology and Child Health ,Psychosocial stress ,Infant, Small for Gestational Age ,Educational Status ,Female ,business ,Stress, Psychological - Abstract
Summary The aim of the study was to examine the association between stress and pregnancy outcome after adjustment for possible confounding and mediating variables. A prospective cohort study of 5511 pregnancies was conducted in 2001–03 in the Netherlands. A standardised questionnaire collecting demographics and mental health data was administered at 14 and 30 weeks of pregnancy. Medical data on the pregnancy and delivery were obtained from obstetricians and midwives. The results showed that a high level of perceived stress at 14 weeks of pregnancy increased the risk for delivery of an infant that was small-for-gestational-age (OR = 1.26 [95% CI 1.01, 1.56]), but the association was reduced after adjustment for the possible confounding effects of demographic variables (OR = 1.16 [95% CI 0.92, 1.47]). The results do not support a direct relationship between perceived stress and adverse pregnancy outcome. Demographic variables may explain the association between psychosocial stress and pregnancy outcome to a significant degree.
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- 2005
26. Bacterial Tracheitis and Septic Shock
- Author
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Foekje Stelma, Ramon O. Tak, C. Neeleman, Jan Bart Yntema, Ben Semmekrot, and Adilia Warris
- Subjects
Microbiology (medical) ,Septic shock ,business.industry ,lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4] ,Paramyxoviridae Infections ,medicine.disease_cause ,Staphylococcal infections ,medicine.disease ,Microbiology ,03 medical and health sciences ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,0302 clinical medicine ,Infectious Diseases ,Tracheitis ,Staphylococcus aureus ,Shock (circulatory) ,Pediatrics, Perinatology and Child Health ,medicine ,030211 gastroenterology & hepatology ,Metapneumovirus ,030212 general & internal medicine ,medicine.symptom ,Bacterial tracheitis ,business - Abstract
Item does not contain fulltext
- Published
- 2016
27. Evaluation of the patterns of Schistosoma mansoni infection and re-infection in Senegal, from faecal egg counts and serum concentrations of circulating anodic antigen
- Author
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S. le Cessie, I. Talla, S. J. De Vlas, B. Gryseels, S. T. M. Falcao Ferreira, A.M. Deelder, Foekje Stelma, K. Polman, Epidemiologie, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, and Public Health
- Subjects
Adult ,Adolescent ,Helminthiasis ,Schistosomiasis ,Biology ,Praziquantel ,Cohort Studies ,Feces ,Recurrence ,Immunity ,parasitic diseases ,medicine ,Parasite Egg Count ,Animals ,Humans ,Child ,Glycoproteins ,Anthelmintics ,Age Factors ,Infant, Newborn ,Infant ,Helminth Proteins ,Schistosoma mansoni ,Middle Aged ,medicine.disease ,biology.organism_classification ,Senegal ,Fertility ,Infectious Diseases ,Antigens, Helminth ,Child, Preschool ,Data Interpretation, Statistical ,Immunology ,Linear Models ,Parasitology ,Trematoda ,medicine.drug - Abstract
Infection and re-infection patterns were evaluated in a recent Schistosoma mansoni focus in northern Senegal, by determining concentrations of serum circulating anodic antigen (CAA), as a measure of worm burden, and counting eggs in faeces before, 6 or 12 weeks and 1 year after praziquantel treatment in two subsequent cohorts (cohort A and B). No differences in egg counts and CAA concentrations or their relationship were found between the cohorts, which were examined 2 years apart. Within both cohorts, CAA concentrations showed the same, typical, age-related patterns as egg counts, with a peak in children and a strong decline in adults. These trends were apparent both before and 1 year after treatment. The results indicate that an age-related resistance to infection and to re-infection has been firmly established, at a steady level, in the recent S. mansoni focus investigated, with no indication of a gradual development of immunity or anti-fecundity immunity over a period of 2 years. Both shortly and 1 year after treatment, the decrease in egg counts was stronger than that in CAA concentrations, indicating that that there had been a reduction in worm fecundity after treatment. The possibility that praziquantel may induce anti-fecundity immunity has important implications for the use and interpretation of the results of (egg-count-based) re-infection studies designed to follow the development of naturally acquired immunity.
- Published
- 2002
28. [Borrelial lymphocytoma]
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Ellen J H, Schatorjé, Herjan, van der Steeg, Foekje, Stelma, Konnie, Hebeda, and Adilia, Warris
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Diagnosis, Differential ,Male ,Lyme Disease ,Adolescent ,Pseudolymphoma ,Biopsy ,Doxycycline ,Nipples ,Erythema Chronicum Migrans ,Humans ,Anti-Bacterial Agents - Abstract
Borrelial lymphocytoma is a relatively rare but typical presentation of Lyme disease. Predilection sites are the ears in children and chest/nipples in adults. It is treated like an erythema migrans and has a good prognosis.A 16-year-old boy presented with a swollen, red and painful right nipple since several months. An ultrasound showed normal breast tissue. The patient was referred to the pediatric surgeon who performed an incision biopsy. Histopathological examination revealed follicular hyperplasia without signs of malignancy. An infectious cause, most likely Lyme disease, was suspected. Serological analysis and PCR of the tissue confirmed the diagnosis of a borrelial lymphocytoma, and the patient was treated with doxycycline with good result.Early recognition of the characteristic clinical presentation of borrelial lymphocytoma, supported by positive results from serologic testing for Lyme disease, avoids the need for additional and invasive diagnostic tests.
- Published
- 2014
29. The contribution of host-related factors to low cure rates of praziquantel for the treatment of Schistosoma mansoni in Senegal
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L. van Lieshout, G.J. van Dam, K. Polman, S. Sow, B. Gryseels, Foekje Stelma, F. Guisse, S. T. M. Falcao Ferreira, M. Diakhate, and A.M. Deelder
- Subjects
Adult ,Male ,Africa, West ,Population ,Helminthiasis ,Physiology ,Schistosomiasis ,Praziquantel ,Statistics, Nonparametric ,Host-Parasite Interactions ,Cohort Studies ,Efficacy ,Feces ,Sex Factors ,Seroepidemiologic Studies ,Virology ,parasitic diseases ,medicine ,Animals ,Humans ,Anthelmintic ,Risk factor ,Child ,education ,Parasite Egg Count ,Retrospective Studies ,Anthelmintics ,education.field_of_study ,biology ,Age Factors ,Helminthic diseases ,Schistosoma mansoni ,biology.organism_classification ,medicine.disease ,Schistosomiasis mansoni ,Senegal ,Treatment ,Immunoglobulin Isotypes ,Treatment Outcome ,Infectious Diseases ,Antigens, Helminth ,Immunology ,Female ,Parasitology ,medicine.drug - Abstract
Surprisingly low cure rates were repeatedly observed after treatment with a standard dosage of praziquantel in a recently established Schistosoma mansoni focus in northern Senegal. In 4 discrete cohorts from the same population, cure rates were 18-36% and egg count reduction rates were 77-88%. Data and material of 920 compliant subjects from all 4 cohorts were further analyzed to identify possible host-related factors associated with low cure rates. The lowest cure rates were found in the highest egg count groups. However, in low and moderate egg count groups, drug efficacy was also below normal values. Cure rates were similar in males and females, showed no seasonal variation, and were independent of previous praziquantel treatment. They were significantly higher in adults than in children, also after allowing for intensity of infection. Individual water contact behavior and specific humoral immune responses were examined in 2 extreme subgroups, either without significant egg count reduction or showing complete parasitologic cure. There was no significant difference in frequency and duration of water contact between those individuals with complete cure and those that showed little effect of praziquantel treatment. Levels of IgG, IgG1, IgG3, IgG4, IgM, and IgE against adult worm antigen were not different between the 2 subgroups. Thus, the abnormally frequent failure of treatment observed in this focus could not be associated with any host-related factor, other than age and pretreatment egg counts.
