Welcome to issue 27 Dear FrIeNDS aND ColleagueS, Following the very successful eSPe Meeting in Dublin in September 2014, eSPe has started finalising the 54th eSPe Meeting in Barcelona, Spain, in 2015. The President of the Meeting, Dr laura audí, shares the latest news on this page: the scientific programme is already on its way and abstract submission closes on 10 april! Time passes quickly, so please mark your calendar... This issue also features fascinating interviews with eSPe members. on page 5 you can read the thoughts of the first recipient of the eSPe Young Investigator award, Jesús argente, as he looks back over the 20 years Welcome continued from page 1 since he received his award. Meanwhile, on page 6, you can learn what a Sabbatical leave grant has meant for the career of anne-Simone Parent.
We thank our colleagues from Switzerland for sharing news from the Swiss Society in our regular column featuring updates from national societies (page 7). Do send us your society’s news and information. You can also enjoy an excerpt from the Yearbook of pediatric endocrinology on page 7, prepared for us by Ze’ev Hochberg. We thank him for his contribution, which is a much appreciated part of the Newsletter. as well as the regular update from the eSPe Team with recent news from our beloved Society (below), there is much information about other eSPe activities.
These include the next eSPe Science School (also below), research unit grants (page 3), the eSPe Summer School (page 6), the 1st eSPe Caucasus & Central asia School (page 4), and an update from the Disorders of Sex Development Working group (page 4). other leading news items include a short summary from the recent Consensus Meeting on growth Hormone Safety (page 3). You can also learn the latest about the eSPe Training Programme from the accreditation and Syllabus Subcommittee on page 3. We, as the editorial Board, endeavour to maintain the quality of the Newsletter and try to enrich it with feedback from all members.
You are encouraged to let us have your comments via the online survey that we are running with this issue please. I also would like to thank lars Sävendahl for his continued support, and all my colleagues in the Newsletter team, whose enthusiasm and collaboration I greatly enjoy. Yours sincerely, Professor Feyza Darendeliler editor, eSpe newsletter firstname.lastname@example.org
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WelCoMe To THe SPrINg 2015 eDITIoN of the eSPe Newsletter! To address the growing needs of your Society and to ensure that you are kept up to date with our many programmes and activities, we are pleased to announce that there will now be four editions of the Newsletter each year. 2015 is full of exciting initiatives, including the return of the eSPe Science School. The Science School is part of eSPe’s ever-expanding school programme, which also includes the Summer, Winter, Diabetes & obesity, Caucasus & Central asia, Maghreb and eSPe-aSPeD Schools. There is a school to suit you at various stages of your career and in various locations. You can find more information about each school at www.eurospe.org/education. eSPe has over 20 activities and programmes, all run by a team of dedicated committee chairs and members. By joining an eSPe committee, you too can make the most of the opportunity to engage and support your Society and take an active role in its development. Current committee vacancies are advertised via the monthly news alerts, which you can find at www.eurospe.org/ news/alert.aspx. If you have any queries about the eSPe committees, such as how to join and what the roles involve, please contact the eSPe Team at email@example.com. The eSPe Team is headed by the Senior operating officer (Soo), a role currently undertaken by Joanne Fox-evans and Hannah
Bonnell in a job-share arrangement. Hannah will be going on maternity leave shortly, and lucy lawrance will be covering her role. Please do not hesitate to contact Joanne, Hannah or lucy if you have any queries regarding this role or your Society on firstname.lastname@example.org. You can also find eSPe on Facebook (www.facebook.com/euroSPe) and Twitter (www.twitter.com/eurospe). and lastly, don’t forget it’s the time of year to renew your membership. You should now have received an email with details of how to renew for 2015 and a link to make payment. There are many great benefits of eSPe membership, so please encourage your colleagues to join as well! Find out more at www.eurospe.org/membership. Hannah Bonnell, Joanne Fox-Evans and Tracey-Leigh Meadowcroft, eSpe tea out more at www.eurospe.org/membership. Hannah Bonnell, Joanne Fox-Evans and Tracey-Leigh Meadowcroft, eSpe team
We are DelIgHTeD To aNNouNCe the return of the eSPe Science
School. The school runs every 2 years, and is an exciting initiative,
bringing together top basic scientists, experts in paediatric
endocrinology and paediatric endocrinologists in training with a strong
basic research interest.
