The first ESPE Science Symposium was on ‘The science of gender: Evidence for what influences gender development and gender dysphoria and what are the respective influences of nature and nurture’, and was held in London, UK, in October 2018. The second ESPE Science Symposium focused on ‘Congenital adrenal hyperplasia: From molecular medical research to clinical application’ and was held in Nijmegen, The Netherlands, in October 2021. The third ESPE Science Symposium was on ‘Hypothalamic dysfunction in childhood: Etiology, consequences and new ways of management to improve outcome’ and took place in Utrecht, The Netherlands, in October 2022. The topic of the fourth ESPE Science Symposium held in Athens, Greece, in October 2023 was ‘Obesity in Childhood and Αdolescence.
Obesity in Childhood and Adolescence.
The fourth ESPE Science Symposium focused on ‘Obesity in Childhood and Αdolescence’ and was held at the Megaron International Conference Center, Athens, Greece, on October 13th & 14th, 2023. It was organized by Professor Evangelia Charmandari (Chair) and members of the scientific and local organizing committee at the National and Kapodistrian University of Athens Medical School (Elpida Vlachopapadopoulou, George Mastorakos), Harokopio University (Yannis Manios, Constantine Tsigos) and University of Patras (Dionysis Chrysis, Arris Giannakopoulos).
The aim of the 2023 ESPE Science Symposium was to bring together clinical and basic science researchers to offer their expertise on the topic of ‘Obesity in Childhood and Adolescence’. It provided an overview of the pathophysiology, etiology and metabolic complications of childhood obesity, strategies for its prevention, and the role of pharmacotherapy and bariatric surgery.
The symposium consisted of seven sessions covering the following thematic areas: i) The Obesity Epidemic: A Global Perspective; ii) Physiology and Pathophysiology of Energy Homeostasis; iii) Etiology of Childhood Obesity; iv) Metabolic and Other Complications of Childhood Obesity; v) Prevention and Treatment of Childhood Obesity: Lifestyle Interventions; vi) Pharmacotherapy and Bariatric Surgery for Obesity and its Co-morbidities; vii) Report of the Patient Representative Group ‘Imeroessa’.
The program of the 2023 ESPE Science Symposium can be viewed here.
The abstracts of all presentations and the short biographies of all Speakers and Chairs/Moderators can be viewed here.
Obesity represents one of the most challenging public health problems of the 21st century owing to both its epidemic proportions worldwide and the associated significant morbidity and mortality. During the last four decades, the prevalence of overweight and obesity in childhood and adolescence has risen substantially in most high-income countries and appears to be rising rapidly in low-income and middle-income countries. According to the World Health Organization (WHO), 41 million children under the age of 5 years, and more than 340 million children and adolescents aged 5–19 years are estimated to be overweight or obese. Childhood obesity is the most prevalent pediatric endocrine disorder.
Obesity is characterized by low-grade, systemic, chronic inflammation, increased production and release of pro-inflammatory, atherogenic cytokines and oxidative stress. Therefore, it is associated with several complications, including insulin resistance, dyslipidemia, hypertension, endothelial dysfunction, diabetes mellitus type 2, early onset atherosclerotic cardiovascular disease, orthopedic problems, fatty liver disease, cholecystitis, social stigmatization, and increased incidence of malignancies. In addition to the increased morbidity and mortality, overweight and obesity account for a significant increase in public health costs. The global economic impact from obesity is approximately $2.0 trillion USD or 2.8% of the global gross domestic product (GDP), which is almost equivalent to the global impact from smoking or armed violence, war and terrorism.
The progressively increasing prevalence of overweight and obesity in childhood and adolescence indicates that our current health policies are not effective, and further developments in health policy strategies are required. The need for community-targeted actions has long been recognized, however, it has been hindered by the lack of monitoring, evaluation framework, and methodological ability to objectively quantify the local community characteristics. Further to life-style interventions, pharmacotherapy and bariatric surgery, recent technological advancements in e-Health applications, and more specifically, big data analytics, intelligent multi-level information systems and specialized artificial intelligence algorithms, have improved healthcare significantly by facilitating precision and personalized medicine. However, their long-term effectiveness requires the support of public health authorities, long-term funding by national authorities and the commitment of the medical community to address the obesity epidemic.