- Published
- 1999
30. Circulating galectin-3 in infections and non-infectious inflammatory diseases
- Author
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F.L. van de Veerdonk, Mihai G. Netea, J. ten Oever, Evangelos J. Giamarellos-Bourboulis, B.J. Kullberg, Melissa D. Johnson, Anna Simon, Alexandre Pachot, Leo A. B. Joosten, Mirian C. H. Janssen, and Foekje Stelma
- Subjects
Microbiology (medical) ,Male ,medicine.medical_specialty ,Gout ,Galectin 3 ,Inflammation ,Bacteremia ,Biology ,Invasive mycoses and compromised host Infection and autoimmunity [N4i 2] ,Communicable Diseases ,Autoimmune Diseases ,Invasive mycoses and compromised host [N4i 2] ,03 medical and health sciences ,Medical microbiology ,Lower respiratory tract infection ,medicine ,Humans ,Respiratory system ,030304 developmental biology ,0303 health sciences ,030306 microbiology ,Pathogenesis and modulation of inflammation Infection and autoimmunity [N4i 1] ,General Medicine ,Middle Aged ,medicine.disease ,Autoinflammatory Syndrome ,3. Good health ,Pathogenesis and modulation of inflammation [N4i 1] ,Infectious Diseases ,C-Reactive Protein ,Pancreatitis ,Galectin-3 ,Immunology ,Female ,medicine.symptom ,Biomarkers - Abstract
Recent studies point to a dual role for galectin-3 as both a circulating damage-associated molecular pattern and a cell membrane-associated pattern recognition receptor. The aim of this study was to assess the potential of circulating galectin-3 for discriminating between infections and non-infectious inflammatory disorders on the one hand, and between fungal and bacterial infections on the other. Galectin-3 and C-reactive protein (CRP) were measured in the plasma of 127 patients with either non-infectious inflammatory disorders (gout, autoinflammatory syndrome or pancreatitis) or an infection (viral lower respiratory tract infection, bacterial sepsis or candidaemia). Circulating galectin-3 concentrations were increased in patients with infections when compared with healthy volunteers or patients with non-infectious inflammatory diseases. At cut-off values with a specificity of 95%, the sensitivity of galectin-3 (20.6 ng/ml) to discriminate between an infection and non-infectious inflammation was higher than that of CRP (156 mg/l): 43% [95% confidence interval (CI) 33-53%] versus 27% (95% CI 19-37%), p = 0.03. After exclusion of patients with CRP156 mg/l, galectin-3 concentration20.6 ng/ml could identify 41 % (95% CI 29-53%) of the patients with an infection at the cost of one false-positive with non-infectious inflammation. Using this sequential approach, 57% of the patients with an infection could be selected. Galectin-3 concentrations were similar in patients with bacterial and Candida sepsis, while being lower in viral respiratory infections. Although galectin-3 does not discriminate between bacterial and Candida sepsis, the sequential use of CRP and galectin-3 in distinguishing infectious diseases from non-infectious inflammation may be superior to CRP alone.
- Published
- 2013
31. Ultrasonography in a Senegalese Community Recently Exposed to Schistosoma mansoni Infection
- Author
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A. K. Vocke, B. Gryseels, I. Talla, A. Mbaye, Y. Yazdanpanah, Foekje Stelma, Anna K. Thomas, Jochen H. H. Ehrich, R Kardorff, Ekkehard Doehring, and M. Niang
- Subjects
Male ,Pathology ,Africa, West ,Gastroenterology ,Praziquantel ,Cohort Studies ,Prevalence ,Schistosomiasis ,Child ,Eggs per gram ,Ultrasonography ,Portal Vein ,Helminthic diseases ,Schistosoma mansoni ,Middle Aged ,Senegal ,Infectious Diseases ,medicine.anatomical_structure ,Liver ,Child, Preschool ,Female ,Trematoda ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,Helminthiasis ,Spleen ,Biology ,Antiplatyhelmintic Agents ,Virology ,Internal medicine ,parasitic diseases ,medicine ,Humans ,Parasite Egg Count ,Aged ,business.industry ,Infant ,medicine.disease ,biology.organism_classification ,Schistosomiasis mansoni ,Clinical manifestations ,Splenomegaly ,Parasitology ,business - Abstract
Inhabitants of Ndombo (n = 614), a village in an area recently infected with Schistosoma mansoni in Northern Senegal, were examined clinically, parasitologically, and ultrasonographically to investigate the presence and degree of S. mansoni-related hepatosplenic morbidity after a few years of exposure to schistosomal infection of regional canals. Despite previous praziquantel treatment of 56% of the inhabitants prior to our investigation, the prevalence of S. mansoni infection in 1993 was 90%, and 42% of the villagers excreted more than 1,000 eggs per gram of stool. Previously untreated individuals were found to have significantly higher egg counts than treated ones. Despite the high intensities of infection, ultrasonographically detected severe periportal thickening of the liver was infrequent. Grading according to body length-dependent normal values of cross-section diameter of peripheral portal vein branches of a European control group correlated with intensities of infection. Of the total group of patients, 30% (n = 182) had more severe thickening of portal vein branch diameters above the 97th percentile and 70% of these had a splenomegaly. The highest egg counts and the most frequent development of periportal thickening were found in 11-20 year-old individuals. Periportal thickening was less frequent in praziquantel-treated adolescents than in untreated ones. This suggests that early antischistosomal medication may be useful to limit schistosomiasis-induced hepatic morbidity especially in children, even though reinfection seems inevitable.
