Pediatric Pulmonology最新文献

{"title":"Identifying Gaps and Disparities in Screening for Cystic Fibrosis Associated Liver Disease: Insights From a CF Center Analysis.","authors":"Alaa Abdelghani, Addison Cuneo, Elizabeth Gibb, Emily R Perito","doi":"10.1002/ppul.71097","DOIUrl":"https://doi.org/10.1002/ppul.71097","url":null,"abstract":"<p><strong>Background: </strong>New 2023 CF liver disease (CFLD) guidelines advocate for additional screening in people with cystic fibrosis (PwCF), including biennial abdominal ultrasound. As a first step towards effective and equitable guidelines implementation, we examined our current practice of CFLD screening and hepatobiliary involvement (HBI) evaluation. We identified characteristics of PwCF at-risk for incomplete screening and factors affecting evaluation.</p><p><strong>Methods: </strong>We retrospectively reviewed medical records of PwCF aged 0-21 years, with native liver and ≥ 2 outpatient CF clinic visits 2017-2023. Logistic regression was used to identify characteristics associated with incomplete screening and with HBI.</p><p><strong>Results: </strong>Amongst 112 PwCF at our center: 37% (n = 42) self-reported as mixed race, 27% (n = 30) as Hispanic; 53% (n = 59) had public insurance. Incomplete lab screening was identified in 19% of our cohort. GGT was the most frequently missed component (14%, n = 16). Hispanics and publicly insured people were more likely to have incomplete screening. Of the 112, 45 met criteria for HBI. Demographics did not predict HBI. Five with CF and HBI had the full hepatitis workup recommended by the new guidelines. Those with HBI documented (42%, n = 19) were more likely to receive additional workup. PwCF who were seen by a gastroenterologist were more likely to have additional diagnostic work-up for HBI.</p><p><strong>Conclusion: </strong>One in five PwCF at our center were incompletely screened for CFLD, with Hispanics and publicly insured at higher risk. Accurate diagnosis and adequate documentation are the first steps to identifying HBI in PwCF. A dedicated CF gastroenterologist is key to completing CFLD screening and liver diagnosis.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 4","pages":"e71097"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of Composite Autonomic Symptom Score (COMPASS)-31 in Congenital Central Hypoventilation Syndrome.","authors":"Benjamin Dudoignon, Plamen Bokov, Fatima Benterki, Nathalie Couque, Casey M Rand, Debra E Weese-Mayer, Christophe Delclaux","doi":"10.1002/ppul.71072","DOIUrl":"10.1002/ppul.71072","url":null,"abstract":"<p><strong>Rationale: </strong>Congenital central hypoventilation syndrome (CCHS) is a rare disorder characterized by alveolar hypoventilation and variable autonomic nervous system (ANS) dysfunction (ANSD) due to mutations in PHOX2B, a gene crucial for ANS neural crest lineage differentiation.</p><p><strong>Objectives and methods: </strong>Our prospective study aims were twofold: to (1) assess the relationships between the subjective Composite Autonomic Symptom Score (COMPASS)-31 and objective indices of ANSD obtained from heart rate variability analyses, ambulatory blood pressure (BP) monitoring, and CO₂ chemosensitivities and (2) describe the organ system ANSD, its relationship to PHOX2B genotype, and its consequences on quality of life (PedsQL) in children with CCHS.</p><p><strong>Results: </strong>Thirty-two PHOX2B mutation-confirmed subjects (median [range] age 9.2 years (4.4; 18.0), 15 girls) were enrolled. COMPASS-31 was assessed in 32 matched (sex and age, range: 4.3; 18.9 years) healthy controls. As compared to healthy controls, children with CCHS had increased vasomotor (p = 0.001), secretomotor (p = 0.021), gastrointestinal (p = 0.002) and pupillomotor (p = 0.028) scores and decreased orthostatic intolerance scores (p = 0.050). There was no difference in overall COMPASS-31 score between CCHS and controls (p = 0.083). However, in CCHS, overall COMPASS-31 scores correlated with high frequencies (HF) normalized (cardiac parasympathetic modulation: R = -0.53; p = 0.002), low frequencies (LF)/HF ratio (R = 0.56; p< 0.001), and both systolic and diastolic nighttime BP dipping (R = 0.45, p = 0.012 and R = 0.40, p = 0.028, respectively). No significant relationships between COMPASS-31 scores and chemosensitivity testing, PedsQL scores, or PHOX2B genotype were identified.