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Pediatric Gastroenterology & Nutrition - Samsom lab


Mucosal Immunology and intestinal homeostasis
Within the laboratory of Pediatrics the research division Gastroenterology and Nutrition is headed by Janneke N. Samsom. The Samsom lab has a focus on mucosal immunology.

The mucosal surfaces of the gastrointestinal tract have developed as the largest surface area of the body that is in contact with the external environment. Not only do most pathogens enter through this site, the intestinal mucosa is continuously exposed to a large variety of harmless antigens, such as dietary proteins and constituents of commensal bacteria. To regulate this high antigenic pressure the human gut holds approximately 50 x109 lymphocytes, a large proportion of all immune cells in the body. In recent years it has become clear that both innate and acquired regulatory immune responses are essential for the development of oral tolerance to harmless antigens.

Our research is focused on identifying immune regulatory processes that are pivotal to intestinal homeostasis. By developing multiple murine models, we have identified that functional mucosal regulatory T-cells differentiate in mucosa draining lymphoid tissue in the presence of specific mucosal factors. We have established a humanized mouse model of gluten tolerance and discovered that tolerance to gluten is mediated by IL-10 secreting  regulatory T-cells, a finding opening new avenues of research for celiac disease. In our translational inflammatory bowel disease (IBD) work we focus on dissecting inflammatory pathways that classify IBD patients in subgroups and yield parameters to characterize their disease subtype. Through analysis of infants with genetic deficiencies we are uncovering pathways that are pivotal for intestinal tolerance and are identifying patterns of inflammation that evolve from a particular defect.

Translation to the clinic
The solid, very direct link between the research lab and the clinical Pediatric gastroenterology department is of great value. Together with the group of Prof. J.C. Escher, our research has a bidirectional approach: key questions from the clinic concerning pathology, diagnosis and treatment of IBD are translated to an experimental setting and vice versa fundamental data are implemented in patient diagnostics and design for new treatment strategies. In parallel, similar initiatives are developed in the field of celiac disease via a strong collaboration with dr. M. Groeneweg in the Maasstad Hospital and by taking advantage of our Dutch Celiac Disease Consortium network involving the LUMC, UMCG, WUR and AMC

The clinical department of Pediatric Gastroenterology of the Sophia Children's hospital is involved in multiple international drug studies in pediatric IBD patients, both initiated by industry as well as investigator-initiated. The department has the largest cohort (n=300) of pediatric IBD patients in the Netherlands. As this is the main pediatric endoscopy center in the South West region of the Netherlands, each year 40 new celiac patients are diagnosed.  Hankje C. Escher is the initiator and leader of EUROKIDS, a web-based European registry of new pediatric IBD patients. This webregistry is ongoing since 2004 and currently harbors data on demographics, diagnostic work-up, and disease phenotype of over 4000 patients. The department is involved in several translational studies on IBD and celiac disease, together with Dr. Samsom of laboratory of Pediatrics, div. Gastroenterology and nutrition.

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