Pediatric Gastroenterology, Hepatology & Nutrition最新文献

{"title":"Use of Noninvasive Biomarker Tests vs. FibroScan for Predicting Significant Fibrosis in Egyptian Pediatric Cancer Survivors with Chronic Hepatitis C Virus Infection.","authors":"Dalia N Toaima, Fatma A Marzouk, Alaa El-Haddad, Aisha Elsharkawy, Gamal E Esmat, Manal H El-Sayed","doi":"10.5223/pghn.2026.29.5.401","DOIUrl":"10.5223/pghn.2026.29.5.401","url":null,"abstract":"<p><p>Egyptian children undergoing chemotherapy are at high risk of hepatitis C virus (HCV) infection because of immunosuppression and multiple blood transfusions. This study evaluated liver fibrosis by comparing transient elastography with aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) in pediatric cancer survivors with chronic HCV infection. Fifty-one cancer survivors with chronic HCV infection (median age, 13.5 years) were prospectively recruited from the pediatric oncology and hepatology clinics at Ain Shams University and the National Cancer Institute. All participants underwent noninvasive fibrosis assessment using transient elastography, APRI, and FIB-4, as well as liver function testing, ultrasonography, and liver biopsy when necessary. Based on liver stiffness measurements, patients were classified into group 1 (fibrosis stage F0-F2; 80.4%) or group 2 (fibrosis stage F3-F4; 19.6%). Compared with group 1, group 2 had significantly higher serum bilirubin and alanine aminotransferase (ALT) levels, lower platelet counts, and higher APRI and FIB-4 scores (<i>p</i><0.05). Liver stiffness was positively correlated with APRI, FIB-4, chemotherapy duration, ALT, ALP, and ferritin (<i>p</i><0.05). The AUROCs of APRI and FIB-4 for predicting significant fibrosis (F3-F4) were 0.85 and 0.712, respectively. The cutoff values providing the best prediction of mild and severe fibrosis were 0.86 for APRI and 0.52 for FIB-4. APRI was more accurate than FIB-4 for detecting significant fibrosis. In conclusion, APRI and FIB-4 are useful noninvasive alternatives for assessing hepatic fibrosis in resource-limited countries, with APRI being preferable to FIB-4 for detecting significant fibrosis.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 5","pages":"401-412"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Acute Diarrhea in Children after Implementing the Thai Clinical Practice Guideline.","authors":"Sittichoke Prachuapthunyachart, Voranush Chongsrisawat, Siriluck Jennuvat, Thitima Ngoenmak, Alisara Damrongmanee, Phisek Yimyaem, Busara Charoenwat, Hansa Sriphongphankul, Punnapatch Piriyanon, Nopaorn Phavichitr","doi":"10.5223/pghn.2026.29.5.390","DOIUrl":"10.5223/pghn.2026.29.5.390","url":null,"abstract":"<p><strong>Purpose: </strong>Acute diarrhea in children is a common clinical problem, although practice management can vary. This study evaluates the practice of pediatricians in the management of acute diarrhea in children after implementing the 2019 Thai Clinical Practice Guideline.</p><p><strong>Methods: </strong>Online questionnaires were sent to Thai pediatricians (general pediatricians or other pediatric subspecialists [GPs] and pediatric gastroenterologists [PGs]) from November 2022 to April 2023. This online survey collected anonymous demographic data and practice-related data.</p><p><strong>Results: </strong>A total of 210 pediatricians (179 GPs and 31 PGs) participated in the survey. PGs administered intravenous fluids less often than GPs (adjusted odds ratio [aOR], 0.12; 95% confidence interval [CI], 0.04-0.38; <i>p</i><0.001) but added potassium after patients began to urinate more than GPs (aOR, 4.76; 95% CI, 1.85-12.27; <i>p</i><0.001). PGs preferred to use reduced-osmolality oral rehydration salts (ORS) more than GPs (aOR, 9.81; 95% CI, 2.63-36.60; <i>p</i><0.001). Both GPs and PGs agreed to continue breastfeeding (88.1%). However, fewer PGs recommended switching to lactose-free formula for formula-fed patients (aOR, 0.36; 95% CI, 0.14-0.92; <i>p</i>=0.04). PGs were more likely to have experiences using adjunctive therapy, such as racecadotril and diosmectite (aOR, 7.86; 95% CI, 1.69-36.52; <i>p</i>=0.009 and aOR, 15.42; 95% CI, 2.90-33.63; <i>p</i><0.001, consecutively). Domperidone was mostly used for patients with the first vomiting episode (52.4%).