</p><p><strong>Conclusions: </strong>COMPASS-31 identified some aspects of CCHS-related ANSD, and scores correlate with objective ANS function measures, supporting the potential utility of COMPASS-31 in CCHS.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 4","pages":"e71072"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an Exercise Intervention on Exercise Capacity in Adults With Cystic Fibrosis: A Quasi-Experimental Study Comparing Individuals Treated With and Without Elexacaftor/Tezacaftor/Ivacaftor.","authors":"Wolfgang Gruber, Jana Koop, Franziska A Haegele, Christian Falkenberg, Strefan Dewey, Burkhard Weisser, Anja Bosy-Westphal","doi":"10.1002/ppul.71076","DOIUrl":"10.1002/ppul.71076","url":null,"abstract":"<p><strong>Background: </strong>The effects of CFTR modulators, particularly elexacaftor/tezacaftor/ivacaftor (ETI), on exercise capacity in people with cystic fibrosis (pwCF) remain unclear, with no data available on their impact within the context of an exercise intervention. Therefore, this study aimed to assess the effects of an exercise intervention on exercise capacity in adults with CF, comparing those treated with and without ETI.</p><p><strong>Methods: </strong>A total of 56 adult pwCF participated in this quasi-experimental study as part of a rehabilitation program, which included a 3.5-week exercise intervention. The program involved five weekly 45-min sessions, including endurance training on a cycle ergometer. VO₂ _peak and W_peak were the primary outcomes used to assess changes in exercise capacity.</p><p><strong>Results: </strong>The intervention significantly increased VO₂ _peak and W_peak in all pwCF, regardless of ETI use, with similar improvements between groups. PwCF with lower baseline fitness (VO₂ _peak ≤ 81%pred) showed greater improvements than those with higher fitness (VO₂ _peak ≥ 82%pred). ppFEV1 remained unchanged, while BMI increased in both groups. Notably, the ETI group spent significantly more time in physical activity (PA) at hard and very hard intensities compared to the non-ETI group. Additionally, a positive correlation was observed between PA intensity and VO₂ _peak and W_peak in the ETI group.</p><p><strong>Conclusion: </strong>Independent of ETI treatment, adult pwCF improve their exercise capacity by participating in a regular exercise program. ETI treatment appears to enhance time spent in higher PA intensities. Despite the effectiveness of CFTR modulators, regular PA and exercise remain essential to maintain and improve exercise capacity in pwCF.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 4","pages":"e71076"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754091","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":"Changes in Respiratory Patterns From Pressure Control Ventilation to Neurally Adjusted Ventilatory Assist Assessed by Electrical Impedance Tomography.","authors":"Marika Rahtu, Inéz Frerichs, Tobias H Becher, Tytti Pokka, Andreas D Waldmann, Thalia Papadouri, Anton H van Kaam, Peter C Rimensberger, Richard Bayford, Outi Peltoniemi, Merja Kallio","doi":"10.1002/ppul.71077","DOIUrl":"10.1002/ppul.71077","url":null,"abstract":"<p><strong>Introduction: </strong>Neurally Adjusted Ventilatory Assist (NAVA) is increasingly used as ventilatory support for preterm infants. Changes in ventilation distribution and respiratory patterns during the transition from patient-triggered time-cycled Pressure Controlled Ventilation (PCV) to NAVA have not yet been studied. This study aimed to evaluate the impact of ventilation mode (PCV and NAVA, respectively) on ventilation distribution and breathing patterns in preterm infants with Electrical Impedance Tomography.</p><p><strong>Methods: </strong>This study included 16 premature infants at Oulu University Hospital who participated in the observational CRADL project and were on NAVA. EIT data was retrospectively assessed by choosing a 1-min stable recording before and after the change from one to the other mode. The primary endpoint was changes in global and regional ventilation parameters (ΔZ), and the secondary endpoints were Centers of Ventilation (CoVs), the amount of silent spaces, and the duration of inspiratory and respiratory cycle times.