- Published
- 1996
32. Impact of bacterial colonization on exhaled inflammatory markers in wheezing preschool children
- Author
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Koen J van Aerde, Onno C. P. van Schayck, Ester M.M. Klaassen, Edward Dompeling, Foekje Stelma, Kim D G van de Kant, Jean W M Muris, Quirijn Jöbsis, Ellen E. Stobberingh, Jan Damoiseaux, Cathrien A. Bruggeman, Kindergeneeskunde, MUMC+: DA CDL Algemeen (9), Med Microbiol, Infect Dis & Infect Prev, Family Medicine, RS: CAPHRI School for Public Health and Primary Care, RS: NUTRIM - R3 - Chronic inflammatory disease and wasting, RS: NUTRIM - R4 - Gene-environment interaction, and Interne Geneeskunde
- Subjects
Pulmonary and Respiratory Medicine ,Male ,Colony Count, Microbial ,medicine.disease_cause ,Wheeze ,Streptococcus pneumoniae ,Medicine ,Humans ,Exhaled breath condensate ,IL-2 receptor ,Interleukin-7 receptor ,Respiratory Sounds ,Inflammation ,Immunity, Cellular ,Bacteria ,business.industry ,Interleukins ,Interleukin ,Exhalation ,Pathogenesis and modulation of inflammation Infection and autoimmunity [N4i 1] ,Odds ratio ,Flow Cytometry ,Asthma ,Breath Tests ,Child, Preschool ,Immunology ,Female ,medicine.symptom ,business ,Biomarkers - Abstract
Item does not contain fulltext Wheeze is a common symptom in preschool children. The role of bacteria, regulatory T (T(reg)) cells and their association with airway inflammation in preschool wheeze is largely unknown. We evaluated inflammatory markers in exhaled breath condensate (EBC), bacterial colonization and circulating T(reg) cells in preschool children with and without recurrent wheeze. We recruited 252 children (aged two to four years) with (N = 202) and without (N = 50) recurrent wheeze. EBC was collected using an efficient closed glass condenser. Inflammatory markers in EBC (Interleukin(IL)-2, IL-4, IL-8, IL-10, IL-13) were assessed using multiplex immunoassay. Nasal and throat swabs were analysed for presence of Streptococcus pneumoniae, Haemophilus (para)influenzae and Staphylococcus aureus. Proportions of T(reg) cells (CD4(+)CD25(high)CD127(-)) were quantified by flow cytometry. Recurrent wheezing children had elevated EBC levels of IL-2, IL-4, IL-10 and IL-13 compared to non-wheezers (odds ratio (95% confidence interval): 1.67 (1.23-2.27): 1.58 (1.15-2.18): 1.47 (1.14-1.90): 1.55 (1.16-2.06), p
- Published
- 2012
33. Humoral and cellular immune responses after influenza vaccination in patients with chronic fatigue syndrome
- Author
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I. Jolanda M. de Vries, Sasja F. Mulder, Gijs Bleijenberg, Foekje Stelma, Carla M.L. van Herpen, L.D. Elving, Jeanette M. Pots, Hetty Prinsen, Hanneke W. M. van Laarhoven, Ruurd Torensma, Other departments, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, and Oncology
- Subjects
lcsh:Immunologic diseases. Allergy ,Adult ,Male ,musculoskeletal diseases ,Cellular immunity ,Health aging / healthy living [IGMD 5] ,Immunology ,Cellular Immunology ,Immune system ,Immunity ,Immune Regulation [NCMLS 2] ,Translational research [ONCOL 3] ,Chronic fatigue syndrome ,medicine ,Humans ,Human Movement & Fatigue [NCEBP 10] ,Immune Regulation Translational research [NCMLS 2] ,Immunity, Cellular ,Fatigue Syndrome, Chronic ,business.industry ,Vaccination ,Case-control study ,Translational research Immune Regulation [ONCOL 3] ,virus diseases ,Pathogenesis and modulation of inflammation Infection and autoimmunity [N4i 1] ,Psychological determinants of chronic illness [NCEBP 8] ,Hemagglutination Inhibition Tests ,Middle Aged ,medicine.disease ,Tissue engineering and pathology [NCMLS 3] ,Influenza ,Immunity, Humoral ,nervous system diseases ,Humoral immunity ,Effective primary care and public health Age-related aspects of cancer [NCEBP 7] ,Influenza Vaccines ,Case-Control Studies ,Antibody Formation ,Female ,lcsh:RC581-607 ,business ,Research Article - Abstract
Contains fulltext : 108175.pdf (Publisher’s version ) (Open Access) ABSTRACT: BACKGROUND: Chronic fatigue syndrome (CFS) is a clinical condition characterized by severe and disabling fatigue that is medically unexplained and lasts longer than 6 months. Although it is possible to effectively treat CFS, the nature of the underlying physiology remains unclear. Various studies have sought evidence for an underlying disturbance in immunity. The aim of this study was to compare the humoral and cellular immune responses upon influenza vaccination in CFS patients and healthy controls. RESULTS: Identical antibody titers were observed in CFS patients and healthy controls. Patients and controls demonstrated similar seroprotection rates against all three virus-strains of the influenza vaccine, both pre- and post-vaccination. Functional T cell reactivity was observed in both CFS patients and healthy controls. CFS patients showed a non-significant, numerically lower cellular proliferation at baseline compared to controls. Vaccination induced a significant increase in cellular proliferation in CFS patients, but not in healthy controls. Cytokine production and the number of regulatory T cells were comparable in patients and controls. CONCLUSIONS: The humoral and cellular immune responses upon influenza vaccination were comparable in CFS patients and healthy controls. Putative aberrations in immune responses in CFS patients were not evident for immunity towards influenza. Standard seasonal influenza vaccination is thus justified and, when indicated, should be recommended for patients suffering from CFS.
- Published
- 2012
34. Oseltamivir-resistant pandemic A(H1N1) 2009 influenza viruses detected through enhanced surveillance in the Netherlands, 2009-2010
- Author
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Bert Niesters, Annelies Riezebos-Brilman, Aloys C.M. Kroes, Marcel Jonges, Marion Koopmans, Sander Leenders, Foekje Stelma, Matthias F. C. Beersma, Floor Abbink, Peter Bloembergen, Aura Timen, Mariken van der Lubben, Margreet J M Te Wierik, Albert D. M. E. Osterhaus, Corien Swaan, Janko van Beek, Leslie D. Isken, Martin Schutten, Jan Jelrik Oosterheert, Arjan de Jong, Rob M Riesmeijer, Fré Sebens, Erhard van der Vries, Adam Meijer, Annemarie van ’t Veen, Gé A. Donker, Wim Ang, Eric C. J. Claas, Charles A. Boucher, Rianne van Gageldonk-Lafeber, Ellen Mascini, Faculteit Medische Wetenschappen/UMCG, Pediatric surgery, Medical Microbiology and Infection Prevention, CCA - Immuno-pathogenesis, Child and Adolescent Psychiatry / Psychology, Virology, Public Health, Erasmus MC other, and Anesthesiology
- Subjects
Male ,medicine.medical_treatment ,OUTBREAK ,viruses ,Resistance ,EMERGENCE ,chemistry.chemical_compound ,Influenza A Virus, H1N1 Subtype ,Pandemic ,A(H1N1) ,Child ,Immunodeficiency ,Phylogeny ,Netherlands ,Enhanced surveillance ,biology ,Transmission (medicine) ,ANTIVIRAL DRUGS ,virus diseases ,Immunosuppression ,SUBSTITUTION ,Middle Aged ,Pathogenesis and modulation of inflammation [N4i 1] ,Child, Preschool ,Female ,A H1N1 VIRUS ,Adult ,Oseltamivir ,EUROPE ,Adolescent ,TRANSMISSION ,Molecular Sequence Data ,Neuraminidase ,Virus ,Cell Line ,Viral Proteins ,Young Adult ,Virology ,Drug Resistance, Viral ,Influenza, Human ,medicine ,Animals ,Humans ,Antiviral ,Pandemics ,Aged ,Pharmacology ,Outbreak ,Infant ,Pathogenesis and modulation of inflammation Infection and autoimmunity [N4i 1] ,medicine.disease ,EVOLUTION ,Influenza ,respiratory tract diseases ,chemistry ,Immunology ,Mutation ,biology.protein ,VIRULENCE ,Sentinel Surveillance - Abstract
Enhanced surveillance of infections due to the pandemic A(H1N1) influenza virus, which included monitoring for antiviral resistance, was carried out in the Netherlands from late April 2009 through late May 2010. More than 1100 instances of infection with the pandemic A(H1N1) influenza virus from 2009 and 2010 [A(H1N1) 2009] distributed across this period were analyzed. Of these, 19 cases of oseltamivir-resistant virus harboring the H275Y mutation in the neuraminidase (NA) were detected. The mean 50% inhibitory concentration (IC50) levels for oseltamivir- and zanamivir-susceptible A(H1N1) 2009 viruses were 1.4-fold and 2-fold, respectively, lower than for the seasonal A(H1N1) influenza viruses from 2007/2008: for oseltamivir-resistant A(H1N1)2009 virus the IC50 was 2.9-fold lower. Eighteen of the 19 patients with oseltamivir-resistant virus showed prolonged shedding of the virus and developed resistance while on oseltamivir therapy. Sixteen of these 18 patients had an immunodeficiency, of whom 11 had a hematologic disorder. The two other patients had another underlying disease. Six of the patients who had an underlying disease died; of these, five had received cytostatic or immunosuppressive therapy. No indications for onward transmission of resistant viruses were found. This study showed that the main association for the emergence of cases of oseltamivir-resistant A(H1N1) 2009 virus was receiving antiviral therapy and having drug-induced immunosuppression or an hematologic disorder. Except for a single case of a resistant virus not linked to oseltamivir therapy, the absence of detection of resistant variants in community specimens and in specimens from contacts of cases with resistant virus suggested that the spread of resistant A(H1N1) 2009 virus was limited. Containment may have been the cumulative result of impaired NA function, successful isolation of the patients, and prophylactic measures to limit exposure. (C) 2011 Elsevier B.V. All rights reserved.