Professor Evangelia Charmandari and the members of the Scientific and Local Organizing Committee would like to thank i) All speakers and chairs for accepting their invitation to participate in the Symposium and for contributing to the organization of a state-of-the-art scientific program; ii) The ESPE Science Committee for the opportunity to organize the 2023 ESPE Science Symposium in Athens; iii) The symposium organizer, ERA Ltd, and in particular Ms Marandou and Ms Mastorakou; iv) All sponsors for their financial support.
Hypothalamic Dysfunction In Childhood; Understanding Its Etiology And Developing New Ways To Improve Outcome Of Children With Genetic Or Acquired Causes Of Hypothalamic Dysfunction
On Friday 7 and Saturday 8 October 2022, the 3rd ESPE Science Symposium on the topic of Hypothalamic Dysfunction in childhood : etiology, consequences and new ways of management to improve outcome was delivered by Associate ProfessorHanneke van Santen and her programme organizing committee at the Princess Máxima Center, Utrecht, The Netherlands.
The meeting was organized as live meeting, which was an excellent way to communicate, meet and discuss. At the symposium, hypothalamic dysfunction was discussed from all different angles; genetic, congenital and acquired. This was a unique setting in which knowledge and expertise of all different fields could be exchanged. The symposium was of top level, with excellent speakers, all internationally acknowledged scientists in the field of hypothalamic dysfunction. There were around 80 participants from around the world, who actively participated in inspiring discussions. Eleven young investigators used the opportunity to join the meeting for free.
The science symposium consisted of six symposia covering all aspects of hypothalamic dysfunction, from etiology to treatment to networking and European collaboration. You can view the programme here.
The symposium opened with an inspiring lecture from Professor Dick Swaab who elaborated on the hypothalamus from an evolutionary point of view. Dr Hoong-Wei Gan provided a wonderful overview of all Appetite-regulating hormones in hypothalamic obesity. This was followed by a wonderful lecture of professor Dattani, who spoke about Congenital Disorders of Hypothalamic Dysfunction associated with Hypopituitarism.
Professor Maithe Tauber spoke upon the children with Prader-Willi syndrome, and how these children are a model to understand and treat hypothalamic dysfunction. It was wonderful to discuss and compare these children to children with acquired hypothalamic dysfunction, in whom the same pattern may be recognized of diencephalic syndrome evolving into hypothalamic obesity.
Professor Hermann Muller shared his great knowledge on hypothalamic dysfunction in children with craniopharyngioma, followed by Professor Kelestimur who learned us that the hypothalamus is very vulnerable and may be damaged after repetitive brain injury. Autoimmune hypothalamitis is a very rare disease, but has been described in adults and may be an entity that deserves further exploration also during childhood.
Dr Geert Janssens shared the results of a European survey amongst radiation oncologists and, surprisingly, illustrated that there is little consensus upon the effects of radiation on hypothalamic outcome.
Professor Eelco Hoving shared a beautiful video to illustrate the challenges for a neuro-surgeon on how to preserve the hypothalamus in children with craniopharyngioma and how delicate this area is. In the evening we had a wonderful Dutch dinner and time to discuss and connect.
On Saturday the focus was on management of hypothalamic dysfunction in childhood. There is currently no effective treatment for hypothalamic dysfunction yet and Hanneke van Santen shared a personalized treatment algorithm by which patients with hypothalamic dysfunction can be systematically treated along 6 clinical domains. She illustrated that in many cases not all aspects ( such as temperature dysregulation, sleep, energy expenditure) of hypothalamic dysfunction are addressed yet, but that this is essential for optimal management. One of the main important adverse outcomes for patients is the hypothalamic obesity, associate professor Erica van den Akker spoke about the treatment of hypothalamic obesity (genetic or acquired) and discussed the importance of combined life style intervention, new upcoming drugs and the developments in bariatic surgery.
The symposium continued with an inspiring talk of professor Nienke Biermasz, chair MTG6 of the ENDO-ERN who discussed the importance of networking and ENDO-ERN for rare diseases such as hypothalamic syndrome. Johan de Graaf, chair of the Dutch Pituitary Patient Association and ePAG representative ENDO-ERN, MTG6, continued with the results of a survey amongst the “unmet needs” of patients with acquired hypothalamic dysfunction. It was clear that most patients have difficulties with their weight and chronic fatigue and that in multiple domains management needs improvement.
