About

A.G. Christina Bergqvist is a Professor of Neurology at the Children's Hospital of Philadelphia. She is an attending pediatrician at the same hospital and serves as the Director of the Ketogenic Diet Program in the Division of Neurology. Her clinical work involves the treatment of neurological disorders, particularly epilepsy, using the ketogenic diet, and she has contributed to the development and management of dietary treatment programs for epilepsy and neurological conditions. Her research expertise includes the effects of the ketogenic diet on neurological health, treatment-resistant epilepsy, and related metabolic and neurological issues. Dr. Bergqvist has been involved in numerous publications and studies related to epilepsy, ketogenic diet therapy, and neuro-metabolic research, and she has played a significant role in advancing clinical practices and educational efforts in this field.

Research topics

• Internal medicine
• Medicine
• Immunology
• Psychiatry
• Pediatrics
• Anesthesia
• Endocrinology
• Pharmacology

Selected publications

• UV1 vaccination in pembrolizumab-treated patients with recurrent or metastatic head and neck cancer: A randomized multicenter phase 2 trial

  Med · 2025-04-11 · 6 citations

  articleOpen access

  BACKGROUND: Human telomerase reverse transcriptase is highly expressed in head and neck squamous cell carcinoma (HNSCC). The FOCUS study examines the role of the telomerase-directed vaccine UV1 in combination with pembrolizumab in patients with recurrent or metastatic (R/M) HNSCC. METHODS: HNSCC. A progression-free survival (PFS) rate at 6 months of 40% was deemed promising for further development in a phase 3 setting. The trial was conducted in 10 centers in Germany (this study was registered at ClinicalTrials.gov: NCT05075122). FINDINGS: From August 2021 to July 2023, 25 patients were enrolled in the pembrolizumab arm and 50 patients in the pembrolizumab + UV1 arm. The PFS rate at 6 months was 40% in the pembrolizumab arm and 30% in the pembrolizumab + UV1 arm. No specific safety signals were observed in the pembrolizumab + UV1 arm apart from a reversible allergic reaction that appeared in one patient. At a median follow-up of 11.3 months, median overall survival was 13.1 months in the pembrolizumab arm and 12.6 months in the pembrolizumab + UV1 arm. CONCLUSIONS: The addition of UV1 to pembrolizumab was safe but did not show an efficacy signal in this study population. FUNDING: The legal sponsor of the trial was the University Medical Center Halle (Saale), Germany and was funded by a grant from Ultimovacs.

  PublisherDOI

• P064: TRIT1-associated combined oxidative phosphorylation deficiency-35: Two cases from opposite ends of the epilepsy spectrum

  Genetics in Medicine Open · 2025-01-01

  articleOpen accessSenior author

  extensive symmetrical abnormalities in the periventricular and deep white matter and thalami.To date, treatment for HMBS-related leukoencephalopathy remains supportive.Here we present the presentation and diagnosis of another individual with adolescent-onset HMBS-related leukoencephalopathy.Case Presentation: A 17-year-old male with mild learning difficulties presented with five months of progressive gait changes and lower extremity paresthesias.He experienced tripping, falling and unsteadiness.Subsequently, he developed painful numbness of his bilateral lower extremities.He became nonambulatory and was unable to attend school in the month prior to presentation.Examination revealed hyperreflexia of the lower extremities, bilateral ankle clonus, widebased gait, and preserved sensation.There were hand tremors and titubation.Diagnostic Workup: Brain magnetic resonance imaging (MRI) revealed bilateral thalamic, subcortical white matter and corpus callosum lesions.Thoracic spine MRI was unremarkable.Ophthalmologic evaluation was only notable for red-green color blindness.Neuroinflammatory work-up was negative.Metabolic screening labs and lysosomal enzyme storage disease panel were unrevealing.Exome and mitochondrial sequencing revealed biparentally inherited variants in HMBS: a paternally inherited pathogenic variant (c.499C>T, p.Arg167Trp) and a maternally inherited variant of uncertain significance (c.674G>A, p.Arg225Gln).Follow-up biochemical testing revealed normal plasma aminolevulinic acid (ALA) and PBG levels, normal urine ALA, elevated urine PBG and decreased erythrocyte PBGD activity.Both parents were found to have mildly decreased PBGD activity.