- Published
- 2011
35. Toll-like receptors and microbial exposure: gene-gene and gene-environment interaction in the development of atopy
- Author
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Jorrit Gerritsen, R. W. B. Bottema, Gerard H. Koppelman, Dirkje S. Postma, Carel Thijs, C.P. van Schayck, Henriette A. Smit, Bert Brunekreef, Marjan Kerkhof, Naomi E. Reijmerink, Foekje Stelma, Epidemiologie, Family Medicine, RS: CAPHRI School for Public Health and Primary Care, and Groningen Research Institute for Asthma and COPD (GRIAC)
- Subjects
Pulmonary and Respiratory Medicine ,Male ,endotoxin ,Single-nucleotide polymorphism ,LIPOPOLYSACCHARIDE ,Biology ,Polymorphism, Single Nucleotide ,Atopy ,Risk Factors ,medicine ,genetic risk factors ,Hypersensitivity ,SNP ,genetic polymorphism ,CHILDHOOD ENVIRONMENT ,Humans ,Gene–environment interaction ,TOTAL IGE ,Child ,Gene ,Genetics ,BIRTH-ORDER ,Bacteria ,Siblings ,Toll-Like Receptors ,Infant ,Pathogenesis and modulation of inflammation Infection and autoimmunity [N4i 1] ,Epistasis, Genetic ,ASSOCIATION ,Child Day Care Centers ,Environmental Exposure ,Immunoglobulin E ,medicine.disease ,Phenotype ,HUMAN-DISEASE ,Minor allele frequency ,TLR6 ,Air Pollution, Indoor ,Child, Preschool ,Immune System ,Immunology ,SINGLE NUCLEOTIDE POLYMORPHISMS ,INNATE IMMUNITY ,ASTHMA ,Female ,Gene-Environment Interaction ,IMMUNOGLOBULIN-E - Abstract
Item does not contain fulltext Environmental and genetic factors contribute to atopy development. High microbial exposure may confer a protective effect on atopy. Toll-like receptors (TLRs) bind microbial products and are important in activating the immune system. To assess whether interactions between microbial exposures and genes encoding TLRs (and related genes) result in atopy, genes, environmental factors and gene-environment interactions of 66 single-nucleotide polymorphisms (SNPs) of 12 genes (TLR 1-6, 9 and 10, CD14, MD2, lipopolysaccharide-binding protein (LBP) and Dectin-1), and six proxy parameters of microbial exposure (sibship size, pets (three different parameters), day-care and intrauterine and childhood tobacco smoke exposure) were analysed for association with atopic phenotypes in 3,062 Dutch children (the Allergenic study). The presence of two or more older siblings increased the risk of developing high total immunoglobulin (Ig)E levels at different ages. This risk increased further in children aged 1-2 yrs carrying the minor allele of TLR6 SNP rs1039559. Furthermore, novel two- and three-factor gene-gene and gene-environment interactions were found (e.g. between sibship size, day-care and LBP SNP rs2232596). Larger sibship size is associated with increased total IgE levels. Furthermore, complex two- and three-factor interactions exist between genes and the environment. The TLRs and related genes interact with proxy parameters of high microbial exposure in atopy development.
- Published
- 2011
36. The contribution of water contact behavior to the high Schistosoma mansoni Infection rates observed in the Senegal River Basin
- Author
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Bruno Gryseels, Sake J. de Vlas, Kim Vereecken, Foekje Stelma, S. Sow, Katja Polman, Infectious Diseases, and Public Health
- Subjects
Male ,Rural Population ,Veterinary medicine ,Bathing ,Adolescent ,Population ,Schistosomiasis ,law.invention ,lcsh:Infectious and parasitic diseases ,Disease Outbreaks ,Feces ,Rivers ,SDG 3 - Good Health and Well-being ,law ,medicine ,Animals ,Humans ,lcsh:RC109-216 ,education ,Child ,Parasite Egg Count ,Morning ,education.field_of_study ,biology ,Ecology ,Outbreak ,Pathogenesis and modulation of inflammation Infection and autoimmunity [N4i 1] ,Environmental Exposure ,Schistosoma mansoni ,biology.organism_classification ,medicine.disease ,Schistosomiasis mansoni ,Senegal ,Rats ,Transmission (mechanics) ,Infectious Diseases ,Female ,SDG 6 - Clean Water and Sanitation ,Contact tracing ,Research Article - Abstract
Background Schistosomiasis is one of the major parasitic diseases in the world in terms of people infected and those at risk. Infection occurs through contact with water contaminated with larval forms of the parasite, which are released by freshwater snails and then penetrate the skin of people. Schistosomiasis infection and human water contact are thus essentially linked, and more knowledge about their relationship will help us to develop appropriate control measures. So far, only few studies have related water contact patterns to infection levels. Methods We have conducted detailed direct water contact observations in a village in Northern Senegal during the first years of a massive Schistosoma mansoni outbreak to determine the role of human water contact in the extent of the epidemic. We quantified water contact activities in terms of frequency and duration, and described how these vary with age and sex. Moreover, we assessed the relationship between water contact- and infection intensity patterns to further elucidate the contribution of exposure to the transmission of schistosomiasis. Results This resulted in over 120,000 recorded water contacts for 1651 subjects over 175 observation days. Bathing was the main activity, followed by household activities. Frequency and duration of water contact depended on age and sex rather than season. Water contacts peaked in adolescents, women spent almost twice as much time in the water as men, and water contacts were more intense in the afternoon than in the morning, with sex-specific intensity peaks. The average number of water contacts per person per day in this population was 0.42; the average time spent in the water per person per day was 4.3 minutes. Conclusions The observed patterns of water contact behavior are not unusual and have been described before in various other settings in sub-Saharan Africa. Moreover, water contact levels were not exceptionally high and thus cannot explain the extremely high S. mansoni infection intensities as observed in Northern Senegal. Comparison with fecal egg counts in the respective age and sex groups further revealed that water contact levels did not unambiguously correspond with infection levels, indicating that factors other than exposure also play a role in determining intensity of infection.
