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Draft:German Center for Child and Adolescent Health

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The German Center for Child and Adolescent Health (DZKJ) is a national research center established in 2024 with support from the Federal Ministry of Research, Technology and Space (BMFTR). Its mission is to sustainably promote the health of children and adolescents and to improve medical care and research in Germany. The research network includes seven leading partner sites in Berlin, Göttingen, Greifswald/Rostock, Hamburg, Leipzig/Dresden, Munich, and Ulm. By bringing together university hospitals, universities, and non-university institutions such as Max Planck and Fraunhofer Institutes, Helmholtz and Leibniz Centers, as well as other partner organizations, the DZKJ pools exceptional expertise and enables the rapid translation of new scientific findings into clinical practice.

Background and establishment

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Since 2009, the Federal Ministry of Research, Technology and Space (BMFTR) has been supporting the German Centers for Health Research (DZG), each focusing on different key areas. They all share the common goal of creating optimal research conditions to combat common diseases by addressing important health-related questions, developing innovative approaches, and promoting the translation of research findings into clinical practice.[1]

The establishment of the German Center for Child and Adolescent Health (DZKJ) was driven by the crucial importance of childhood and adolescence as formative phases in which the foundations for lifelong health are laid. In 2017, then-Chancellor Angela Merkel emphasized during a public event that children's health must be given even greater importance in our society, and that pediatric and adolescent medicine required its own dedicated German Center for Health Research.[2] Since children are not simply small adults, promoting their health and providing medical treatment and care demands a specifically tailored approach. This includes the development of age-appropriate medications, treatments, and therapies that address their unique needs.[3] Moreover, health is a fundamental right of every child, enshrined in the United Nations Convention on the Rights of the Child.[4][5]

To meet the specific needs of child and adolescent health, the German Federal Government decided in 2018 to establish the DZKJ.[6] In a competitive selection process, an international panel of experts evaluated over 20 applications and selected seven partner sites. These were officially announced at a press conference on March 10, 2021, by the then Federal Minister of Education and Research, Anja Karliczek.[7] According to Karliczek, the creation of the DZKJ represents a further boost to Germany’s international leadership in research and will provide important impetus for the future of pediatric and adolescent medicine. Following the concept development phase in 2021/22 and a renewed evaluation by an international expert panel, the DZKJ has been in its implementation phase since June 2024 [8–21].[8][9][10] The two-year setup phase is funded with 30 million euros. This will be followed by long-term institutional funding to establish the DZKJ as a permanent part of Germany’s research infrastructure.

The Importance of Research in Child and Adolescence Health

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Promoting research in this field is essential, as childhood and adolescence are critical developmental phases that lay the foundation for a healthy life.[11][12] Diseases identified and treated during these life stages can not only alleviate immediate suffering but also reduce long-term health risks. Furthermore, this research contributes to the evidence-based advancement of prevention and treatment concepts and addresses specific challenges arising from socioeconomic and societal changes. It is, therefore, a key pillar for ensuring a healthy future for our society.[13][14]

Goals & Research Priorities of the DZKJ

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The DZKJ aims to establish an excellent research foundation for the diagnosis, prevention, and treatment of diseases in childhood and adolescence. Using a translational approach, the center integrates basic and clinical research to develop personalized therapies and preventive measures.[15] The focus is on seven key research areas that cover the full spectrum of child and adolescent health and address the specific challenges faced by these age groups:

Rare Genetic Diseases

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Rare genetic diseases present a particular challenge, as they are often difficult to diagnose and treat. Despite their perceived rarity, a significant number of children and adolescents are affected by such conditions.[16] Research in this area not only enables improved genetic diagnostics but also the development of more precise, personalized therapies. Advances in genomics and molecular medicine are crucial in this context.

Immunity, Inflammation and Infection

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The immune system of children differs fundamentally from that of adults. Understanding the developmental processes of the immune system, its response to infections, and the mechanisms of chronic inflammatory diseases forms the basis for new therapies and vaccination strategies specifically tailored to children and adolescents.

CNS Development and Neurological Diseases

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The development of the central nervous system (CNS) is an extremely complex process that is highly vulnerable to disruptions, which can have lasting effects throughout a person's life. Research in this area aims to better understand neurological developmental disorders and diseases in childhood and adolescence and to develop innovative therapeutic approaches. This research takes into account the close interaction between the CNS and all organ systems of the body. The goal is to prevent long-term impairments and disabilities and to lay the foundation for a healthy life.

