Pediatric Research最新文献

{"title":"Placental pathology is associated with lower quality fidgety movements in preterm infants.","authors":"Ana S Abrudan, Mirthe H Schoots, Elisabeth M W Kooi, Sanne J Gordijn, Karianne E Kraft, Jelmer R Prins, Annemiek M Roescher","doi":"10.1038/s41390-025-03905-5","DOIUrl":"10.1038/s41390-025-03905-5","url":null,"abstract":"<p><strong>Background: </strong>Preterm infants are at risk for neurodevelopmental disabilities later in life, like motor delays and cerebral palsy (CP). The placenta plays a critical role throughout pregnancy, particularly in preterm birth. Our aim is to explore the relation between placental lesions and accurate predictors of neurodevelopmental outcomes in preterm infants.</p><p><strong>Methods: </strong>Preterm infants (<30 weeks and/or birthweight <1000 g) were included with histopathological examination (according to Amsterdam criteria) of the placentas. We predicted the risk for future possible neurodevelopmental impairment using Prechtl's General Movement Assessment to evaluate fidgety movements (FM) at 3 months post-term. We also calculated the Motor Optimality Score-Revised (MOS-R).</p><p><strong>Results: </strong>In total 78 infants were included. The gestational age ranged from 24.1 to 32.6 weeks and birth weight was between 550 and 1950 g. The presence of AIUI (ascending intrauterine infection) was significantly associated with absent FMs (p = 0.034). Both the presence of fetal and maternal vascular malperfusion (FVM and MVM) were associated with a MOS-R < 23[OR4.58, 95% CI[1.35, 15.55], p = 0.015;OR2.55, 95% CI[1.02, 6.64], p = 0.045).</p><p><strong>Conclusion: </strong>AIUI is associated with a higher risk of absent FMs and therefore an increased risk for CP. FVM and MVM are significantly associated with MOS-R < 23, which is predictive of an elevated risk for adverse neurodevelopmental (non-CP) outcomes. This finding supports the hypothesis that impaired neurodevelopment in preterm infants already starts before birth.</p><p><strong>Impact: </strong>Our article underscores a key message: neurodevelopmental challenges in preterm infants originate prenatally. Our research has identified a significant association between certain placental lesions and a lower quality of fidgety movements, placing these preterm born infants at a high risk for adverse neurodevelopmental outcomes. To our knowledge, this is the first study to investigate the role of placental pathologies and risk of neurodevelopmental outcomes, while using general movements during the fidgety period. We advocate for neonatologists to integrate placental pathology assessments into their treatment strategies for newborns, recognizing its importance in enhancing care outcomes.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel biomarkers of fetal and neonatal environmental exposure, effect and susceptibility.","authors":"Eric S Peeples, Eleanor J Molloy, Cynthia F Bearer","doi":"10.1038/s41390-025-03816-5","DOIUrl":"https://doi.org/10.1038/s41390-025-03816-5","url":null,"abstract":"<p><p>Rapid advancements in science and technology have allowed medical providers to treat wider ranges of diseases with safer and more effective therapies than ever before. One of the areas of health that has been consistently understudied, however, is one that affects us all: environmental health or the effects that the chemicals we are exposed to every day have on our acute and chronic health. This effect can be exacerbated during and shortly after pregnancy, as an individual exposure is often shared by both the mother and the fetus/neonate. The diagnosis and monitoring of chemical exposure can be quite challenging, and improving our understanding of the effects of exposure will therefore require effective use of an expanding set of biomarker tests and biological matrices. This review covers the background and history of neonatal biomarkers of exposure, effect, and susceptibility, focusing on the potential uses for the non-invasive matrix of exhaled breath for the detection and monitoring of chemical exposures. IMPACT: Provides a brief overview of Food and Drug Administration and National Institutes of Health Joint Leadership Council BEST (Biomarkers, EndpointS, and other Tools) Resource. Summarizes new and potential biomarkers for fetal exposure. Collates studies using breath as a matrix for environmental exposures.