- Published
- 2011
37. Timing of infection and development of wheeze, eczema, and atopic sensitization during the first 2 yr of life: the KOALA Birth Cohort Study
- Author
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Monique, Mommers, Carel, Thijs, Foekje, Stelma, John, Penders, Johan, Reimerink, Ronald, van Ree, and Marion, Koopmans
- Subjects
Diarrhea ,Male ,Eczema ,Infant, Newborn ,Infant ,Infections ,Cohort Studies ,Maternal Exposure ,Pregnancy ,Risk Factors ,Hypersensitivity ,Humans ,Female ,Age of Onset ,Respiratory Sounds - Abstract
To investigate if infections in pregnancy and very early in life present a risk for wheezing, eczema, or atopic sensitization in later infancy. A total of 2319 children enrolled before birth in the KOALA Birth Cohort Study were followed during their first 2 yr of life using repeated questionnaires. Information was obtained on common colds, fever, and diarrhea with fever as well as on wheeze and eczema at ages 3 and 7 months and 1 and 2 yr, respectively. Blood samples were collected from 786 children at age 2 yr for specific immunoglobulin E analyses. Children with a common cold [adjusted odds ratio (aOR) 2.03 95% CI 1.21-3.41] or fever episode (aOR 1.81 95% CI 1.10-2.96) in the first 3 months of life had a higher risk of new onset wheeze in the second year of life compared to children who had not. For children with diarrhea with fever in the first 3 months of life, the aOR for new onset wheeze in the second year of life was 3.94 (95% CI 1.36-11.40) compared to children without diarrhea. Infections becoming clinically manifest during the first 3 months of life may be a general marker for a wheezy phenotype.
- Published
- 2010
38. Association of interacting genes in the toll-like receptor signaling pathway and the antibody response to pertussis vaccination
- Author
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Gerard H. Koppelman, Marjan Kerkhof, Naomi E. Reijmerink, Johan Reimerink, Foekje Stelma, Sander Banus, Carel Thijs, Tjeerd G. Kimman, Dirkje S. Postma, Groningen Research Institute for Asthma and COPD (GRIAC), Epidemiologie, RS: NUTRIM - R2 - Gut-liver homeostasis, and RS: CAPHRI School for Public Health and Primary Care
- Subjects
TIRAP ,Male ,Bordetella pertussis ,Immunology/Innate Immunity ,lcsh:Medicine ,Genetics and Genomics/Complex Traits ,Pertussis toxin ,Polymorphism, Single Nucleotide ,Linkage Disequilibrium ,Cohort Studies ,Infectious Diseases/Bacterial Infections ,Immunology/Immunity to Infections ,Humans ,Gene Regulatory Networks ,lcsh:Science ,Genetics and Genomics/Genetics of Disease ,Genetics ,Pertussis Vaccine ,Multidisciplinary ,Membrane Glycoproteins ,biology ,TOLLIP ,Infectious Diseases/Respiratory Infections ,lcsh:R ,Toll-Like Receptors ,Vaccination ,Intracellular Signaling Peptides and Proteins ,Infant ,Receptors, Interleukin-1 ,Receptors, OX40 ,IRAK4 ,biology.organism_classification ,Antibodies, Bacterial ,Toll-like receptor signaling pathway ,Toll-Like Receptor 4 ,Adaptor Proteins, Vesicular Transport ,Interleukin-1 Receptor-Associated Kinases ,Haplotypes ,Immunoglobulin G ,Immunology ,Immunology/Immune Response ,TLR4 ,lcsh:Q ,Female ,Genetics and Genomics/Genetics of the Immune System ,Signal transduction ,Signal Transduction ,Research Article - Abstract
Background: Activation of the Toll-like receptor (TLR) signaling pathway through TLR4 may be important in the induction of protective immunity against Bordetella pertussis with TLR4-mediated activation of dendritic and B cells, induction of cytokine expression, and reversal of tolerance as crucial steps. We examined whether single nucleotide polymorphisms (SNPs) in genes of the TLR4 pathway and their interaction are associated with the response to whole-cell vaccine (WCV) pertussis vaccination in 490 one-year-old children.Methodology/Principal Findings: We analyzed associations of 75 haplotype-tagging SNPs in genes in the TLR4 signaling pathway with pertussis toxin (PT)-IgG titers. We found significant associations between the PT-IgG titer and SNPs in CD14, TLR4, TOLLIP, TIRAP, IRAK3, IRAK4, TICAM1, and TNFRSF4 in one or more of the analyses. The strongest evidence for association was found for two SNPs (rs5744034 and rs5743894) in TOLLIP that were almost completely in linkage disequilibrium, provided statistically significant associations in all tests with the lowest p-values, and displayed a dominant mode of inheritance. However, none of these single gene associations would withstand correction for multiple testing. In addition, Multifactor Dimensionality Reduction Analysis, an approach that does not need correction for multiple testing, showed significant and strong two and three locus interactions between SNPs in TOLLIP (rs4963060), TLR4 (rs6478317) and IRAK1 (rs1059703).Conclusions/Significance: We have identified significant interactions between genes in the TLR pathway in the induction of vaccine-induced immunity. These interactions underline that these genes are functionally related and together form a true biological relationship in a protein-protein interaction network. Practically all our findings may be explained by genetic variation in directly or indirectly interacting proteins at the extra-and intracytoplasmic sites of the cell membrane of antigen-presenting cells, B cells, or both. Fine tuning of interacting proteins in the TLR pathway appears important for the induction of an optimal vaccine response.
- Published
- 2008
39. Gut microbiota composition and development of atopic manifestations in infancy: the KOALA Birth Cohort Study
- Author
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Hanne Adams, Piet A. van den Brandt, Bianca E. P. Snijders, Ischa Kummeling, Carel Thijs, Ellen E. Stobberingh, Foekje Stelma, Ronald van Ree, John Penders, Other departments, AII - Amsterdam institute for Infection and Immunity, APH - Amsterdam Public Health, Experimental Immunology, Epidemiologie, Medische Microbiologie, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, RS: NUTRIM - R2 - Gut-liver homeostasis, RS: GROW - School for Oncology and Reproduction, and RS: CAPHRI School for Public Health and Primary Care
- Subjects
DNA, Bacterial ,Hypersensitivity, Immediate ,Male ,medicine.medical_specialty ,Allergy ,Gut flora ,Polymerase Chain Reaction ,Dermatitis, Atopic ,Atopy ,Feces ,Wheeze ,Internal medicine ,Intestinal Microflora and Immunity ,Escherichia coli ,Respiratory Hypersensitivity ,Medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Respiratory Sounds ,biology ,Bacteria ,business.industry ,Clostridioides difficile ,Gastroenterology ,Infant ,Atopic dermatitis ,Clostridium difficile ,Immunoglobulin E ,biology.organism_classification ,medicine.disease ,Immunology ,Female ,medicine.symptom ,business ,Cohort study ,Follow-Up Studies - Abstract
BACKGROUND AND AIMS: Perturbations in the intestinal microbiota composition, as a result of changed lifestyles, may be involved in the development of atopic diseases. We examined the gut microbiota composition in early infancy and the subsequent development of atopic manifestations and sensitisation. PATIENTS AND METHODS: Faeces of 957 one-month-old infants, participating in the KOALA Birth Cohort Study, were analyzed using quantitative real-time PCR. Information on the manifestation of atopic symptoms (eczema, wheeze) and potential confounders was retrieved through repeated questionnaires. Total and specific IgE were measured in venous blood samples collected during home visits at the infant's age of 2 years. During these home visits also a clinical diagnosis of atopic dermatitis was made according to the UK Working- Party criteria. RESULTS: The presence of E. coli was associated with a higher risk of developing eczema (ORadjusted = 1.87; 95%CI 1.15-3.04), this risk being increased with increasing numbers of E. coli (Pfor trend = 0.016). Infants colonised with C. difficile were at higher risk of developing eczema (ORadjusted = 1.40; 95%CI 1.02- 1.91), recurrent wheeze (ORadjusted = 1.73; 95%CI 1.08- 2.77) and allergic sensitisation (ORadjusted = 1.54; 95% CI 1.02-2.31). Furthermore, the presence of C. difficile was also associated with a higher risk of a diagnosis of atopic dermatitis during the home visit (ORadjusted = 1.73; 95%CI 1.08-2.78). CONCLUSION: This study demonstrates that differences in the gut microbiota composition precede the manifestation of atopy. Since E. coli was only associated with eczema, whereas C. difficile was associated with all atopic outcomes, the underlying mechanims explaining these association may be different.