Obesity and Metabolism

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Obesity and metabolic disorders in childhood and adolescence have increased significantly over the past decades. These conditions not only raise health risks in adulthood but can also impair quality of life at a young age. The goal of research in this area is to develop early prevention and intervention strategies tailored to the specific needs of this age group.

Early Determinants of Health and Diseases

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Children’s development is shaped by a wide range of internal and external (environmental) factors that have a lasting impact on health and disease risk later in life. The goal is to understand the health risks arising from the interaction between genetic predispositions and a changing environment. This includes identifying both risk and protective factors and uncovering the underlying mechanisms. These insights aim to improve our understanding of the origins of common diseases—many of which begin in childhood—and to enable the development of effective early prevention strategies.

Psychosocial Health, Mental Health

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In cooperation with the German Center for Mental Health (DZPG), the DZKJ is dedicated to researching psychosocial and mental challenges in children and adolescents. The focus is particularly on the psychosocial and psychological aspects associated with physical illnesses. Through interdisciplinary collaboration, the complex interactions between physical and mental health are examined. The goal is to gain a deeper understanding of these connections and, based on this, to develop innovative approaches for prevention, therapy, and the long-term promotion of health.

Community Medicine

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Community Medicine examines the interactions between social determinants and health, including epidemiological analyses of morbidity, risk and protective factors, as well as healthcare epidemiology aspects such as care needs and access to health services. This research area also considers social justice, participation, and psychosocial and socioeconomic factors, with the goal of making healthcare more equitable for all children and adolescents and achieving long-term health improvements.

Partner sites, participating institutions and members

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Each of the seven DZKJ sites contributes specific research priorities. The sites collaborate with each other as well as with additional research institutions to promote interdisciplinary exchange and the development of innovative treatment methods. The DZKJ is led by the directors of the seven sites (Board of Directors). They are supported across locations by a Scientific Advisory Board, which consists of internationally leading experts in child and adolescent health, representatives from politics and the public sector, as well as a patient representative.

In total, more than 150 Principal Investigators (PIs) and currently 20 institutions are involved across the seven sites:

Berlin (Site Director: Prof. Dr. med. Marcus A. Mall)

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Göttingen (Site Director & DZKJ Chair: Prof. Dr. med. Jutta Gärtner)

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Greifswald/Rostock (Site Director: Prof. Dr. rer. med. habil. Neeltje van den Berg)

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Hamburg (Site Director: Prof. Dr. med. Ania C. Muntau)

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Leipzig/Dresden (Site Director: Prof. Dr. med. Antje Körner)

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Munich (Site Director: Prof. Dr. med. Dr. sci. nat. Christoph Klein)

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Ulm (Site Director & DZKJ Vice Chair: Prof. Dr. med. Klaus-Michael Debatin)

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Support for Early Career Researchers & DZKJ Academy

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A key focus of the DZKJ is the promotion of early-career scientists as well as Medical and Clinician Scientists, who bridge the gap between clinical practice and research. The specially established DZKJ Academy offers targeted programs for training and career development. At the same time, the academy serves as a platform for interdisciplinary exchange and enables close collaboration across disciplinary boundaries. These measures sustainably strengthen the competitiveness of research institutions and the scientific landscape at both the national and international levels.[17]

Patient Participation & Empowerment of Children and Adolescents

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The DZKJ places great importance on participatory research: the needs and perspectives of children and adolescents, as well as their parents, are included and taken into account. The center pursues innovative participation models to integrate patients as experts in their own right throughout the research process—from planning and implementation to the communication of results. This program is complemented by various local participation formats at the individual DZKJ sites, specifically tailored to children, adolescents, and their families. While previous participation approaches have primarily targeted adult patients, there are hardly any specific offerings for children and adolescents.[18][19] The DZKJ aims to close this gap and serve as a pioneer for other institutions.