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatiotemporal expression pattern of dyslexia susceptibility 1 candidate 1 (DYX1C1) during rat cerebral cortex development.","authors":"Kazumasa Zensho, Ikuko Miyazaki, Aika Isse, Ichika Misawa, Kaori Masai, Makio Oka, Hirokazu Tsukahara, Masato Asanuma","doi":"10.1038/s41390-025-03920-6","DOIUrl":"https://doi.org/10.1038/s41390-025-03920-6","url":null,"abstract":"<p><strong>Background: </strong>Developmental dyslexia (DD) is a common learning disorder with significant consequences for affected individuals. Although several candidate genes, including dyslexia susceptibility 1 candidate 1 (DYX1C1), have been implicated in dyslexia, their role in brain development remains unclear. We aimed to elucidate the spatiotemporal expression patterns of DYX1C1 during cerebral cortex development in rats.</p><p><strong>Methods: </strong>We investigated DYX1C1 expression during cerebral cortex development using rat embryos at various gestational stages (E13.5, 15.5, 17.5 and 20.5) by immunohistochemistry (n = 7 embryos/stage), quantitative real-time PCR (n = 6), and in situ hybridization (n = 11-15).</p><p><strong>Results: </strong>The DYX1C1-positive cells were predominantly located in the outermost layers of the cortical plate, particularly at E15.5. DYX1C1 mRNA expression peaked at E15.5 and subsequently declined. DYX1C1-positive cells did not co-localize with reelin-positive Cajal-Retzius cells, but co-localized with neuronal markers expressed during development, and had shorter primary cilia than DYX1C1-negative cells.</p><p><strong>Conclusions: </strong>Our findings highlight the dynamic expression of DYX1C1 in the developing cerebral cortex of rats, implicating its involvement in neurodevelopmental processes. Further investigation of the functional interactions of DYX1C1, particularly its relationship with reelin and its role in cerebrocortical and hippocampal development, may provide insights into the pathophysiology of dyslexia and neurodevelopmental disorders.</p><p><strong>Impact: </strong>Our study elucidates spatiotemporal expression patterns of endogenous DYX1C1 predominantly in the primitive cortical zone (PCZ), outermost layer of the cortical plate (CP) during cerebral cortex development, particularly peaked at E15.5. We revealed the spatial relationship between DYX1C1-positive and reelin-expressing Cajal-Retzius (CR) cells, and co-localize with neuronal markers expressed during cerebral cortex development, indicating its contribution to neuronal migration and cortical layer formation. DYX1C1-positive cells mainly in the PCZ possess shorter primary cilia than DYX1C1-negative cells, suggesting the completion of migration.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden of multidrug-resistant tuberculosis in children and adolescents.","authors":"Yanyan Zhong, Huiru Xie, Fucheng Cai, Miao Liu, Hui Gan, Zhuo Tang, Yan Bai","doi":"10.1038/s41390-025-03917-1","DOIUrl":"https://doi.org/10.1038/s41390-025-03917-1","url":null,"abstract":"<p><strong>Objectives: </strong>Multidrug-resistant tuberculosis (MDR-TB) has become a major global public health issue, which has worsened over time owing to changes in disease-related trends. This study aimed to determine global trends in MDR-TB among children and adolescents for strategic health planning.</p><p><strong>Methods: </strong>A secondary analysis was performed on MDR-TB burden among children and adolescents (<20 years) at the global, regional, and national levels based on sociodemographic index (SDI) quintiles from 1990 to 2019, using the Global Burden of Disease (GBD) 2019 database.</p><p><strong>Results: </strong>In 2019, 67,710.82 (95% uncertainty interval [UI]: 38,823.61 to 110,582.03) incidents of MDR-TB were reported among children and adolescents aged <20 years worldwide. The global incidence rate has increased from 1990 to 2019, with the estimated annual percentage change (EAPC) at 4.15% (95% UI: 1.10-12.19%), particularly in low- and low-middle SDI regions. The top three highest incidence rates were observed in Southern sub-Saharan Africa, Eastern Europe, and South Asia. The mortality and disability-adjusted life years (DALYs) rates (0.62 [95% UI: 0.28-1.14] and 55.19 [95% UI: 25.24-100.74] cases per 100,000, respectively) were higher among children aged <5 years than those in older age groups in 2019.