- Published
- 2006
40. Do parents with an atopic family history adopt a 'prudent' lifestyle for their infant? (KOALA Study)
- Author
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Carel Thijs, Foekje Stelma, M. Huber, Ischa Kummeling, Piet A. van den Brandt, Pieter C. Dagnelie, Epidemiologie, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, and RS: CAPHRI School for Public Health and Primary Care
- Subjects
Adult ,Parents ,medicine.medical_specialty ,Pediatrics ,Immunology ,Breastfeeding ,Mothers ,Disease ,Atopy ,Cohort Studies ,Alternative lifestyle ,Anti-Infective Agents ,Epidemiology ,Hypersensitivity ,Immunology and Allergy ,Medicine ,Animals ,Humans ,Family history ,Life Style ,Family Health ,business.industry ,Siblings ,Vaccination ,Infant ,medicine.disease ,body regions ,Breast Feeding ,Animals, Domestic ,Female ,Infant Food ,Tobacco Smoke Pollution ,business ,Breast feeding ,Attitude to Health ,Demography ,Cohort study - Abstract
Summary Background Atopic parents may adopt lifestyle characteristics that allegedly protect against atopic disease. If this is true, infants from atopic parents will be characterized by low-risk behaviour. Consequently, aetiologic studies on lifestyle factors and allergic disease in childhood may be biased by confounding by indication. Objective We explored whether the prevalence of ‘prudent’ lifestyle characteristics differs between atopic and non-atopic families. Methods Information about a family history of atopic manifestations and lifestyle characteristics was collected by repeated questionnaires in the Dutch KOALA Birth Cohort Study in 2469 infants from families with divergent lifestyle practices (conventional vs. alternative). Results In conventional lifestyle families, infants were less often exposed to environmental tobacco smoke when parents were atopic than when they were non-atopic (10.0% vs. 14.7%, P=0.001). In alternative lifestyle families, exposure to smoking was very rare in both groups (1.7% vs. 2.6%). Pets were less often present in families with than without parental atopy (38.8% vs. 51.1%, P=0.008 for conventional lifestyle families; 43.0% vs. 48.4%, P=0.014 for alternative lifestyle families). Infants with atopic siblings had less often been vaccinated according to the standard scheme than infants with non-atopic siblings in conventional lifestyle families (76.6% vs. 85.5%, P
- Published
- 2006
41. Effectiveness of a tailor-made intervention for pregnancy-related pelvic girdle and/or low back pain after delivery: Short-term results of a randomized clinical trial [ISRCTN08477490]
- Author
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Rob A. de Bie, Pieter M J C Wolters, Foekje Stelma, Johan W.S. Vlaeyen, Piet A. van den Brandt, Janneke M Bastiaanssen, Caroline H. G. Bastiaenen, Gerard G.M. Essed, Pieter Leffers, Epidemiologie, Dep.Medische en Klin. Experimentele Psy., Clinical Psychological Science, Gynaecologie en Obstetrie, RS: FPN CPS I, and RS: CAPHRI School for Public Health and Primary Care
- Subjects
Adult ,Biopsychosocial model ,medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,Adolescent ,Sports medicine ,Pelvic Pain ,law.invention ,Physical medicine and rehabilitation ,Double-Blind Method ,Rheumatology ,Randomized controlled trial ,Pregnancy ,law ,medicine ,Humans ,Orthopedics and Sports Medicine ,Prospective cohort study ,Physical Therapy Modalities ,Pain Measurement ,Pelvic girdle ,business.industry ,Pelvic pain ,Low back pain ,Pregnancy Complications ,Treatment Outcome ,Cohort ,Physical therapy ,Female ,lcsh:RC925-935 ,medicine.symptom ,business ,Low Back Pain ,Research Article - Abstract
Background For the moment, scientific evaluation of programs on treatment of pregnancy-related pelvic girdle and/or low back pain after delivery is hardly available with only one study with a positive result, suggesting uncertainty about the optimal approach. Investigators draw particular attention to biomedical factors but there is growing evidence that biopsychosocial factors appear to be even more important as a basis of an intervention program. Methods We studied the effectiveness of a tailor-made program with respect to biopsychosocial factors (intervention group) in women with pregnancy-related pelvic girdle and/ or low back pain versus usual care based on a pain contingent basis (control group) shortly after delivery in a randomized controlled trial. Women with severe complaints shortly after delivery were selected from a longitudinal prospective cohort study (n = 7526), aimed at pregnancy-related pelvic girdle and/or low back pain in the Netherlands. A concealed block randomization was performed after collecting baseline data. Researchers were blinded to treatment assignment. Outcomes were evaluated within the domains of the biopsychosocial approach. Primary outcome concerned limitations in activities (RDQ). Follow-up measurements were performed 12 weeks after delivery. Results Since May 2001 until July 2003, 869 women out of the cohort made a request for treatment by a physiotherapist, 10 days after delivery. Because of a quick recovery in two weeks time, we included only 126 women three weeks after delivery. There was a statistically significant and clinically relevant difference in improvement on the primary outcome (RDQ) between the two groups in favor of the experimental intervention. Conclusion The results favored the hypotheses. Women's worries about their condition were major targets in the experimental intervention. The prognosis after delivery, especially in de first weeks, turned out to be favorable.