The school is aimed at final year PhD students, post-doc fellows or
research active young paediatric endocrine investigators who are
within 5 years of their PhD or fellowship. Participants will discuss new
scientific and clinical avenues for improving the understanding of pathogenic mechanisms, diagnosis and treatment of paediatric
The 2015 eSPe Science School will focus on ‘Non-coding rNa in
paediatric endocrinology’. It takes place on 3–6 June 2015, at The
Pensières, Veyrier-le-lac, near lake annecy, France.
The deadline for applications is 31 March 2015 and successful
applicants will be notified in april 2015.
Further information and an application form are available at
THe reVISeD eSPe TraININg PrograMMe was approved by the eaP (european academy of Paediatrics) in 2014. revisions had been undertaken between 2011 and 2014 by the eSPe accreditation and Syllabus Subcommittee, in a process involving consultation with colleagues from different countries. The revisions were advertised in the eSPe Newsletter as well as on the eSPe website and at a poster presentation at the eSPe meeting in leipzig. The approved version can be found at www.eurospe.org/education/education_training.html. Following the approval of the Training Programme, the next step is its implementation at a national level and distribution of the Programme among centres and fellows in each country. The accreditation and Syllabus Subcommittee decided at the eSPe meeting in Dublin that the revised Training Programme should be distributed to the President of each National Society and/or to the colleague responsible for training in each country represented within eSPe. at the same time, we are also seeking answers to the following questions for each country. This will help us facilitate implementation of the Training Programme. QueSTIoN 1: is paediatric endocrinology legally recognised as a specific subspecialty in your country? ESPE Training Programme from the Accreditation and Syllabus Committee obtaining a thorough knowledge of the structure of paediatric endocrine training in countries in and around the eu will enable to us to find efficient methods of implementing the Training Programme. This will achieve harmony between different countries and, with the use of portfolios, will allow feedback from the fellows, as well as ultimately achieving efficient mobility among centres. You will be able to read further updates in the eSPe Newsletter. Please send us your feedback if you have further suggestions or questions by contacting email@example.com. Feyza Darendeliler, Sten Drop, Stefano Cianfarani, Jan Lebl, Wilma Oostdijk, Giorgio Radetti, Stefan Riedl and Lars Sävendahl, accreditation and Syllabus Subcommittee Members
eSPe reCeNTlY orgaNISeD a CoNSeNSuS WorKSHoP with the North american PeS (Pediatric endocrine Society) and the grS (growth Hormone research Society). The workshop’s aim was to examine the current state of knowledge about the long term safety of growth hormone (gH) in adults and children, including those in transition. It was held on 5–8 November 2014 near Manchester, uK. Published and unpublished studies and specially commissioned reviews were examined, and senior medical advisers from the main gH manufacturing companies were also invited to present the results of their post-marketing surveillance studies. Participants worked on a series of specific questions over the 3-day meeting, and the particular points from each of the four discussion groups were collated in plenary sessions. on the last day, a final document was prepared, hotly debated and agreed without industry members being present, to ensure complete impartiality and independence. It is a comprehensive statement about gH safety in the longer term, which in general is reassuring. It is being submitted for publication very shortly and, once published, will be widely available. For further information, please contact gary Butler, Chair, eSPe Clinical Practice Committee (firstname.lastname@example.org)
PleaSe SuBMIT Your preliminary requests for eSPe research unit Collaborative Project
grants by 15 March 2015.
The eSPe research unit co-ordinates high quality research in paediatric endocrinology.
It aims to support the involvement of as many eSPe members as possible in various research
activities, as well as disseminating information about on-going research.
Participation in research studies and other related activities of the research unit is open to
any ordinary member of eSPe actively involved in paediatric endocrinology (non-members may
participate as co-investigators).
Collaborative Project grants will only be awarded for applications based on co-operative
studies among eligible eSPe applicants from different countries. Competing applications for
Collaborative Project grants will be peer-reviewed by physicians and scientists who are actively
involved in research. Full terms and conditions can be found at www.eurospe.org/research.
eSPe is pleased to announce that Sandoz continues to be the eSPe research unit sponsor
for 2015. Preliminary requests by 15 March
Your proposal for a Collaborative Project
grant should start with a preliminary
request directed to the eSPe research
unit Co-ordinator, Irène Netchine
(email@example.com; marked ‘eSPe
research unit’). guidance and forms may be
found at www.eurospe.org/research. If your
proposal is approved you will be asked to
submit a full grant application.
Grant applications by 26 April
Further information will need to be submitted
on the more detailed form available at the
above web address.