</p><p><strong>Conclusion: </strong>The global burden of MDR-TB among children and adolescents has increased from 1990 to 2019, particularly in regions with lower SDI. Extensive collaborative research and interventions are needed to mitigate this disease burden to secure the health of our future generation.</p><p><strong>Impact: </strong>MDR-TB disease burden in children and adolescents using GBD 2019 database was analyzed. In total, 67710.82 MDR-TB cases were identified in children and adolescents in 2019. Global MDR-TB burden in children and adolescents has risen over the past 30 years. MDR-TB disease burden is negatively correlated with the sociodemographic index. MDR-TB disease burden varies across countries and age groups.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"An opportunity to help neonates and small infants to breath in low and middle-income countries\".","authors":"Manuel Sanchez Luna, Noelia González Pacheco","doi":"10.1038/s41390-025-03931-3","DOIUrl":"https://doi.org/10.1038/s41390-025-03931-3","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family reflections: decades of advancements in medical technology results in pioneering congenital heart defect patient thriving with life-long condition.","authors":"Eric P Ankerud","doi":"10.1038/s41390-025-03904-6","DOIUrl":"https://doi.org/10.1038/s41390-025-03904-6","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Somewhere, high in the sky. A tribute to a longstanding commitment to neonatal air transport.","authors":"Carlo Bellini","doi":"10.1038/s41390-025-03910-8","DOIUrl":"https://doi.org/10.1038/s41390-025-03910-8","url":null,"abstract":"","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased AGEs/sRAGE ratio and dyslipidemia risk in Down syndrome youths: a cross-sectional study.","authors":"Wendy P Gastélum Espinoza, Alma M Guadrón Llanos, Kenia K Esparza Ocampo, Jesús M Pérez Villareal, Verónica J Picos Cárdenas, Loranda Calderón Zamora, Marco A Valdés Flores, Alberto K De la Herrán Arita, Mayra Arias Gastélum, Javier A Magaña Gómez","doi":"10.1038/s41390-025-03912-6","DOIUrl":"https://doi.org/10.1038/s41390-025-03912-6","url":null,"abstract":"<p><strong>Background: </strong>Down syndrome (DS) is associated with a higher risk of diseases linked to advanced glycation end products (AGEs) accumulation.</p><p><strong>Objective: </strong>To evaluate serum AGEs and their soluble receptor (sRAGE) levels in children and adolescents with DS and explore associations with anthropometric and biochemical variables.</p><p><strong>Methods: </strong>A cross-sectional study compared 51 DS participants (ages 3-18) with an age-matched control group (n = 51). Anthropometric measurements, blood chemistry, and lipid profiles were assessed. AGEs and sRAGE concentrations were determined by fluorescence and ELISA, respectively.</p><p><strong>Results: </strong>DS individuals showed an unfavorable lipid profile, with higher triglycerides and lower HDL-C than controls. AGEs concentrations were significantly elevated in DS compared to controls (2.01 ± 0.48 vs. 1.33 ± 0.26 FAU/µg/mL; p < 0.001), while sRAGE levels were reduced (761.3 ± 433.7 vs. 1,196 ± 411.5 pg/mL; p < 0.001). The AGEs/sRAGE ratio was three times higher in the DS group than in controls (3.5 ± 1.9 vs. 1.2 ± 0.4; p < 0.001). Regression analysis identified HbA1c as a strong predictor of increased AGEs in both groups.</p><p><strong>Conclusion: </strong>Individuals with DS have an increased risk of dyslipidemia. Additionally, the elevated AGEs/sRAGE ratio associated with this genetic condition may reduce the protective effect of sRAGE against inflammatory processes.</p><p><strong>Impact statement: </strong>This is the first study to evaluate the AGEs/sRAGE ratio alongside biochemical and anthropometric markers in individuals with Down syndrome. DS individuals are at higher risk for dyslipidemia (elevated triglycerides, low HDL-C) and obesity, potentially linked to altered AGEs and sRAGE dynamics. Lower levels of sRAGE in DS may weaken its protective effects against tissue damage and inflammation caused by AGEs accumulation. HbA1c emerged as a strong predictor of AGEs, sRAGE, and the AGEs/sRAGE ratio in the DS cohort, highlighting the importance of monitoring glycemic control.