pediatrics-conference-2016_posters-accepted-abstracts

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Volume 6, Issue 4(Suppl) Pediat Therapeut 2016
ISSN: 2161-0665 Pediatrics, an open access journal
Page 68
Pediatrics Conference 2016
September 14-16, 2016
conferenceseries.com
7th European Pediatrics and
Pediatric Surgery
September 14-16, 2016 Amsterdam, Netherlands
Pediat Therapeut 2016, 6:4(Suppl)
Gut-the Trojan horse of systemic autoimmunity
Aaron Lerner1 and Torsten Matthias 2
1Technion-Israel Institute of Technology, Israel
2AESKU KIPP Institute, Germany
Objectives & Study: In suitable circumstances, the human gut possesses all the components necessary to start the autoimmune
cascade. The aim of the study was to characterize the multiple gut-remote organ autoimmune axes.
Methods: A systematic review was performed to identify studies referred to gut-gut, brain, joint, bone, endocrine, kidney, lung, liver,
heart and skin exes using Medline, Google and Cochrane Library databases.
Results: The specific dysbiota and tight junction dysfunction seems to be a primary defect in autoimmune diseases. Intestinal
permeability is decreased inmany: Ulcerative colitis, Crohn’s disease, celiac disease, inflammatory joint disease, ankylosing spondylitis,
juvenile onset arthritis, psoriatic arthritis, type 1 diabetes mellitus and primary biliary cirrhosis. The end result of the passage of those
non-self- proteins, from the luminal compartment to the sub epithelial one, initiates the autoimmune cascade. The richness of the
mucosal milieu in immune components, cells and systems; blood and lymphatic vessels; entero-neuronal and endocrine network;
and mural endo-mesoderm cohabitation constitute an ideal place to initiate, maintain and propagate the autoimmune process. The
mucosal committed immune cells, post translation modified proteins, proinflammatory cytokines and lymphokines have the capacity
to circulate via the local vessels, to bring the autoimmune message to remote organs, thus creating gut-extra intestinal organ axes of
autoimmunity. Each one of the remote organs: Brain, joint, bone, endocrine, kidney, lung, liver, heart and skin, is directionally relayed
to the intestinal events taking place in the genetically susceptible individuals
Conclusions: The immune system carefully distinguishes between self and non-self-components. The intestine is a major site of
changing tolerance to autoimmunity. The disease specific dysbiota, its post translational capacity to modify proteins, the plethora
of substrates, the leaky gut, the local adjacent immune, neuroendocrine, vascular and lymphatic systems make the intestine a prime
candidate to drive systemic autoimmunity
No-fistula vs. fistula anorectal malformation: Outcome comparative study
Abdullah Sarkar
Alfaisal University, Saudi Arabia
Anorectal malformations (ARM) refer to a wide variety of congenital anomalies, most commonly referring to imperforate anus.
Occurring on average of 1:3500 live births, imperforate anus is described as the failure of the rectum to descend through
the external sphincter complex. In surgical history, the first form of management for imperforate anus began in the 7th century
with a highly morbid procedure by Paulus Aegineta, and until current day pediatric surgical intervention of ARM has evolved
with modifications and updates periodically; attempting to improve our pathophysiological understanding and surgical outcome.
Anorectal malformation is a congenital defect that exists in varying presentations. These are of two types, high and low anomalies
owing to its severity. The high-type anorectal malformation is divided into two types, with (fistula) and without fistula (no-fistula). Of
the categorical presentations, no-fistula type ARM has recently been investigated and reported on as its own disease in the literature;
with increasing evidence of distinct associations, risk factors, and anatomical differences with surgical management implications and
outcomes. As pediatric surgeons globally have identified unique characteristics associated with no-fistula type ARM, we aim to report
our experience with management of this anomaly and its outcome, compared to the more common fistula type ARM.