Lastly, there was a very interesting panel discussion, involving all participants and experts. It was concluded that it is actually surprising that the hypothalamus, being such as old an important organ for the humans balance, has had relatively little attention. In the different endocrine societies hypopituitarism is often discussed, but hypothalamic dysfunction may be put more often on the agenda. Together with all experts, it was decided to start a Hypothalamic Network, aiming to increase awareness of hypothalamic dysfunction with the ultimate goal to better understand this rare disease and to improve its management. In addition, plans were made for building new networks and collaboration within ESPE and Europe, together with the patient organizations and ENDO-ERN.
The organizers would like to thank ESPE and all sponsors for financial support and all speakers for their contribution and the moderators for guiding us through the programme.
Congenital Adrenal Hyperplasia
On Friday 29 and Saturday, 30 October 2021, the 2nd ESPE Science Symposium on the topic of Congenital adrenal hyperplasia: from molecular medical research to clinical application was delivered by Prof. Hedi Claahsen – van der Grinten and her programme organizing committee at Radboud University Medical Centre, Nijmegen, The Netherlands. After the uncertain COVID 19 period which made the organizers decide to postpone their symposium from October 2020 to October 2021, it was decided to host the symposium completely online. With excellent speakers, all top scientists in the field of CAH, the online format gave around 200 participants, from around the world, the opportunity to join and to actively participate in inspiring discussions. The organizers welcomed participants from America, Europe, Africa, Asia and Australia. Furthermore, 14 young investigators used the opportunity to join the meeting for free.
The symposium consisted of six sessions covering an introduction to CAH, diagnostics, treatment, long term outcomes, research aspects and future perspectives. The speakers discussed many exciting new developments in the field of CAH. The programme can be viewed here.
Beside the well-known classical androgen pathway, in the past few years the importance of the backdoor pathway and of 11-oxygenated steroids in the pathophysiology and diagnostics of CAH has become clearer. Professor Christa Flück explained the backdoor pathway in more detail and its importance for CAH patients especially in prenatal life. Prof Wiebke Arlt and Professor Richard Auchus described the more recently described 11-oxygenated androgens which are nowadays known as the most important adrenal androgens in CAH patients. An important topic in the CAH symposium were new treatment modalities such as CRH antagonists presented by Richard Auchus and promising gene therapy, discussed by Leonardo Guasti. In the session on basic and translational research, four researchers discussed their approaches which included the use of a zebrafish model as presented by Dr. Nils Krone and interesting models to test novel therapeutic interventions discussed by Professor Angela Huebner. Dr. Agustini Utari, pediatric endocrinologist from Indonesia pointed out the special problems and risks for CAH patients in developing countries where a lack of infrastructure, knowledge and medication leads to high morbidity and mortality
One highlight of the symposium was a session about past and future perspectives with two excellent talks of Professor Walter Miller and Professor Perrin White, both well known, experienced and outstanding researchers in the field of CAH. They gave an excellent overview of the history of CAH and discussed future perspectives based on their more than 35 years’ experience in CAH research.
The organizers would like to thank all sponsors for financial support and all speakers for their contribution and the moderators for guiding us through the programme. They would also like to thank Prevents for the perfect organization of the online symposium.
Gender Dysphoria
The first international multidisciplinary ESPE Science Symposium was held at the Tavistock Gender Identity Disorder Service (GIDS) in London, UK, October 19-20 under the chair of professor Gary Butler. It was conceived and organised by the ESPE Gender Dysphoria working group and GIDS and was seen as a success from all involved. A total of 96 participants from 22 countries met to network and discuss unmet scientific needs for evidence-based health care of transgender children and teenagers.
Genes, hormones and social factors play a pivotal and interactive role for physical, emotional, social, sexual and cognitive development of youngsters. The symposium focused on how to better achieve an understanding of the impact of current treatment regimens on all these aspects of health during adolescence and over long-term.
The 2018 ESPE Science Symposium was accredited by the European Accreditation Council for Continuing Medical Education (EACCME®) with 10 European CME credits.