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References

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  1. ^ Bundesministerium für Bildung und Forschung: Deutsche Zentren der Gesundheitsforschung. "Deutsche Zentren". Retrieved 17.12.24. {{cite web}}: Check date values in: |access-date= (help)
  2. ^ Deutsches Zentrum für Neurodegenerative Forschung (DZNE): Spitzenforschung für ein gesundes Leben. "Bundeskanzlerin Merkel und NRW-Wissenschaftsministerin Schulze eröffnen Neubau des DZNE". Retrieved 14.03.25. {{cite web}}: Check date values in: |access-date= (help)
  3. ^ Hoffmann, Georg F.; et al. (2020). Pädiatrie – Grundlagen und Praxis. Fünfte, vollständig überarbeitete Auflage. Berlin: Springer. ISBN 978-3-662-60299-7.
  4. ^ Deutsches Kinderhilfswerk. "UN-Kinderrechtskonvention". Retrieved 04.12.24. {{cite web}}: Check date values in: |access-date= (help)
  5. ^ Bundesministerium für Gesundheit (2018). "Wegweiser zum gemeinsamen Verständnis von Gesundheitsförderung und Prävention bei Kindern und Jugendlichen in Deutschland". Retrieved 17.12.24. {{cite web}}: Check date values in: |access-date= (help)
  6. ^ Bundesministerium für Bildung und Forschung (2018). "Startschuss für zwei neue Deutsche Zentren der Gesundheitsforschung. Pressemitteilung". Retrieved 29.10.24. {{cite news}}: Check date values in: |access-date= (help)
  7. ^ Thieme kma Online (2021). "Deutschland bekommt zwei neue Zentren für Gesundheitsforschung". Retrieved 17.12.24. {{cite news}}: Check date values in: |access-date= (help)
  8. ^ Bundesministerium für Bildung und Forschung. "DZKJ - Entwicklung eines wissenschaftlichen Konzeptes für das Deutsche Zentrum für Kinder- und Jugendgesundheit". Retrieved 04.12.24. {{cite web}}: Check date values in: |access-date= (help)
  9. ^ aerzteblatt.de (02.06.24). "Zentrum für Kinder- und Jugendgesundheit neues Mitglied der Deutschen Zentren der Gesundheitsforschung". Retrieved 04.12.24. {{cite news}}: Check date values in: |access-date= and |date= (help)
  10. ^ Deutsche Gesellschaft für Kinder- und Jugendmedizin e.V. (DGKJ) (31.05.24). "Endlich: Gemeinsam forschen für die Kindergesundheit!". Retrieved 05.12.24. {{cite web}}: Check date values in: |access-date= and |date= (help)
  11. ^ KiGGS. "Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland". Retrieved 15.03.25. {{cite web}}: Check date values in: |access-date= (help)
  12. ^ KIDA. "Kindergesundheit in Deutschland aktuell". Retrieved 15.03.25. {{cite web}}: Check date values in: |access-date= (help)
  13. ^ Ärztezeitung (Heft 32-33/2024). "Forschende Pädiatrie soll sichtbarer werden". pp. 24–26. {{cite news}}: Check date values in: |date= (help)
  14. ^ Gärtner, Jutta (2024). "Neues Zentrum: Ein gesundes Leben von Anfang an". SYNERGIE. Forschen für Gesundheit. 2: 52–54.
  15. ^ J. Gärtner, R. Berner, K.M. Debatin, C. Klein, A. Körner, M. Mall, A. Muntau, N. van den Berg (2024). "Deutsches Zentrum für Kinder- und Jugendgesundheit. Interdisziplinäre Forschung für eine gesunde Zukunft von Kindern und Jugendlichen". Monatsschrift Kinderheilkunde. 8: 704–710. doi:10.1007/s00112-024-02009-4.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  16. ^ Bundesministerium für Gesundheit. "Seltene Erkrankungen". Retrieved 11.12.24. {{cite web}}: Check date values in: |access-date= (help)
  17. ^ Deutsche Forschungsgemeinschaft (DFG) (2024). "Zielpositionen für Clinician Scientists – Perspektiven in der Universitätsmedizin. Empfehlungen der Senatskommission für Grundsatzfragen in der Klinischen Forschung".
  18. ^ Bauer, Julia; et al. (2024). "Teilhabe im Kinderkrankenhaus: Formate zur Verwirklichung des Rechts auf Partizipation von jungen Patientinnen und Patienten". Gesundheitswesen. 86 (11): 712–714. doi:10.1055/a-2270-2840. PMC 11555779. PMID 38653470.
  19. ^ Council of Europe (2024). "Guide to children's participation in decisions about their health". Retrieved 05.12.24. {{cite web}}: Check date values in: |access-date= (help)