[FG] Szinnai Gabor

The main research interests and ongoing clinical studies of our research group cover a broad spectrum of endocrine disorders and diabetes from birth to adulthood.

• Pediatric thyroid disease
• Pediatric diabetes
• Pediatric adrenal insufficiency

Ongoing Projects:

Pediatric thyroid disorders (OptiThyDose study)

Thyroid hormones are essential for normal brain development, and for normal cognitive functions. Treatment of thyroid diseases is difficult in newborns and children. Over- or underdosing is an important problem in clinical practice. To mitigate the risk of negative neurological and developmental outcome, it is essential to establish an optimal, personalized dosing that is continuously fine-tuned in neonates, infants and children with hyper- or hypothyroidism.

In the context of a collaborative research project with Pediatric Pharmacology at UKBB, and Department of Mathematics, University of Konstanz, we developed mathematical population pharmacokinetic-pharmacodynamic (PKPD) models that are able to describe and predict individual thyroid disease progression during treatment with thyroid hormone replacement therapy or anti-thyroid drugs based on routine clinical and laboratory data. These PKPD models were generated based on retrospective patient data from four Swiss pediatric centers (Basel, Bern, St.-Gallen and Zurich).

Currently, these PKPD models are being enhanced and validated in a prospective international multicenter study (Basel, Paris, Rome, Yerevan), the OptiThyDose study. The ultimate aim is to provide simple personalized dosing to children with thyroid diseases avoiding under- or overdosing.

Pediatric diabetes (DiaCamp and DiaMonitor studies)

Another research focus of our Research Group is clinical research around pediatric diabetes mainly in the field of pediatric type 1 diabetes (T1D). Research interests include diabetic ketoacidosis and the use of diabetes technology in children and adolescents. Furthermore, our group is investigating the interaction of glucose profiles, insulin, physical activity and physiological parameters such as heart rate and heart rate variability, mainly with the intention to foresee and possibly prevent hypoglycemia. This research is performed also in collaboration with the Pediatric Pharmacology at UKBB and research groups at ETH Zurich.

Our group is also active in collaborative research projects within the German-Austrian-Luxembourg-Swiss Diabetes Prospective Follow-up registry DPV (Diabetes-Patienten-Verlaufsdokumentation) and the international SWEET initiative, an international network of pediatric diabetes centers.

Pediatric adrenal insufficiency (LeukemiaCort study)

A new research focus of our Research Group is clinical research on the hypothalamo-pituitary adrenal (HPA) axis in children exposed to high dose glucocorticoids, especially in the context of leukemia treatment according to current protocols, e.g. the AIEOP-BFM ALL 2017 protocol for acute lymphoblastic leukemia (ALL). Glucocorticoid induced HPA suppression can cause relevant morbidity in ALL patients and is potentially life-threatening. In this national multicenter study in close collaboration with pediatric oncology and hematology at UKBB and KSA, the effect of high dose glucocorticoids is analyzed longitudinally in individuals with ALL from start of therapy to describe in detail incidence, duration, clinical morbidity, and risk factors for glucocorticoid induced HPA suppression. The ultimate aim is to improve detection and prediction of HPA axis suppression in individuals with ALL.

Collaborations:

National Collaborations

• Prof. Marc Pfister, Head Pediatric Pharmacology and Pharmacometrics Research Center, University Children's Hospital Basel
• Prof. Myriam CHRIST-CRAIN, Endokrinologie, Diabetologie und Metabolismus, Universitätsspital Basel
• Prof. Daniel KONRAD, Päd. Endokrinologie/Diabetologie, Universitäts-Kinderspital Zürich
• Prof. Christa FLÜCK, Päd. Endokrinologie/Diabetologie und Metabolismus, Universitäts-Kinderspital Bern
• Prof. Dagmar L'ALLAMAND, Päd. Endokrinologie/Diabetologie, Ostschweizer Kinderspital
• Prof. Julia VOGT, Department of Computer Science, ETH Zürich
• Prof. Nelly PITTELOUD, Service d'endocrinologie, diabétologie et métabolisme, Centre hospitalier universitaire Vaudois
• PD Dr. Michael KALTENBACH, Computational Systems Biology Group, D-BSSE ETH Zürich
• PD Dr. Matthias BETZ, Endokrinologie, Diabetologie und Metabolismus, Universitätsspital Basel
• Dr. Jeanette GREINER, Päd. Hämatologie und Onkologie, Kantonsspital Aarau

International Collaborations

• Prof. Michel POLAK, Service d'endocrinologie, gynécologie et diabétologie pédiatriques, Hôpital Universitaire Necker Enfants-Malades, Paris
• Prof. Marco CAPPA, Pediatric Endocrinology and Research Group for Innovative Therapies in Endocrinology, Ospedale Bambino Gesu', Rome
• Prof. Lusine NAVASARDYAN, Pediatric Endocrinology, Arabkir Medical Center, Yerevan
• Prof. Tim JONES, Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, University of Western Australia, Perth
• Prof. Johannes SCHROPP, Fachbereich Mathemathik und Statistik, Universität Konstanz