To better understand the physiological and pathological processes that determine the individual phenotypes of neonates, we have established the Munich Preterm and Term Clinical (MUNICH-PreTCl) birth cohort (#Pangratz-Fuehrer et al., 2021) that econmpises > 800 neonates (~550 term and ~ 260 preterm) and is currently still recruting.

We collect dried blood spot samples from term infants at the time of the newborn screening and during suspected or proven infection and from preterm infants longitudinally including up to 4 time points (after birth, at newborn screening, at adjusted 32 weeks of gestation and at discharge) to generate MS-based blood proteomes in collaboration with the group of Prof. Mann at the Max Planck Institute of Biochemistry. To enable later adjustment for possible influence factors, we gather extensive clinical data (e.g. birth-related data, treatments, complications) and laboratory data of infants as well as information on parental demographics and anthropometric data, family history, pregnancy (e.g prenatal screenings, infections and substance abuse) and birth resulting in 450 data points per child-parent set.

DOI: 10.1136/bmjopen-2021-050652

Infections in newborns remain a leading cause of neonatal mortality and lifelong disability. Each year, severe bacterial infections kill approximately 400,000 newborns worldwide. Early diagnosis and treatment are crucial but challenging, particularly for early onset sepsis (EOS), due to the nonspecific initial symptoms and limited early-stage diagnostic tools.

This project aims to improve the diagnosis of EOS, which currently results in many neonates being unnecessarily separated from their mothers and subjected to invasive diagnostics and treatments. We will study a cohort of term newborns exposed to specific EOS risk factors (prolonged rupture of membranes, group B streptococci in the mother, and clinical signs of chorioamnionitis) but without other complications or comorbidities during pregnancy.

Our analyses will include:

a) Isolation and characterization of extracellular vesicles from the umbilical cord blood of at-risk neonates and maternal blood (collaboration PD Dr. Reithmair, LMU and Prof.. Michael Pfaffl, TUM School of Life Sciences.

b) Identification of microbiome signatures and potential infection routes in suspected EOS cases by characterizing the gut microbiome through shotgun sequencing and performing 16S rRNA gene amplicon sequencing of blood samples (collaboration Prof. Thomas Clavel, University of Aachen)

The vascular endothelium is crucial in SARS-CoV-2 pathogenesis. The virus targets cells via ACE2 receptors, degrades the protective glycocalyx, and causes persistent endothelial dysfunction in Long-COVID patients. Despite milder initial illness, children suffer from SARS-CoV2 related diseases including long-COVID and mutisystem inflammatory syndrom in children (MIS-C), a severe pediatric complication.

In collaboration with the the team of Andre Jacob (pediatric cardiology, LMU) we investigate microcirculatory changes and molecular signatures of SARS-CoV-2 related diseases in children. Using a longitudinal design, microcirculation parameters will be assessed in children/adolescents with acute COVID-19, PIMS, Long COVID, and asymptomatic SARS-CoV-2 infection during the acute phase and three months post-recovery.