Emerging Areas

EATC4Children continue to work on the development of emerging workstreams, including a focus on Behcet's syndrome, Juvenile Dermatomyositis (JDM) and our Childhood renal inflammatory programme.

Emerging Areas

EATC4Children continues to work on the development of emerging workstreams, including a focus on Behcet's syndrome, Juvenile Dermatomyositis (JDM), and our Childhood renal inflammatory programme.

Behcet’s syndrome

Behçet’s Disease, or Behçet’s Syndrome, is a rare, multi-system inflammatory condition characterised by recurrent oral ulceration, genital ulceration, and eye and skin involvement but it can affect other parts of the body, including the joints, brain, heart and gut. There is no diagnostic test for Behçet’s Disease, and diagnosis is often difficult because the way it presents can vary and overlap with other conditions. Behçet’s Disease is even rarer in children and young people, making diagnosis even harder in this group.

A New Doctor of Dental Science

In 2024, Dr. Eman AlQahtani, undertook her DDSc viva in Paediatric Dentistry. Her research explored the impact of Behçet’s Syndrome on children's quality of life.

SPOUCH study – “Do Salivary Proteins Predict Causes of Oral Ulceration in Children?”

SPOUCH is a research project investigating whether it may be possible to use saliva to diagnose Behçet’s Disease in children and young people (CYP). Mouth ulceration is the most common (and often the first) sign of Behçet’s Disease. Because of this, this project wants to see whether there are any diagnostic clues in the saliva of CYP with Behçet’s Disease, which could then lead to the development of saliva as a diagnostic tool. This project will collect and analyse saliva samples from CYP with Behçet’s Disease and compare it to the saliva of CYP with other conditions that can cause mouth ulcers (Crohn’s Disease and Systemic Lupus Erythematosus), as well as healthy CYP.

The project is funded by the Alder Hey Children’s Charity and the University of Liverpool’s Institute of Life Course and Medical Sciences. It is being led by Dr Teslimat Ajeigbe, a dentist and Academic Clinical Fellow at the University of Liverpool.

BPSU Behçet’s study

The purpose of this study is to establish the current UK and ROI incidence and prevalence of Behçet’s syndrome and to describe the burden of disease in children under 16 years of age in the UK. This study has completed follow up (CI: C. Pain).

Molecular mechanisms of bronchial inflammation

Does inhalation therapy enhance bronchial inflammation in viral bronchiolitis?

Small airway inflammation (bronchiolitis) is the most common cause of hospital admission in the first year of life. Currently, there are no specific treatments for this condition other than management based on supportive measures that can include inhalation treatment. This is thought to induce cough as a clearing mechanism for mucus that would otherwise obstruct airways, but its effectiveness as a treatment for bronchiolitis is currently unknown. This study will help to understand mechanisms of airway inflammation during virus infection, and whether inhalation treatment helps or hinders these mechanisms (CIs: C. Hedrich and P. McNamara).

Systemic inflammation in Cystic Fibrosis

Cystic fibrosis (CF) is a heritable and devastating multisystem disease, particularly involving the lungs and gastrointestinal tract. Tissue inflammation is a central contributor to disease expression and organ damage in CF, but the exact mechanisms triggering inflammation remain unclear.

Since a subset of CF patients develop joint pain and/or inflammation (arthritis), and some patients even develop symptoms of vasculitis (blood vessel inflammation), uncontrolled activation of immune cells appears likely to be involved in the pathophysiology of CF and its sequelae. In this project, we investigate molecular mechanisms contributing to bronchial and systemic inflammation (CIs: C. Hedrich and P. McNamara).

PIMS-TS/acute-COVID-19. Demographic, clinical and laboratory differences between paediatric acute COVID-19 and PIMS-TS-results from a single centre study in the UK

Our researchers contributed to the review of medical records of children admitted to Alder Hey Children's Hospital in Liverpool between February 2020 and August 2022. This study looked at the differences between two COVID 19-related conditions in children:

Acute COVID-19 (the regular COVID illness)
PIMS-TS (a rare, serious inflammatory condition that can happen weeks after a child has COVID-19)

PIMS-TS mostly affected older children (median age ~10 years) and was more common in children from ethnic minority backgrounds, whereas Acute COVID-19 hospitalisations were more common in infants and children with pre-existing health problems, like heart disease, respiratory issues, or being born prematurely.

PIMS-TS caused high fever, gut problems (like stomach pain and vomiting), skin rashes, red eyes, and sometimes neurological symptoms (like confusion or headaches).

Acute COVID-19 mainly caused respiratory symptoms like cough and trouble breathing.

Children with PIMS-TS had:

Higher inflammation markers (like C-reactive protein)
Lower platelet counts
More electrolyte imbalances (like low sodium)
More signs of immune system activation
This lab pattern may help doctors tell the two conditions apart early on.

This emerging research helps doctors:

Recognise and treat these different conditions in children
Understand who is most at risk
Shape vaccination and public health strategies for children