- Published
- 2006
42. Etiology of atopy in infancy: the KOALA Birth Cohort Study
- Author
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Rob A. de Bie, Piet A. van den Brandt, Carel Thijs, Marion Koopmans, Foekje Stelma, Johan Reimerink, M.C.J.F. Jansen, Bianca E. P. Snijders, John Penders, Pieter C. Dagnelie, Ischa Kummeling, Machteld Huber, Gezondheidsvoorlichting, Epidemiologie, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, RS: CAPHRI School for Public Health and Primary Care, and TNO Kwaliteit van Leven TNO Voeding
- Subjects
Hypersensitivity, Immediate ,Questionnaires ,Alternative medicine ,Scoring system ,Pediatrics ,Infancy ,Allergy ,Etiology ,Intestinal microbiota ,Blood sampling ,Breastfeeding ,Cohort Studies ,Bacterial flora ,Pregnancy ,Risk Factors ,Surveys and Questionnaires ,Immunology and Allergy ,Drug use ,Prospective cohort study ,Netherlands ,Priority journal ,Risk assessment ,Intestine flora ,Atopy ,Antibiotic agent ,Human milk ,Vaccination ,Feces analysis ,Atopic dermatitis ,Venous blood ,Anti-Bacterial Agents ,Intestines ,Gene-environment ,Breast Feeding ,Female ,Child rearing ,Cohort analysis ,Infection ,Human ,Oral biopsy ,Cohort study ,medicine.medical_specialty ,Breast milk ,Capillary blood ,Family history ,Immunology ,Food and Chemical Risk Analysis ,Anthroposophy ,Documentation ,Major clinical study ,Infections ,Fetus ,Vegetarian ,medicine ,Humans ,Disease severity ,Life Style ,Nutrition ,Questionnaire ,business.industry ,Dietary intake ,Infant, Newborn ,Infant ,Gestational age ,DNA ,Follow up ,Lifestyle ,medicine.disease ,Child care ,DNA isolation ,Diet ,Pediatrics, Perinatology and Child Health ,Risk factor ,business ,Breast feeding - Abstract
PG - 679-84 AB - The aim of the KOALA Birth Cohort Study in the Netherlands is to identify factors that influence the clinical expression of atopic disease with a main focus on lifestyle (e.g., anthroposophy, vaccinations, antibiotics, dietary habits, breastfeeding and breast milk composition, intestinal microflora composition, infections during the first year of life, and gene-environment interaction). The recruitment of pregnant women started in October 2000. First, participants with 'conventional lifestyles' (n = 2343) were retrieved from an ongoing prospective cohort study (n = 7020) on pregnancy-related pelvic girdle pain. In addition, pregnant women (n = 491) with 'alternative lifestyles' with regard to child rearing practices, dietary habits (organic, vegetarian), vaccination schemes and/or use of antibiotics, were recruited through organic food shops, anthroposophic doctors and midwives, Steiner schools, and dedicated magazines. All participants were enrolled between 14 and 18 wk of gestation and completed an intake questionnaire on family history of atopy and infant care intentions. Documentation of other relevant variables started in the pregnant mother and covered the first and third trimester as well as early childhood by repeated questionnaires at 14-18, 30, and 34 wk of gestation and 3, 7, 12, and 24 months post-partum. A subgroup of participants, including both conventional and alternative lifestyles, was asked to consent to maternal blood sampling, breast milk and a faecal sample of the infant at 1 month post-partum, capillary blood at age 1 yr, venous blood and observation of manifestation of atopic dermatitis during home visits at the age of 2 yr (using the UK working party criteria and the severity scoring of atopic dermatitis index), and buccal swabs for DNA isolation from child-parent trios. From the start, ethical approval and informed consent procedures included gene-environment interaction studies. Follow-up at 3 and 7 months post-partum was completed with high response rates (respectively 90% and 88% in the conventional group, and 97% and 97% in the alternative group). The home visits at 2 yr of age will be completed in 2005. Preliminary results show that we have succeeded in recruiting a large population with various lifestyle choices with a fairly large contrast with regard to dietary habits (including organic foods, vegetarian diet), vaccination schemes and/or use of antibiotics. We have also been able to collect a large number of faecal samples (n = 1176) and capillary blood samples at age 1 yr (n = 956). Furthermore, a large proportion of the participants have consented with genetic studies. Mid 2006 we expect to report our first results on the relationship between the various exposures in early life and childhood atopy. An outline of the focus and design of the KOALA Birth Cohort Study is presented. AD - Department of Epidemiology, Care and Public Health Research Institute (Caphri), Maastricht University, Maastricht, The Netherlands. ischa.kummeling@epid.unimaas.nl
- Published
- 2005
43. Influence of SERTPR and STin2 in the serotonin transporter gene on the effect of selective serotonin reuptake inhibitors in depression: a systematic review
- Author
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Kim M. Smits, Patricia J. Nelemans, Martin H. Prins, Luc J.M. Smits, Jan S. A. G. Schouten, and Foekje Stelma
- Subjects
Adult ,Male ,medicine.medical_specialty ,Serotonin ,Genotype ,Drug Resistance ,Nerve Tissue Proteins ,Minisatellite Repeats ,Pharmacology ,White People ,Cellular and Molecular Neuroscience ,Asian People ,Internal medicine ,medicine ,Humans ,Promoter Regions, Genetic ,Molecular Biology ,Serotonin transporter ,Depression (differential diagnoses) ,Genetic testing ,Response rate (survey) ,Serotonin Plasma Membrane Transport Proteins ,Depressive Disorder ,Membrane Glycoproteins ,Polymorphism, Genetic ,biology ,medicine.diagnostic_test ,Membrane Transport Proteins ,Middle Aged ,Introns ,Psychiatry and Mental health ,Treatment Outcome ,biology.protein ,Antidepressant ,Female ,Reuptake inhibitor ,Selective Serotonin Reuptake Inhibitors - Abstract
Large differences in clinical response to selective serotonin reuptake inhibitors (SSRIs) are observed in depressive patients with different genotypes. Quantification of these differences is needed to decide if genetic testing prior to antidepressant treatment is useful. We conducted a systematic review of the literature on the influence of polymorphisms in the serotonin transporter gene (SERTPR (or 5-HTTLPR) and STin2) on SSRI response. Studies were identified by the use of MEDLINE, EmBase and PsycINFO, references of articles, reviews and information from pharmaceutical companies. Nine studies assessing the influence of SERTPR or STin2 on treatment response were included. Outcome was expressed as the percentage of decrease in depression score (HAM-D or MADRS) or as the percentage of responders (> or =50% reduction on the depression scale). Both study methodologies and study outcomes showed large heterogeneity. Weighted mean decreases in depression score for patients with the s/s, s/l and l/l genotypes were 35.4, 46.3 and 48.0% at week 4, respectively, and 53.9, 54.6 and 48.3% at week 6. Among Caucasian patients, both mean decrease in depression score and response rate were lowest in the s/s group, while among Asian patients, results were inconsistent. Weighted response rates were 36.1% for the 10/12 genotype of the STin2 polymorphism and 80.7% for the 12/12 genotype (chi2=27.8, P
- Published
- 2004
44. Emergence of a Multidrug-Resistant Pandemic Influenza A (H1N1) Virus
- Author
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Foekje Stelma, Erhard van der Vries, Charles A. Boucher, and Virology
- Subjects
Oseltamivir ,medicine.drug_class ,viruses ,medicine.disease_cause ,Microbiology ,chemistry.chemical_compound ,Zanamivir ,Influenza A virus ,medicine ,Viral neuraminidase ,Neuraminidase inhibitor ,biology ,business.industry ,virus diseases ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,Virology ,Influenza A virus subtype H5N1 ,respiratory tract diseases ,Pathogenesis and modulation of inflammation [N4i 1] ,chemistry ,Human mortality from H5N1 ,biology.protein ,business ,Infection and autoimmunity [NCMLS 1] ,Neuraminidase ,medicine.drug - Abstract
To the Editor: Since the outbreak of influenza A (H1N1) virus pandemic, almost 300 cases of infection with an oseltamivir-resistant influenza virus have been reported to the World Health Organization as of June 2010.1 These strains typically contain a single histidine-to-tyrosine substitution at position 275 (H275Y) of the viral neuraminidase, but they remain susceptible to zanamivir. Successful clearance of an oseltamivir-resistant virus with zanamivir, the other approved neuraminidase inhibitor, has been reported.2 We report the emergence of a pandemic influenza virus in a patient treated with neuraminidase inhibitors, with a novel resistance pattern that conferred resistance to oseltamivir, zanamivir, and . . .