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• Preclinical development and clinical safety assessment of a synthetic peptide conjugate enabling endogenous antibody binding to promote innate receptor engagement

  Molecular Therapy Oncology · 2025-02-20 · 1 citations

  articleOpen access

  cross-linking of pre-existing tetanus toxin-directed antibodies, facilitating antigen delivery to, and activation of DCs. To achieve this, multiple identical tetanus toxin-derived B cell epitopes (MTTEs) are conjugated to synthetically produce target antigens of choice. Herein, we describe the generation of a prostate cancer vaccine candidate (TENDU) based on this technology. It includes long synthetic peptides harboring epitopes (CD4 and CD8) from prostate-specific antigen (PAP) and prostate-specific membrane antigen (PSMA). The preclinical efficacy of TENDU was assessed in experimental systems, and safety was evaluated in a rabbit toxicity study and a human whole blood loop assay. We also report the first clinical safety assessment of TENDU. Experimental studies showed that prostate cancer patients mounted anti-MTTE antibodies in response to tetanus vaccination with recall T cell responses detected in two patients. Transgenic humanized HLA-DR4 mice displayed T cell responses and increased anti-MTTE IgG levels after vaccination with a peptide construct including an HLA-DR4 epitope. The vaccine candidate was found safe, and a positive correlation between T cell responses and anti-MTTE antibodies was noted in the first-in-human study.

  PublisherDOI

• Abstract CT108: Phase I data from TENDU101, a first-in-human trial of a novel synthetic peptide conjugate cancer vaccine platform assessed in recurrent prostate cancer patients before salvage treatment

  Cancer Research · 2024-04-05 · 1 citations

  article

  Abstract Synthetic peptides are explored in the clinic in cancer vaccine development for the purpose of inducing tumor-directed T cell responses. Their immunogenicity is dependent on the chosen adjuvant and target organ exposure (lymphoid organs). To improve peptide immunogenicity, we have developed a technology enabling cross-linking of endogenous, pre-existing circulating antibodies (Abs) by employing a three-dimensional chemistry design. Multiple identical tetanus toxin-derived B cell epitopes (MTTEs) are conjugated to synthetically made antigenic tumor peptides intended to induce T cell responses. Here we report the first clinical safety assessment of the vaccine platform in the trial TENDU101 (NCT04701021). The cancer vaccine candidate (TENDU) was designed to include longer synthetic peptides harboring prostate cancer derived epitopes (CD4 and CD8) from PAP and PSMA. The study was a 3+3 design and doses were 40, 400 and 960 microgram in patients with documented recurrent disease after radical prostatectomy. A tetanus toxoid (TTd) containing vaccine boost was followed by TENDU vaccination via subcutaneous injection in the abdomen (4 doses in total with a 2 week interval) in n=9 patients (gr 1, 2, 3.1). For group 3.2 (n=3) TENDU vaccination was administrated in the same arm as the TTd vaccination. Primary objective was safety and secondary objective assessment of immune responses and preliminary anti-tumor responses. A total of 52 adverse events (AEs) were reported, most mild and deemed unrelated to vaccination. Six treatment-related AEs were reported of which 50% were mild transient injection site reactions in a single patient (gr 3.1), and three events of increases in lipase levels in two patients (gr 2). No serious AEs was reported. T cell responses pre/post TENDU were assessed in a total of six patients of which five patients displayed increased response against vaccine-related CD8 and CD4 epitopes (ELISpot). The three patients with the greatest increase in T cell responses were found to display the highest anti-MTTE IgG responses. A trend towards decrease in circulating tumor cells from screening to the end of treatment visit was observed in the patients with the highest levels of anti-MTTE IgGs post TENDU vaccination. There were no trends for decrease in PSA and/or PAP at the end of treatment and follow-up measurements were affected by initiation of radiation and short-term androgen deprivation. The administration of TTd and TENDU to the same anatomical location although spaced in time appeared to negatively influence immune responses to TTd and TENDU. In conclusion, the novel synthetic peptide conjugate vaccine conjugate was found safe with no serious AEs reported and a positive correlation between anti-MTTE and T cell responses was noted in patients when TENDU was administrated in the abdomen. Citation Format: Wolfgang Lilleby, Anna Bergqvist, Aikaterini Nasi, Wenche Rasch, Sara Mangsbo. Phase I data from TENDU101, a first-in-human trial of a novel synthetic peptide conjugate cancer vaccine platform assessed in recurrent prostate cancer patients before salvage treatment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr CT108.

