Umbilical cord procalcitonin to detect early-onset sepsis in newborns: a promising biomarker

Background: Up to 7% of neonates born in high-income countries receive antibiotics for suspected early-onset sepsis (EOS). Culture-proven neonatal sepsis has a prevalence of 0.2%, suggesting considerable overtreatment. We studied the diagnostic accuracy of umbilical cord blood and infant blood procalcitonin (PCT) in diagnosing EOS to improve antibiotic stewardship.Methods: Umbilical cord blood PCT was tested in newborns >= 32 weeks of gestation. Groups were defined as following: A) culture-proven or probable EOS (n = 25); B) Possible EOS, based on risk factors for which antibiotics were administered for = 32 weeks with a proven or probable EOS and low in newborns with risk factors for infection, but PCT seems not a reliable marker after maternal antibiotic treatment. PCT could be useful to distinguish infected from healthy newborns with or without EOS risk factors.Afdeling Klinische Chemie en Laboratoriumgeneeskunde (AKCL

C-type lectin signaling in dendritic cells: molecular control of antifungal inflammation

Fungal pathogens represent a continuous and increasing danger to the human host. For design of novel preventive and therapeutic interventions to fungal infection, a concise understanding of the molecular mechanisms by which the immune system elicits antifungal inflammation is of utmost importance. In this thesis, we have addressed the roles of C-type lectin receptors (CLRs) dectin-1, dectin-2 and mincle and how these receptors collaborate in ‘shaping’ an ensuing antifungal immune response. These studies have revealed markedly distinct modes of ‘action’ during polarization of the effector CD4+ T cell response. From our studies a model is emerging in which dectin-1 as an ‘inducer’ fuels T helper (TH) polarization, but that the overall outcome of the inflammatory response -whether protective or not- is dictated by ‘modulating’ receptors such as dectin-2 and mincle, which by themselves are incapable of inducing the response. Our attempt to understand (part of) the molecular events that underlie their functional specialization has led to novel insights into how expression of T helper cell-polarizing cytokines by dendritic cells (DCs) is transcriptionally regulated or dysregulated, but also to the characterization of the signal transduction pathways and molecular mechanisms operating downstream dectin-2 and mincle. Thus, studying these receptors has provided new insights into human antifungal immunity

Clinical symptoms of adult metachromatic leukodystrophy and arylsulfatase A pseudodeficiency

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Patient Reported Outcomes in Early Arthritis Patients

Pathophysiology and treatment of rheumatic disease