The gut microbiome: an overview of current trends and risks for paediatric populations
Purpose of review Gut health is an increasingly popular topic of discussion among scientists and the general population alike. As interest surrounding the gut microbiome grows, the accessibility to misinformation and unfounded gut health trends to youth is likely to emerge as a public health concern. The purpose of this review is to provide paediatricians with current information about the gut microbiome, as well as explanations and possible risks of the multitude of gut health trends that adolescents may be exposed to. Recent findings The gut microbiome is implicated in overall health by playing roles in digest...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Pediatric strength training: benefits, concerns, and current trends
Purpose of review With the advent of social media combined with several large-scale promotions by nationwide gym chains, pediatric interest in strength training has reached new heights during the past few years. While this is a healthy way for young gym users to build strength and stay active, there are significant risks associated with improper utilization of exercise resources. Lack of adult supervision and guidance in the gym can lead to physical injury, inappropriate use of supplements, and body image issues. The purpose of this review is to provide pediatricians with up-to-date information about well tolerated exe...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: OFFICE PEDIATRICS: Edited by Henry H. Bernstein Source Type: research

Host-directed immunotherapy to fight infectious diseases
Purpose of review This review provides readers with examples of refractory infections due to inborn errors of immunity, highlighting how they may be successfully treated by deducing and targeting the underlying immunodeficiency. Recent findings The use of host-directed immunotherapy to treat infectious disease in inborn errors of immunity is currently limited but growing. Different strategies include depleting the cellular reservoir for pathogens with restricted cell-tropism; augmenting the diminished effector response; and restoring molecular equipoise. The immunotherapies illustrated are existing drugs that ha...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research

Advances in immunoglobulin E mediated antibiotic allergy
Purpose of review The purpose of this review is to identify recent advances in our understanding and management of immunoglobulin E (IgE)-mediated antibiotic allergy. Recent findings Antibiotics remain a leading cause of fatal anaphylaxis reported to the FDA. However, recent advances have defined the features of adult and pediatric patients without true IgE-mediated allergy or any mechanism of anaphylaxis when tested. This has created opportunities to use direct challenges to disprove these allergies at the point-of-care and improves antibiotic stewardship. Additional advances have highlighted cross-reactive str...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research

Tree nut allergy: a systematic review
Purpose of review Systematic scoping review, focusing on randomized clinical trials of recent research addressing tree nut allergy. Recent findings This review addresses published, unpublished, and re-analyzed studies on tree nut allergy definition, epidemiology, etiology, diagnosis, prognosis, and therapy. Summary The importance of tree nut allergy spans nations, economies, and cultures. While broad themes in epidemiology, etiology, diagnosis, prognosis, and therapy are emerging, the next major advance in tree nut allergy will require large, robust studies to deliver results important to patients and fam...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research

Challenges in and ideas for diagnosing primary immunodeficiencies in Uganda
Purpose of review Primary immunodeficiencies (PIDs) lately referred to as inborn errors of immunity, are consequences of mutations that affect the immune integrity and function. Globally, severe PIDs are more common in infants and are fatal if not timely – appropriately diagnosed and managed. PID programmes and policies vary from country to country. The purpose of this review is to highlight PIDs initiatives and activities in Uganda with a focus on challenges and ideas for diagnosis. Recent findings It is now established that appropriate PID diagnosis leads to best treatment options for quality of life for the...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research

Navigating diagnostic options for inborn errors of immunity in children: a case-based illustration
Purpose of review In recent years, there has been a dramatic increase in the number of recognized inborn errors of immunity (IEI), many of which present in childhood. This review discusses diagnostic approaches for some of the more common presentations of IEI in childhood. Recent findings Implementation of newborn screening (NBS) using the T cell receptor excision circle (TREC) assay has led to the timely identification of patients with severe combined immunodeficiency (SCID) as well as both syndromic and nonsyndromic forms of T cell lymphopenia, including DiGeorge syndrome. Improvements in the availability of i...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research

A great disturbance in the force: IL-2 receptor defects disrupt immune homeostasis
Purpose of review The current review highlights how inborn errors of immunity (IEI) due to IL-2 receptor (IL-2R) subunit defects may result in children presenting with a wide variety of infectious and inflammatory presentations beyond typical X-linked severe combined immune deficiency (X-SCID) associated with IL-2Rγ. Recent findings Newborn screening has made diagnosis of typical SCID presenting with severe infections less common. Instead, infants are typically diagnosed in the first days of life when they appear healthy. Although earlier diagnosis has improved clinical outcomes for X-SCID, atypical SCID or oth...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research

