Coronavirus disease 2019 in patients with inborn errors of immunity: lessons learned
Purpose of review
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused extreme concern for patients with inborn errors of immunity (IEIs). In the first 6 months of the pandemic, the case fatality rate among patients with IEIs resembled that of the general population (9%). This review aims at summarizing what we have learned about the course and outcome of coronavirus disease 2019 (COVID-19) in patients with different IEIs and what this can potentially teach us about the immune mechanisms that could confer protection or predisposition to severe disease.
Recent findings
A total o...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research
The airway microbiome and pediatric asthma
Purpose of review
Asthma is the most common chronic disease of childhood. Investigations of the lower and upper airway microbiomes have significantly progressed over recent years, and their roles in pediatric asthma are becoming increasingly clear.
Recent findings
Early studies identified the existence of upper and lower airway microbiomes, including imbalances in both associated with pediatric asthma. The infant airway microbiome may offer predictive value for the development of asthma in later childhood, and it may also be influenced by external factors such as respiratory viral illness. The airway microbiome ...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research
Primary immunodeficiency and the microbiome
Purpose of review
The current understanding of the relationship of the microbiota to clinical manifestation in patients with primary immunodeficiency, specifically the inflammatory processes caused by or that result in microbial dysbiosis, and their potential therapeutic options in primary immunodeficiency diseases (PID), is the basis of this review.
Recent findings
PIDs are heterogeneous diseases with variable presentations, genetic backgrounds, complications, and severity. The immune-mediators may be extrinsic, such as therapeutic regimens that patients are on, including immunoglobin, biologics, antibiotics an...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research
B cells and food allergy
Purpose of review
B cells are known in food allergy pathogenesis for their production of IgE but their roles in the development of tolerance to foods are not well understood. Further understanding of B-cell biology in the context of food allergy is essential for the creation of effective prevention strategies and therapies.
Recent findings
The majority of allergen-specific IgE in humans appears to arise from antigen-experienced B cells that have already undergone class switch recombination to other antibody isotypes, such as IgG1, and can also be produced by cells class switching to IgE locally in the gastrointe...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research
The effect of coronavirus disease 2019 on newborns
Purpose of review
To evaluate the available literature regarding effects of coronavirus disease 2019 (COVID-19) on newborns, ranging from effects related to in utero and perinatal exposure to maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, to pandemic-related stress and socioeconomic changes.
Recent findings
Several large studies and national registries have shown that the risk of vertical transmission from SARS-CoV-2-infected mothers to newborns is rare and does not appear to be related to postnatal care policies such as mother–newborn separation and breastfeeding. Newborns ex...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research
COVID-19 mRNA vaccine allergy
Purpose of review
A known history of a severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine is the only contraindication to coronavirus disease 2019 (COVID-19) mRNA vaccination. It is important for pediatricians to understand the likelihood of an allergic reaction to COVID-19 mRNA vaccines, including its excipients.
Recent findings
Episodes concerning for anaphylaxis were immediately reported following early administration of COVID-19 mRNA vaccines to adults. Although allergic type symptoms were reported equally in recipients of placebos and test vaccines in phase 3 clinical trials, post-...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research
Learning about Kawasaki disease from COVID-19 and the Multisystem Inflammatory Syndrome in Children
Purpose of review
Multisystem Inflammatory Syndrome in Children (MIS-C) is a novel syndrome that has appeared in the wake of the severe acute respiratory syndrome coronavirus -2 pandemic, with features that overlap with Kawasaki disease (KD). As a result, new interest and focus have arisen in KD, and specifically mechanisms of the disease.
Recent findings
A major question in the literature on the nature of MIS-C is if, and how, it may be related to KD. This has been explored using component analysis type studies, as well as other unsupervised analysis, as well as direct comparisons. At present, the answer to thi...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: ALLERGY, IMMUNOLOGY AND RELATED DISORDERS: Edited by Jordan S. Orange Source Type: research
Neuropathogenesis of severe acute respiratory syndrome coronavirus 2
Purpose of review
The purpose of this review is to address our current understanding of the pathophysiology of neurologic injury resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection on the developing nervous system.