- Published
- 2010
45. Humoral and cellular immune response after influenza vaccination in patients with postcancer fatigue and patients with chronic fatigue syndrome
- Author
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Carla M.L. van Herpen, Hanneke W. M. van Laarhoven, Hetty Prinsen, Sasja F. Mulder, Gijs Bleijenberg, Jan Willem H. Leer, L.D. Elving, Foekje Stelma, and Jolanda de Vries
- Subjects
Cancer Research ,Hemagglutination assay ,business.industry ,T cell ,Cancer ,Lymphocyte proliferation ,medicine.disease ,Vaccination ,medicine.anatomical_structure ,Immune system ,Oncology ,Quality of life ,Immunology ,Chronic fatigue syndrome ,Medicine ,business - Abstract
9070 Background: Postcancer fatigue (PCF) is a frequently occurring problem, impairing quality of life. Patients with chronic fatigue syndrome (CFS) also suffer from severe fatigue symptoms. We hypothesized that in fatigued patients (PCF and CFS) alterations in immune response could explain fatigue symptoms. Therefore, we examined whether the humoral and/or cellular immune response after influenza vaccination differed between fatigued patients and non-fatigued individuals and between PCF and CFS patients. Methods: PCF (n=15) and CFS patients (n=22) were vaccinated against influenza. Age and gender matched non-fatigued cancer survivors (n=12) and healthy controls (n=23) were included for comparison. Antibody responses were measured at baseline and at day 21 by a hemagglutination inhibition test. T cell responses were measured at baseline and at day 7 by a lymphocyte proliferation and activation assay. Results: Both patient groups developed seroprotection rates comparable to the accompanying control groups. Functional T cell reactivity was observed in all groups. Proliferation at baseline was significantly lower in fatigued patients compared to non-fatigued individuals. A significant increase in proliferation from baseline to day 7 was observed in fatigued patients, but not in controls. At day 7, proliferation was not significantly different between fatigued patients and non-fatigued individuals. CD4+CD127-FoxP3+ expression was significantly higher in PCF patients compared to non-fatigued cancer survivors. Conclusions: We observed a lower T cell proliferation at baseline in fatigued patients compared to non-fatigued individuals, suggesting a difference in the baseline state of the immune system between fatigued patients and non-fatigued individuals. Furthermore, the difference in CD4+CD127-FoxP3+ expression between PCF and CFS patients suggests subtle differences in immune state between these two fatigued patient groups. However, since humoral and cellular immune responses after vaccination did not differ significantly between fatigued patients and non-fatigued individuals, vaccination of fatigued patients (PCF and CFS) can be effective.
- Published
- 2012
46. CD4+ T-cell count to predict the response to new H1N1 vaccination in pediatric patients with cancer
- Author
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C. van Leer-Buter, Foekje Stelma, Annelies M. C. Mavinkurve-Groothuis, Frank Preijers, M. van der Flier, and Peter M. Hoogerbrugge
- Subjects
Vaccination ,Oncology ,Cancer Research ,medicine.medical_specialty ,Cd4 t cell ,business.industry ,Internal medicine ,medicine ,Cancer ,medicine.disease ,business - Abstract
9087 Background: The efficacy of vaccination in (pediatric) cancer patients is still a topic of debate. We aimed to study the immunologic determinants of influenza vaccination response in pediatric...
- Published
- 2011
47. Herpes simplex (HSV) viral load in bronchoalveolar lavage: risk factors and clinical outcome
- Author
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Marjolein Drent, W. N. K. A. van Mook, Catharina F. M. Linssen, A. Smismans, C.A. Bruggeman, Jan Jacobs, Cornelis Vink, and Foekje Stelma
- Subjects
Infectious Diseases ,Bronchoalveolar lavage ,medicine.diagnostic_test ,business.industry ,Virology ,Immunology ,medicine ,HSL and HSV ,business ,Viral load ,Article - Published
- 2006
48. Specific antibody patterns in a senegalese population recently exposed to Schistosoma mansoni
- Author
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A.M. Deelder, F. Guisse, G.J. van Dam, I. Talla, M. Niang, B. Gryseels, L. van Lieshout, S. T. M. Falcao Ferreira, and Foekje Stelma
- Subjects
education.field_of_study ,Specific antibody ,Immunology ,Population ,Immunology and Allergy ,Schistosoma mansoni ,Biology ,education ,biology.organism_classification ,Virology - Published
- 1997
49. Cytokines and soluble CD14 in breast milk in relation with atopic manifestations in mother and infant (KOALA Study)
- Author
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Ischa Kummeling, Foekje Stelma, Jan Damoiseaux, John Penders, R. van Ree, P.A. van den Brandt, Bianca E. P. Snijders, Carel Thijs, Epidemiologie, Interne Geneeskunde, RS: NUTRIM School of Nutrition and Translational Research in Metabolism, RS: CAPHRI School for Public Health and Primary Care, RS: CARIM School for Cardiovascular Diseases, Other departments, Amsterdam institute for Infection and Immunity, Amsterdam Public Health, and Experimental Immunology
- Subjects
Allergy ,Immunology ,Lipopolysaccharide Receptors ,Breastfeeding ,Mothers ,Enzyme-Linked Immunosorbent Assay ,Immunologic Tests ,Breast milk ,Immunoglobulin E ,Dermatitis, Atopic ,Allergic sensitization ,Atopy ,Transforming Growth Factor beta ,Immunopathology ,medicine ,Humans ,Immunology and Allergy ,Prospective Studies ,Prospective cohort study ,Netherlands ,Analysis of Variance ,Milk, Human ,biology ,business.industry ,Infant ,medicine.disease ,Interleukin-12 ,Interleukin-10 ,biology.protein ,Cytokines ,Female ,business - Abstract
Background Conflicting evidence exists concerning the protective role of breastfeeding in allergy and atopic disease aetiology. Breast milk contains biologically active molecules influencing the innate immune system of newborns. Objective We aim to assess whether cytokines (TGF-beta1, IL-10 and IL-12) and soluble CD14 (sCD14) in breast milk are influenced by maternal atopic constitution and modify the development of atopic manifestations in infants. Methods Milk samples were collected at 1 month post-partum of 315 lactating mothers participating in the ongoing KOALA Birth Cohort Study. The cytokines and sCD14 were analysed by ELISA in the aqueous fraction. We compared the concentrations of cytokines and sCD14 in breast milk between mothers with and without an allergic history and also with and without allergic sensitization (specific IgE). Associations of cytokines and sCD14 with the development of eczema, wheezing in the first 2 years of life and allergic sensitization of infants at the age of 2 years were analysed by multivariate logistic regression analyses to correct for confounders. Results We found higher sCD14 levels in mothers with a positive vs. negative allergic history (7.6 vs. 7.0 microg/mL; P = 0.04) and in mothers who were sensitized vs. non-sensitized (7.8 vs. 7.1 microg/mL; P = 0.03). None of the studied immune factors were associated with infant's atopic outcomes. IL-10 was not detected above the detection limit of 0.2 pg/mL. Conclusion Taking together the results of the present and previous studies, we conclude that there is no convincing evidence for a relation between TGF-beta1, sCD14, IL-10 or IL-12 in breast milk and atopic manifestations in infants.
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