  PublisherDOI

• Impact of a ketogenic diet on sleep quality in people with relapsing multiple sclerosis

  Sleep Medicine · 2024-08-28 · 6 citations

  articleOpen access
  PublisherOA PDFDOI

• UV1 cancer vaccine in pembrolizumab-treated patients with recurrent or metastatic PD-L1 positive head and neck squamous cell carcinoma: results from the randomized phase 2 FOCUS trial

  medRxiv · 2024-10-24 · 1 citations

  preprintOpen access

  Abstract Background Human telomerase reverse transcriptase (hTERT) is highly expressed (75-100%) in head and neck squamous cell carcinoma (HNSCC). The FOCUS study examines the role of the hTERT-directed vaccine UV1 in combination with pembrolizumab in patients with recurrent or metastatic (R/M) HNSCC. Methods The FOCUS trial, a two-armed, open-label, non-comparative, randomized, multicenter phase 2 study, was designed to assess the efficacy and feasibility of UV1 as an add-on to pembrolizumab in the first-line treatment of patients with R/M PD-L1 positive HNSCC. A progression-free survival rate at 6 months (PFSR@6) of 40% was deemed promising for further development in a phase 3 setting. The trial was conducted in 10 centers in Germany. Results From August 2021 to July 2023, 25 patients were enrolled in the calibration arm A and 50 patients in the UV1 arm B. Median age was 65 years and 18% of patients had an ECOG performance score of 2. The PFSR@6 was 30% in the UV1 arm. No specific safety signals were observed in the UV1 arm apart from a reversible allergic reaction that appeared in one patient. At a median follow-up of almost one year (11.3 months), median overall survival was 13.1 months in the calibration arm A and 12.6 months in the UV1 arm B. Clinical trial identification number NCT05075122 . Conclusions The addition of UV1 to pembrolizumab was safe but did not show an efficacy signal in this study population.

  PublisherOA PDFDOI

• Diagnosis and treatment of growth hormone deficiency in children on the ketogenic diet: A case series

  Epilepsia Open · 2024-04-20 · 1 citations

  articleOpen accessSenior author

  The ketogenic diet (KD) can have a negative impact on the linear growth and body composition of children. The aims of this study were to review two centers' experience with children who developed height deceleration on the KD and determine if the height deceleration was secondary to growth hormone deficiency (GHD), and if growth hormone therapy (GHT) would be effective and safe (not altering ketosis or seizure frequency). Retrospective chart reviews were performed on patients with KD referred to Endocrinology between 2013 and 2018. Seventeen children were identified. Data reviewed included: demographics, growth velocity, KD ratio, protein/calorie intake, lab results, GH dosage, Tanner stage, and seizure frequency, and endocrine recommendations. Descriptive statistics were performed. Of the 17 children referred to the Endocrine Division, seven children were growth hormone deficient and began GHT. Data were provided for six patients (2 males, 4 females; age 2-7 years at the start of KD) on the KD for >6 years and on GHT for >4 years. Growth for all patients stabilized or increased. IGF-1 z-scores normalized. GHT did not affect seizure frequency or ketosis. GHT in those with GHD can be an appropriate option allowing better growth while still maintaining ketogenic therapy and seizure control. PLAIN LANGUAGE SUMMARY: The KD can be an effective treatment for difficult-to-control epilepsy and some disorders of carbohydrate metabolism. The KD can adversely affect the linear growth (height) of children. This case series reviewed six patients who had slow linear growth. It was found that all six children had growth hormone deficiency, grew better with growth hormone treatments, and that their seizures and ketone levels were not affected.