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiota, inflammatory cytokines, and Kawasaki disease: a Mendelian randomization study and mediation analysis.","authors":"Ji-Gan Wang, Hui-Hong Dou, Qiong-You Liang","doi":"10.1038/s41390-025-03911-7","DOIUrl":"https://doi.org/10.1038/s41390-025-03911-7","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the causal relationship between gut microbiota, inflammatory cytokines, and Kawasaki disease (KD), and whether cytokines mediate the effect of gut microbiota on KD.</p><p><strong>Methods: </strong>A Mendelian randomization analysis using the inverse-variance weighted method assessed the causal effects of gut microbiota and inflammatory cytokines on KD and explored potential mediation.</p><p><strong>Results: </strong>The study found causal links between 20 types of gut microbiota and KD. Ten types increased KD risk, notably Francisellales (OR = 27.82, P = 0.0309). Ten types provided protection, with Fusobacteriaceae showing the strongest effect (OR = 0.0424, P = 0.002). Five inflammatory cytokines were significantly associated with KD; adenosine deaminase was most protective (OR = 0.7447, P = 0.0037), while Fractalkine indicated higher risk (OR = 2.0448, P = 0.0315). Mediation analysis revealed that the Interleukin-10 receptor subunit beta mediates the effect of Bifidobacterium adolescentis on KD, with a mediation effect of -0.0237 (4.75% ratio). Interleukin-20 mediates the effect of Faecalicatena lactaris on KD, with a mediation effect of -0.1168 (15.30% ratio).</p><p><strong>Conclusion: </strong>The findings indicate a causal relationship among gut microbiota, inflammatory cytokines, and KD, suggesting that the gut microbiome influences KD through specific cytokines.</p><p><strong>Impact: </strong>The study confirmed a causal relationship between 20 types of gut microbiota and Kawasaki disease, finding that 10 types increase the risk of Kawasaki disease, particularly Francisellales. Five inflammatory cytokines were significantly associated with Kawasaki disease, with adenosine deaminase showing a protective effect, while Fractalkine increased the risk. Mediation analysis indicated that specific inflammatory cytokines (such as Interleukin-10 receptor subunit beta and Interleukin-20) play a significant mediating role between gut microbiota and Kawasaki disease.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle physiology and the science of tone agents.","authors":"Joshua Vova","doi":"10.1038/s41390-025-03918-0","DOIUrl":"https://doi.org/10.1038/s41390-025-03918-0","url":null,"abstract":"<p><p>Cerebral Palsy (CP) encompasses a spectrum of permanent motor disorders stemming from early insults to the developing brain, resulting in alterations in muscle tone. While spasticity and dystonia are common motor disorders in CP, non-neural factors such as changes in muscle architecture contribute to muscle stiffness. Muscle stiffness in CP involves changes in muscle morphology and structure. Current treatments, such as botulinum toxin, have limitations, leading to exploration of alternative techniques like cryoneurolysis, hyaluronidase, and extracorporeal shockwave therapy. This brief review advocates for a comprehensive approach that considers both muscular and neurologic components of hypertonia, emphasizing the need for further research on cellular-level changes contributing to muscle stiffness. IMPACT: This review highlights the gap in current literature regarding the complex interplay between neural and non-neural factors in muscle stiffness and hypertonia in children with cerebral palsy (CP). While spasticity and dystonia are well studied, the review emphasizes the need for interventions addressing muscle morphology and extracellular matrix stiffness. It introduces emerging therapies like cryoneurolysis, hyaluronidase, and extracorporeal shockwave therapy, calling for more research on their long-term efficacy and safety.</p>","PeriodicalId":19829,"journal":{"name":"Pediatric Research","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}