Bringing you recent highlights from the world of research
THe 1ST eSPe CauCaSuS & CeNTral aSIa SCHool took place at alatau Sanatorium near almaty, Kazakhstan, on 24–30 october 2014. It was the first time that an eSPe teaching course was conducted in two languages: russian and english. This was extremely advantageous for students from Central asian countries, where proficiency in english is generally limited. The 5-day course covered most paediatric endocrine topics in the form of lectures, interactive clinical cases and research project presentations by students. Teachers’ clinical case discussions took place in small groups and were much appreciated by students. The School witnessed a novel educational approach: the e-learning Programme. The main topics were available in russian, thanks to over 300 hours of translation beforehand! PDFs of all lectures will be available for the course participants for a year following the school, at the C&Ca area of the eSPe e-learning portal (www.espe-elearning.org). In total, 25 fellows from Kazakhstan, uzbekistan, Tajikistan, azerbaijan, armenia, georgia, Kirgizstan and ukraine were selected from more than 40 applications on the basis of clinical and academic experience. The teaching faculty comprised both english and russian speakers: gunduz ahmadov (azerbaijan), rimma Bazarbekova (Kazakhstan), Francesco Chiarelli (Italy), Sten Drop (The Netherlands), alina german (Israel), Jan lebl (Czech republic), gulnora rakhimova (uzbekistan) and rasa Verkauskiene (lithuania). rimma Bazarbekova and her local team receive our thanks for excellent course organisation, which contributed greatly to the School’s success. The course provided an extraordinary experience of teaching at the interface of several different cultures, bringing together paediatric endocrinologists in various positions in training with academic clinicians. The exchanges between students and teachers were very lively during interactive teaching time as well as during the breaks, which were rather short due to the busy schedule! Nevertheless, we all enjoyed a pleasant half-day excursion in almaty and a relaxing evening of presentations from students’ countries – not forgetting a very amusing song with the teachers’ skits at the gala dinner! and so the spirit and tradition of teaching and paediatric endocrine team building redolent of all eSPe Schools was successfully created at the 1st eSPe Caucasus & Central asia School. all fellows were extremely proud and grateful to be generously awarded 1 year’s free eSPe membership following the School. The educational programme for the eSPe Caucasus & Central asia School has been approved by the eSPe Council initially for 3 years, and we are grateful to Ferring Pharmaceuticals a/S for their generous support.
THe DSD WorKINg grouP held a well attended successful symposium at the 2014 eSPe annual Meeting in Dublin. The topic was ‘advances in endocrine understanding and detailed phenotyping of DSD’. John achermann (london, uK) gave the first talk and discussed the role of steroidogenic factor-1 (SF-1) mutations in DSD. The backdoor pathway of steroid biosynthesis was presented by Clemens Kamrath (giessen, germany). Svetlana lajic (Stockholm, Sweden) presented long term data from prenatal dexamethasone treatment in congenital adrenal hyperplasia (CaH), based on a large Swedish cohort. Further talks were given by Michelle Welsh (edinburgh, uK), who explained the role of early embryonic androgens on genital development, and by paediatric surgeon lutz Wünschfrom (lübeck, germany), who presented the role of imaging for better phenotype description. Subsequently, Jillian Bryce (glasgow, uK) updated us on the I-DSD and I-CaH databases and activities. Then Birgit Köhler (Berlin, germany) informed us about the progress of the dsd-lIFe outcome study (currently funded by the eu) and olaf Hiort (lübeck, germany) discussed the development of the european reference Networks in DSD.