Wingless/integrase-1 signaling in allergic asthma and pediatric lung diseases
Purpose of review To provide an update on the current understanding of the role of wingless/integrase-1 (Wnt) signaling in pediatric allergic asthma and other pediatric lung diseases. Recent findings The Wnt signaling pathway is critical for normal lung development. Genetic and epigenetic human studies indicate a link between Wnt signaling and the development and severity of asthma in children. Mechanistic studies using animal models of allergic asthma demonstrate a key role for Wnt signaling in allergic airway inflammation and remodeling. More recently, data on bronchopulmonary dysplasia (BPD) pathogenesis poin...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research

An update on teratogens for pediatric healthcare providers
Purpose of review To review updates regarding teratogens and give pediatric healthcare providers insight into the prevention of teratogenic exposures. Recent findings Application of the principles of teratology can help to assess the potential for exposures to be teratogenic. Identification of Zika virus as a teratogen, the most recent teratogenic agent identified, allowed public health measures to be put in place to mitigate its spread. Risk management strategies for teratogenic medications have resulted in a decrease but often not elimination of prenatal exposures. The failure to include pregnant persons in cl...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: GENETICS: Edited by Nathaniel H. Robin Source Type: research

Advancements in therapeutics for inborn errors of metabolism
Purpose of review To present new therapeutic modalities for inborn errors of metabolism that are in clinical trials or recently approved by the US Food and Drug Administration (FDA) and to improve pediatricians’ understanding of therapies their patients with inborn errors of metabolism receive. Recent findings New therapies that move beyond the old standard modalities of recombinant human enzyme therapies, diet and medications have been recently approved by the US FDA to include nonhuman enzyme therapies, gene therapy and chaperone therapies. Summary These new therapies offer more therapeutic options fo...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: GENETICS: Edited by Nathaniel H. Robin Source Type: research

Prenatal genetic testing 2: diagnostic tests
Purpose of review Prenatal genetic testing can be divided into two categories: screening and diagnosis. Prenatal genetic screening tests are used to assess carrier status or as a fetal risk assessment for a particular genetic disorder [1]. Prenatal genetic diagnostic testing is used to diagnose particular genetic conditions with as much certainty as possible [1,2]. This review will focus on the diagnostic side of prenatal genetic testing. Recent findings Next generation sequencing (NGS) has revolutionized prenatal genetic diagnostic testing. NGS methods are becoming more advanced and accurate as more genetic inf...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: GENETICS: Edited by Nathaniel H. Robin Source Type: research

Prenatal genetic testing 1: screening tests
This article will focus on reviewing prenatal genetic screening tests. Recent findings Cell-free DNA (cfDNA) is a new prenatal genetic screening test with a high degree of accuracy for identifying certain genetic conditions like trisomy 21, 18, and 13. However, cfDNA has also been applied in the screening of other genetic conditions without similar research support. Summary Prenatal genetic screening evaluates at risk pregnancies - including both carrier screening, which can be done at any point in a person's life, and aneuploidy screening, which is done during pregnancy. Within screening, there is a new noni...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: GENETICS: Edited by Nathaniel H. Robin Source Type: research

Updates on the diagnostic evaluation, genotype–phenotype correlation, and treatments of genetic epilepsies
This article reviews the latest publications in genetic epilepsies, with an eye on publications that have had a translational impact. This review is both timely and relevant as translational discoveries in genetic epilepsies are becoming so frequent that it is difficult for the general pediatrician and even the general child neurologist to keep up. Recent findings We divide these publications from 2021 and 2022 into three categories: diagnostic testing, genotype–phenotype correlation, and therapies. We also summarize ongoing and upcoming clinical trials. Summary Two meta-analyses and systematic reviews sugg...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: GENETICS: Edited by Nathaniel H. Robin Source Type: research

Genetic testing for psychiatric illness in children: ethical issues
Purpose of review Genetic and genomic technologies are showing great potential in the field of psychiatry. Genetic testing for psychiatric conditions poses a range of ethical challenges, many of which are likely to be exacerbated for paediatric populations. As a large proportion of psychiatric conditions present in late adolescence and early adulthood, testing in childhood may be considered in some circumstances. Synthesis of issues specific to psychiatric genetic testing in paediatric populations has been limited. Recent findings Balancing the autonomy of the child and parents requires consideration and judging...
Source: Current Opinion in Pediatrics - November 7, 2022 Category: Pediatrics Tags: GENETICS: Edited by Nathaniel H. Robin Source Type: research