</p><p><strong>Results: </strong>A larger variation in the global tidal impedance variation (p < 0.05) and the respiratory cycle time (p < 0.05) was observed on NAVA than on PCV. Sighs, which were determined as a breath impedance change twice the size of an average breath on PCV, were more frequent during NAVA than PCV (5.1% vs 0.8%, respectively). Mean global or regional impedance variations or silent spaces did not differ between PCV and NAVA.</p><p><strong>Conclusion: </strong>NAVA allowed more variable breathing patterns during invasive respiratory support than patient-triggered PCV. However, variability in the respiratory cycle did not lead to systematic changes in ventilation distribution or silent spaces.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 4","pages":"e71077"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764603","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":"Oscillometry Phenotypes in Children With Down Syndrome.","authors":"Katharine L Hamlington, Emily H Cooper, Kristine Wolter-Warmerdam, Monica L Vielkind, John T Brinton, Allison Keck, Rawan J Bresselsmith, Jennifer Maybee, Arwen Jackson, Francis Hickey, Emily M DeBoer","doi":"10.1002/ppul.71069","DOIUrl":"10.1002/ppul.71069","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate lung function patterns measured by oscillometry in children with Down syndrome and determine associations with pulmonary diagnoses that may co-occur with Down syndrome, including evidence of dysphagia, obstructive sleep apnea, tracheomalacia, and congenital heart disease.</p><p><strong>Study design and patients: </strong>Cross-sectional study of children with Down syndrome who were enrolled during 2019-2022 at ages 4-18 years old.</p><p><strong>Measurements: </strong>Children performed oscillometry before and after albuterol administration to obtain respiratory impedance measures of resistance (R) and reactance (X). Aspiration from swallow study, obstructive sleep apnea from polysomnogram, tracheomalacia from flexible bronchoscopy, and congenital heart disease diagnoses were obtained from the electronic medical record.</p><p><strong>Results: </strong>In 50 children with Down syndrome, more negative X (median X5 z-score -0.93 [IQR - 2.15, 0.17]) was observed compared to a z-score of zero representing the mean in a pediatric reference population, but R was not increased at any frequency. Neither R nor X were related to tested pulmonary co-occurring diagnoses. Frequency dependence of resistance (R5-19) was elevated (median z-score 0.50 [IQR - 0.01, 1.14]), which, in combination with the more negative X, could indicate heterogeneity in peripheral and/or central airway sizes. After bronchodilator, R5 and AX decreased -26% [IQR -32%, -12%] and -43% [IQR -58%, -28%], respectively, and X5 increased 31% [IQR 12%, 45%], indicating physiological improvement.</p><p><strong>Conclusions: </strong>In our population, a phenotype of lower lung compliance in 50% of children with Down syndrome was not associated with the presence of co-occurring pulmonary diagnoses. More work is needed to understand if this may be related to their diagnosis of DS.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 4","pages":"e71069"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731219","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":"School-Based Health Providers' Approaches to Social Risk Screening for Pediatric Asthma: A Qualitative Study.","authors":"Vera Borkowski, Mariann R Piano, Erin D Maughan, Stacy Curry-Johnson, Alvin D Jeffery","doi":"10.1002/ppul.71105","DOIUrl":"https://doi.org/10.1002/ppul.71105","url":null,"abstract":"<p><strong>Background: </strong>Asthma has a high prevalence among children and is associated with negative outcomes and extreme costs. Asthma exacerbations, often preventable, have been associated with social determinants of health and social risk factors. It is unclear whether school-based health providers consider social information for asthma, possibly related to a lack of knowledge or data availability.</p><p><strong>Objective: </strong>Describe the information-gathering behaviors and approaches for social risk screening for patients with asthma exacerbations performed by school-based health center providers.</p><p><strong>Methods: </strong>We conducted a qualitative descriptive study with a purposive sample of school-based health center medical providers. We conducted four focus group sessions (total participants = 16 nurse practitioners) and employed thematic analysis to generate themes.