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• Co-Expression of Immunohistochemical Markers MRP2, CXCR4, and PD-L1 in Gallbladder Tumors Is Associated with Prolonged Patient Survival

  Cancers · 2023-06-30 · 7 citations

  articleOpen access

  Gallbladder cancer (GBC) is a rare pathology in Western countries. However, it constitutes a relevant health problem in Asia and Latin America, with a high mortality in middle-aged Chilean women. The limited therapeutic options for GBC require the identification of targetable proteins with prognostic value for improving clinical management support. We evaluated the expression of targetable proteins, including three epithelial tumor markers, four proteins associated with multidrug and apoptosis resistance, and eleven immunological markers in 241 primary gallbladder adenocarcinomas. We investigated correlations between tumor marker expression, the primary tumor staging, and GBC patients’ survival using automated immunohistochemistry, a semi-automatic method for image analysis, univariate and multivariate statistical analyses, and machine learning algorithms. Our data show a significant association between the expression of MRP2 (p = 0.0028), CXCR4 (p = 0.0423), and PD-L1 (p = 0.0264), and a better prognosis for patients with late-stage primary tumors. The expression of the MRP2/CXCR4/PD-L1 cluster of markers discriminates among short-, medium-, and long-term patient survival, with an ROC of significant prognostic value (AUC = 0.85, p = 0.0012). Moreover, a high MRP2/CXCR4/PD-L1 co-expression is associated with increased survival time (30 vs. 6 months, p = 0.0025) in GBC patients, regardless of tumor stage. Hence, our results suggest that the MRP2/CXCR4/PD-L1 cluster could potentially be a prognostic marker for GBC.

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• Narrative Formulation Revisited: On Seeing the Person in Mental Health Recovery

  Philosophy, psychiatry & psychology · 2023-03-01

  articleOpen access1st authorCorresponding

  The use of narrative in mental health contexts models consciousness as something necessarily embodied, as already part of the world, in an inherently value-laden and perspectival way

  PublisherOA PDFDOI

• Epilepsy with Myoclonic-Atonic Seizures (Doose Syndrome)

  2023-05-04

  book-chapter1st authorCorresponding

  A child has a diagnosis of epilepsy with myoclonic-atonic seizures, aka myoclonic astatic epilepsy, or Doose syndrome after the initial reporting author. Doose syndrome is classified as a generalized epilepsy, which develops in normal children between the ages of 6 months and 6 years, with maximal onset around age 2–3 years. Myoclonic-atonic seizures are the characteristic seizure type in this syndrome and typically consist of symmetric myoclonic jerks of the upper extremities, followed by atonia causing a head drop or a whole body fall if standing. A thorough history focusing on the development and the seizure types as they emerge is essential to making the correct diagnosis. Video-EEG monitoring is essential for diagnosis as it can document specific seizure types. The optimal treatment for Doose syndrome is not known. There has been no randomized clinical trial comparing all our current treatment options. Treatment is therefore extrapolated from our knowledge of treating genetic generalized epilepsies.

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Frequent coauthors

• Brenda Banwell

  Children's Hospital of Philadelphia

  28 shared

• Myla Goldman

  Virginia Commonwealth University

  24 shared

• Diana Lehner-Gulotta

  University of Virginia

  24 shared

• J. Nicholas Brenton

  University of Virginia

  23 shared

• Rachael Coleman

  University of Virginia

  23 shared

• Emily Leytham

  University Vascular Associates

  17 shared

• Lauren Gampper

  University of Virginia Health System

  17 shared

• Virginia A. Stallings

  13 shared

Education

• B.S., Chemistry

  Gannon University

  1986

• M.D., Medicine

  Temple University School of Medicine

  1992

• Ph.D., Statistics

  Stockholm’s University

  1983

Awards & honors

• Peter H Berman Lectureship fund (created in the memory of Dr…