ESPE is now more than 50 years old. Your Society has been uniting paediatric endocrinologists ever since its formation,
aiding communication and education and improving patient care. In this article, we look back at the Society's formative
Childhood environment influences adrenarcheal timing among first-generation Bangladeshi migrant girls to the UK Houghton lC, Cooper gD, Booth M, Chowdhury oa, Troisi r, Ziegler rg, Katki Ha, Hoover rN & Bentley gr pLoS one 2014 oct 13;9(10):e109200 BaCKgrouND: adrenarche marks middle childhood at about 7 years of age. research examining British–Bangladeshi migrant women suggested that environmental conditions experienced before adrenarche influence adult reproductive function. This study investigated whether Bangladeshi children who migrate to the uK reach adrenarche earlier than non-migrants in Bangladesh or the uK. MeTHoDS: Healthy girls (aged 5–16 years) recruited from schools in Sylhet, Bangladesh, and london, uK, comprised four groups: Sylhetis (n= 165), first-generation migrants to the uK (n= 42), second-generation girls (n = 162), and British girls of european origin (n= 50). anthropometric measurements were collected with questionnaire data for migration and socioeconomic characteristics. Saliva samples were assayed for dehydroepiandrosterone (DHeaS) using elISas. Multiple linear regressions tested for group differences in anthropometric and socioeconomic variables and DHeaS levels. Median ages at adrenarche (DHeaS>400 pg/ml) were estimated using Weibull regression models for parametric survival analysis. Hazard ratios for reaching adrenarche earlier and 95% confidence intervals (CI), both unadjusted and adjusted for anthropometric variables, were estimated from the survival analyses. FINDINgS: First-generation migrants had a median age at adrenarche (5.3 years) that was significantly earlier than Sylheti (7.2), second-generation (7.4) and european (7.1) girls. In univariate analyses, first-generation girls reached adrenarche significantly earlier than Sylhetis [Hr(CI): 2.8 (1.4–5.5)]. In multivariate models, first-generation girls still reached adrenarche earlier than Sylhetis after adjusting for height [Hr(CI): 1.9 (0.9–4.1)] and weight [Hr(CI): 1.7 (0.8–3.8)], but these results were attenuated. CoNCluSIoNS: We suggest rapid catch-up growth experienced by first-generation girls during early childhood may explain their advanced adrenarche. The environmental conditions leading to earlier adrenarche, and the health implications of this early transition, merit further exploration. COMMENTARY Plasticity in developmental programming has evolved to provide the best chances of survival and reproductive success under changing environments. environmental conditions experienced in early life can profoundly influence human biology and long term health. Developmental origins of health and disease and life history transitions are purported to use placental, nutritional and endocrine cues for setting long term biological, mental and behavioural strategies in response to local ecological and/or social conditions.1 The window of developmental plasticity extends from preconception to early childhood and involves epigenetic responses to environmental changes, which exert their effects during life history phase transitions. This paper shows that environmental conditions experienced by British– Bangladeshi migrants before adrenarche influence adult reproductive function, and that rapid catch-up growth experienced by first-generation girls in early childhood may explain their advanced adrenarche. The adrenarcheal transition is a key event defining the transition from childhood to juvenility.2 Such life history transitions are when the child adaptively responds to environmental cues to enhance growth, body composition, lifespan, fecundity schedules and behavioural strategies that yield the highest fitness in a given environment.3 Here, we learn that childhood environment before adrenarche might represent a key period influencing adult reproductive function, that adrenarche itself might represent a critical childhood threshold for later life development, and that rapid catch-up growth might provide the switch for this cascade of events. 1. Hochberg Z et al. 2011 endocrine Reviews 32 159–224. 2. Hochberg Z 2008 archives of diseases of Childhood 93 534–539. 3. Hochberg Z 2009 european Journal of endocrinology 160 135–141. Société Suisse d’Endocrinologie-Diabétologie Pédiatrique The SSeDP (the Swiss Society for Paediatric endocrinology and Diabetology) was founded in 1993 and has 46 members, led by President Valérie Schwitzgebel. It has working groups covering two main areas: • Disorders of Sex Differentiation (DSD) – aiming to assess DSD epidemiology and quality of care in Switzerland (Co-ordinator Christa Flück; firstname.lastname@example.org) • growth Hormone register – initially involved in the Saghe Study, resulting in a national register of every child treated with recombinant human growth hormone in Switzerland since 1985 (Co-ordinator Primus Mullis; email@example.com) There is also an ongoing collaborative project on monogenic diabetes, co-ordinated by Professor Schwitzgebel. The SSeDP organises an annual Meeting, as well as the eSPe advanced Seminar in Developmental endocrinology (arranged by Professor Mullis). eSPe and ISPaD (International Society for Pediatric and adolescent Diabetes) guidelines are currently followed in Switzerland. There are six centres of excellence with full fellowship programmes (the universities of Basel, Berne, geneva, lausanne and Zurich, and the Children’s Hospital of St gallen). The fellowship programme, including the learning goals, can be found at www.fmh.ch/bildung-siwf/fachgebiete/facharzttitel-und schwerpunkte/kinder-und-jugendmedizin.html. a national exam is mandatory after the 3-year fellowship for accreditation in paediatric endocrinology. For further information about SSeDP visit www.ssedp-sgped.ch or contact firstname.lastname@example.org.