</p><p><strong>Results: </strong>We identified four major themes: (1) Information-gathering tactics, (2) diligence, (3) challenges accessing and assessing social determinants of health information, and (4) uncertainty. Major findings include: (1) There is a variety of information-gathering tactics used; (2) there are missed opportunities for social risk screenings in schools; (3) social risk screening is feasibly challenging; and (4) there is continued need for resources and increased awareness of screening.</p><p><strong>Conclusion: </strong>This study highlights the lived experiences of school-based health center providers in gathering information about social determinants of health and social risk factors. Challenges limit the ability to provide effective screening and referral to resources, particularly for school-age children with asthma. Our findings can be used for further research and development of informatics resources to promote effective social risk screening in school-based health centers.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 4","pages":"e71105"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of the Asthma Clinical Score in the Evaluation of Acute Asthma in the Emergency Department.","authors":"Adjoa A Andoh, Annie Truelove, Sara Helwig, Matthew C Nash, Lisa Ulrich, Richard Shell, Julie C Leonard","doi":"10.1002/ppul.71084","DOIUrl":"https://doi.org/10.1002/ppul.71084","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this study was to examine the performance of the Asthma Clinical Score (ACS) relative to the Pediatric Respiratory Assessment Measure (PRAM). Our secondary objectives were to determine interrater reliability, discriminative validity, responsiveness, and predictive validity of the ACS and PRAM.</p><p><strong>Methods: </strong>This was a single-site prospective observational study of children ages 2 to < 18 years presenting to the emergency department (ED) for asthma exacerbations. Clinicians completed paired assessments using ACS and PRAM at three time points of each patients ED stay. Construct validity correlating the performance of the ACS to PRAM, and interrater reliability were analyzed using Spearmen's rank correlation coefficients and Cohen's kappa coefficient, respectively. Cohen's d was calculated to compare the scores of patients who received certain treatments to patients who did not. Reliable change index (RCI) was used to determine the responsiveness of each score. Predictive validity for hospitalization was analyzed using Area Under the Receiver Operating Characteristic curve (AUROCc) and Akaike Information Criterion (AIC).</p><p><strong>Results: </strong>399 children were enrolled with 338 paired clinician observations. The ACS and PRAM scores were strongly correlated at all time points (n = 1383, <math> <semantics> <mrow><mrow><mi>ρ</mi></mrow> </mrow> <annotation>$rho $</annotation></semantics> </math>  = 0.874). Both the ACS and PRAM showed moderate interrater reliability at all time points (n = 338, κ_w = 0.77 and κ_w = 0.69, respectively). Patients receiving albuterol nebulization or adjunctive medications had higher average ACS and PRAM scores. ACS showed a better ability to detect responsiveness than the PRAM (31% vs 15% respectively). The pretreatment ACS showed comparable predictive validity to the PRAM.</p><p><strong>Conclusion: </strong>The ACS was highly correlated with PRAM and is a reliable score in this cohort. The ACS showed good discriminative validity, predictive validity and responsiveness. This study supports the ACS as a useful tool in ED assessment of asthma exacerbation severity in children.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 4","pages":"e71084"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 in Children With Severe Lung Disease-A Tertiary Center Cohort Study in Denmark.","authors":"Esben Lægsgaard, Signe Bødker Thim, Mette Holm, Sune Rubak","doi":"10.1002/ppul.71094","DOIUrl":"https://doi.org/10.1002/ppul.71094","url":null,"abstract":"<p><strong>Background: </strong>Severe lung disease such as chronic pulmonary disease (CPD), severe asthma and cystic fibrosis (CF) in children is associated with increased risk of severe COVID-19. Information regarding SARS-CoV-2 infection, disease severity and outcome of COVID-19 is limited in this pediatric population.</p><p><strong>Objectives: </strong>We captured the number of SARS-CoV-2 infected children and evaluated COVID-19 disease severity in non-immunized children with CPD, asthma, and CF in a cohort at a Danish tertiary center.