University of Gothenburg
Cover illustration: Eosinophilic granulocyte, lymphocyte and antibodies.
Cover illustration: Eosinophilic granulocyte, lymphocyte and antibodies.
Photo: Timo Käppi
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  4. Timo Käppi - Liver Transplantation-associated Food Allergy and Eosinophilic Gastrointestinal Inflammation in Children - Clinical and Immunological Aspects

Timo Käppi - Liver Transplantation-associated Food Allergy and Eosinophilic Gastrointestinal Inflammation in Children - Clinical and Immunological Aspects

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The Institute of Clinical Sciences

On October 28 Timo Käppi is defending his thesis for Doctor of Medical Science at the Institute of Clinical Sciences, Sahlgrenska Academy, in the research subject of paediatric

The title of the thesis is: Liver Transplantation-associated Food Allergy and Eosinophilic Gastrointestinal Inflammation in Children - Clinical and Immunological Aspects

Link directly to the doctoral thesis

ABSTRACT

Timo Käppi, senior consultant in pediatric gastroenterology and hepatology at Queen Silvia Children’s Hospital, Sahlgrenska Univ
Timo Käppi,senior consultant in pediatric gastroenterology and hepatology at Queen Silvia Children’s Hospital, Sahlgrenska University Hospital in Gothenburg, Sweden.
Photo: Linnea van Lokhorst

This thesis focuses on three recently described childhood-onset gastrointestinal disorders: liver transplantation-associated food allergy (LTFA), collagenous gastritis (CG) and eosinophilic esophagitis (EoE). Its aim was to gain additional understanding of both the clinical disease characteristics and the associated immunological aberrations in these conditions.

Study I investigated the frequencies of allergy, allergic sensitization as well as autoimmune disease and autoantibodies in a cross-sectional cohort of pediatric liver transplant recipients. The co-occurrence of food allergy and autoantibodies was found to be increased, indicating an underlying immune dysregulation that impairs immune tolerance to both food allergens and autoantigens in the affected individuals.

Relationship between current food allergy and positive autoantibody screen in the cohort of 43 children who had received liver t
Figure above from study I: Relationship between current food allergy and positive autoantibody screen in the cohort of 43 children who had received liver transplants. The areas are proportional to the numbers of cases.

Study II analyzed serum cytokine concentrations and circulating lymphocyte subsets of the same patients who were included in Study I. Signs of ongoing immune activation were found to be prevalent despite clinically stable graft function. Additionally, the excessive underlying immune activation appeared to be associated with an increased susceptibility to develop LTFA.

Study III investigated the clinical disease course in childhood-onset CG. Further, CG was found to be associated with autoimmune predisposition and serum calprotectin and amyloid A was proposed as novel candidate biomarkers for monitoring the disease activity in CG.

Study IV involved analysis of blood eosinophil phenotype in children with active EoE. We found that these patients had a distinct molecular pattern of blood eosinophils compared with both healthy children and adults with active EoE.

The results of this thesis contribute to the improved clinical follow-up of the patients with the studied conditions. They also provide new insights into the associated immune deviations, which may facilitate the development of the future diagnostic and treatment options for these disorders.

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Health and medicine
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