Recent findings
SARS-CoV2 may enter the brain through three potential mechanisms: transsynaptic spread from the olfactory bulb following intranasal exposure, migration across the blood–brain barrier through endothelial cell infection, and migration following disruption of the blood–brain barrier from resulting inflammation. SARS-CoV2 does not appear to directly inf...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: NEUROLOGY: Edited by Robert Tasker and Mark S. Wainwright Source Type: research
Acute central and peripheral nervous system injury associated with coronavirus disease 2019: recognition and treatment strategies
Purpose of review
Acute central and peripheral nervous system injury may occur in association with coronavirus disease 2019 (COVID-19) caused by infection with the severe acute respiratory syndrome coronavirus 2 virus. This review will assist readers to recognize neurologic manifestations associated with COVID-19 including common and life-threatening symptoms and diagnostic testing. We will also review current recommendations for treatment of neurologic injury associated with COVID-19 infection in children.
Recent findings
Data from systematic reviews and prospectively collected cohorts of children with COVID-19...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: NEUROLOGY: Edited by Robert Tasker and Mark S. Wainwright Source Type: research
Worldwide epidemiology of neuro-coronavirus disease in children: lessons for the next pandemic
Purpose of review
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has overwhelmed the global community, negatively impacting patient health and research efforts; associated neurological manifestations are a significant cause of morbidity. This review outlines the worldwide epidemiology of neurologic manifestations of different SARS-CoV-2 clinical pediatric phenotypes, including acute coronavirus disease 2019 (COVID-19), multisystem inflammatory syndrome in children (MIS-C) and postacute sequelae of COVID-19 (PASC). We discuss strategies to develop adaptive global research platforms for future ...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: NEUROLOGY: Edited by Robert Tasker and Mark S. Wainwright Source Type: research
Editorial: The path to resilience and recovery: understanding the epidemiology, neuropathology and treatment of neurologic injury due to the SARS-CoV-2 virus in children
No abstract available (Source: Current Opinion in Pediatrics)
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: NEUROLOGY: Edited by Robert Tasker and Mark S. Wainwright Source Type: research
Fetal alcohol spectrum disorders: current state of diagnosis and treatment
Purpose of review
The purpose of this review is to describe recent findings on the clinical presentation, pathogenesis, and management of fetal alcohol spectrum disorders (FASDs). Alcohol causes a range of physical, developmental, and cognitive impairments on the developing fetus. Individuals exposed to alcohol prenatally have a wide variability in dysmorphic and neurologic features. Hence, a greater understanding of the mechanisms through which alcohol induces defects in the developing fetus is imperative in developing therapies that prevent alcohol-induced effects.
Recent findings
Current research has focused ...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: GENETICS: Edited by Nathaniel H. Robin Source Type: research
Pharmacogenomics insights into precision pediatric oncology
Purpose of review
Pharmacogenomic insights provide an opportunity to optimize medication dosing regimens and patient outcomes. However, the potential for interindividual genomic variability to guide medication dosing and toxicity monitoring is not yet standard of care. In this review, we present advances for the thiopurines, anthracyclines and vincristine and provide perspectives on the actionability of pharmacogenomic guidance in the future.
Recent findings
The current guideline on thiopurines recommends that those with normal predicted thiopurine methyltransferase and NUDT15 expression receive standard-of-care...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: GENETICS: Edited by Nathaniel H. Robin Source Type: research
Genetics of human sexual development and related disorders
Purpose of review
The aim of this study was to provide a basic overview on human sex development with a focus on involved genes and pathways, and also to discuss recent advances in the molecular diagnostic approaches applied to clinical workup of individuals with a difference/disorder of sex development (DSD).
Recent findings
Rapid developments in genetic technologies and bioinformatics analyses have helped to identify novel genes and genomic pathways associated with sex development, and have improved diagnostic algorithms to integrate clinical, hormonal and genetic data. Recently, massive parallel sequencing ap...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: GENETICS: Edited by Nathaniel H. Robin Source Type: research
Host genetics of pediatric SARS-CoV-2 COVID-19 and multisystem inflammatory syndrome in children
Purpose of review
This review is meant to describe the genetic associations with pediatric severe COVID-19 pneumonia and the postinfectious complication of the multisystem inflammatory syndrome in children (MIS-C). Multiple genetic approaches have been carried out, primarily in adults with extrapolation to children, including genome-wide association studies (GWAS), whole exome and whole genome sequencing (WES/WGS), and target gene analyses.
Recent findings
Data from adults with severe COVID-19 have identified genomic regions (human leukocyte antigen locus and 3p21.31) as potential risk factors. Genes related to ...
Source: Current Opinion in Pediatrics - November 10, 2021 Category: Pediatrics Tags: GENETICS: Edited by Nathaniel H. Robin Source Type: research