</p><p><strong>Methods: </strong>The number of children with PCR-verified SARS-CoV-2 infection in the cohort and in the age-related background population was identified through the Danish Microbiology Database. Clinical data were retrieved from the electronic medical health records and from the Danish Health Authority.</p><p><strong>Results: </strong>In a cohort of 664 children with severe lung disease 594 were either PCR-tested or had an antibody test for SARS-CoV-2 infection due to symptoms or exposure and 18 (3%) had verified SARS-CoV-2 infection. The total number of verified SARS-CoV-2 infection was at that time 34.575(4.342%) thus, not significantly different from the reference population (p = 0.152). The symptoms ranged from asymptomatic to mild symptoms, and none of the children with severe lung disease required hospitalization due to COVID-19. None of the children were treated with antiviral treatment during the acute infection.</p><p><strong>Conclusion: </strong>Of the 664 children in the Danish cohort with severe lung disease, none were hospitalized with COVID-19. Our findings imply that this particular group of patients do not experience increased risk of severe COVID-19.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 4","pages":"e71094"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Chronic Pulmonary Aspiration Is Associated With Low Molecular Weight Hyaluronic Acid in the Bronchoalveolar Lavage.","authors":"Ammar Saadoon Alishlash, Zhihong Yu, Ahmed Lazrak, Ryne Simpson, Guillermo Beltran Ale, William T Harris, Sadis Matalon","doi":"10.1002/ppul.71070","DOIUrl":"10.1002/ppul.71070","url":null,"abstract":"<p><strong>Objectives: </strong>Low molecular-weight hyaluronic acid (LMW-HA) is produced by the degradation of high-molecular-weight hyaluronic acid at the pulmonary interstitium and alveolar epithelium by reactive intermediates following lung injury. We aimed to investigate the role of bronchoalveolar lavage (BAL) LMW-HA as a biomarker of pediatric chronic pulmonary aspiration (CPA).</p><p><strong>Methods: </strong>Single-center prospective comparison of LMW-HA presence in BAL in pediatric Aerodigestive patients with and without CPA undergoing clinically indicated bronchoscopy. Pediatric pulmonologists diagnosed CPA based on video-fluoroscopic swallowing evaluation.</p><p><strong>Results: </strong>Fifteen children (mean age 6.1 years, male predominance at 73%, and 53% with CPA) were enrolled. Children with CPA have comparable baseline characteristics (age, sex, and race), but their BAL had higher white blood cell count, higher neutrophil percentages, higher bacterial culture positivity rates, and lower macrophage percentages than those without CPA. The two groups were comparable in sex, BAL lymphocyte percentages, eosinophil percentages, red blood cell counts, and lipid-laden macrophage positivity. Detection of BAL LMW-HA in the BAL had a 100% specificity and 88% sensitivity for CPA diagnosis. BAL protein levels were higher in the CPA group and in participants with positive LMW-HA.</p><p><strong>Conclusions: </strong>We suggest BAL LMW-HA as a potential novel biomarker of pediatric CPA with high specificity and sensitivity. BAL LMW-HA is not detectable in subjects without CPA and is associated with increased BAL protein levels.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 4","pages":"e71070"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731220","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":"Local Versus Systemic Cytokine Dynamics in Pediatric Pneumonia.","authors":"Jilei Lin, Mingyu Tang, Shuhua Yuan, Jiande Chen, Guijun Yang, Huishan Zhang, Wanlin Li, Jing Zhang, Lei Zhang, Yong Yin","doi":"10.1002/ppul.71093","DOIUrl":"https://doi.org/10.1002/ppul.71093","url":null,"abstract":"<p><p>No significant correlation was observed between most local and systemic cytokines in children with pneumonia. The observed elevation of specific cytokines such as IL-2, IL-2R, and IL-4 in the BALF of pneumonia patients, alongside increases in IL-2, IL-6, and IL-12p70 in peripheral blood, underscores the robust local and systemic inflammatory response in pneumonia.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 4","pages":"e71093"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041994","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}