</p><p><strong>Conclusion: </strong>This survey provides insight into the practices of Thai pediatricians for the management of acute diarrhea in children. Variations in the use of oral antibiotics, antiemetics, adjunctive drugs, electrolyte supplementation, and feeding were observed, which may not align with the guideline.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 5","pages":"390-400"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sheffield Scoring System: An 8-Year Descriptive Cohort Analysis of a Tool for Predicting the Need for Endoscopic Hemostatic Intervention in Pediatric Patients with Upper Gastrointestinal Bleeding at a Tertiary Hospital in Khon Kaen, Thailand.","authors":"Busara Charoenwat, Sumitr Sutra, Kaewjai Thepsuthammarat, Mike A Thomson","doi":"10.5223/pghn.2026.29.5.381","DOIUrl":"10.5223/pghn.2026.29.5.381","url":null,"abstract":"<p><strong>Purpose: </strong>Upper gastrointestinal bleeding (UGIB) is life-threatening, and the gold standard for diagnosis and treatment is endoscopy, which is relatively invasive. Our purpose was to predict the need for endoscopy among children with UGIB using the Sheffield scoring system, characterize clinical and endoscopic findings among children with UGIB, and determine the predictive value of the Sheffield scoring system for endotherapeutic intervention.</p><p><strong>Methods: </strong>This descriptive cohort study included 28 children aged 0-18 years who presented with UGIB between 2017 and 2024 and were assessed using the Sheffield scoring system. Clinical and endoscopic data were analyzed.</p><p><strong>Results: </strong>Among the 28 children, 21 (75.0%) and 7 (25.0%) respectively scored >8 (group 1) and <8 (group 2) in the Sheffield system. Endoscopic hemostasis was required for 22 (78.6%) patients, of whom 95.5% were in group 1. One child in Group 2 who underwent endoscopy had a vascular malformation with prior bleeding. The most prevalent underlying disease was portal hypertension (85.7%). The most significant endoscopic finding was esophageal varices (71.4%). The positive and negative predictive values were respectively 100.0% (95% confidence interval [CI], 83.9-100.0%) and 85.7% (95% CI, 42.1-99.6%). The sensitivity and specificity were respectively, 95.5% (95% CI, 77.2-99.9%) and 100.0% (95% CI, 54.1-100.0%).</p><p><strong>Conclusion: </strong>The Sheffield scoring system might be a useful tool for predicting the need for endoscopic hemostasis among children with UGIB. However, larger prospective studies are required for validation.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 5","pages":"381-389"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Impact of the COVID-19 Pandemic on the Clinical Presentation of Pediatric Celiac Disease.","authors":"Edibe Gozde Basaran, Coskun Firat Ozkececi, Melike Arslan, Yasin Maruf Ergen, Necati Balamtekin","doi":"10.5223/pghn.2026.29.5.351","DOIUrl":"10.5223/pghn.2026.29.5.351","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of the coronavirus disease (COVID-19) pandemic on the clinical presentation, serological load, and duodenal histopathological damage in pediatric celiac disease (CD) patients compared to the pre-pandemic period.</p><p><strong>Methods: </strong>This retrospective cohort study included 114 pediatric patients with biopsy-confirmed CD diagnosed between June 2017 and November 2021. The study population was divided into a Pandemic Group (n=57) and a Pre-Pandemic Control Group (n=57). To ensure histopathological comparability, patients diagnosed without biopsy due to high antibody titers were excluded. Demographic data, clinical symptoms, anti-tissue transglutaminase antibody (anti-tTG) IgA/IgG titers, and Modified Marsh scores were analyzed.</p><p><strong>Results: </strong>The median age at diagnosis was significantly higher in the Pandemic Group compared to the Pre-Pandemic Group (<i>p</i>=0.004). Regarding serology, the proportion of patients with anti-tTG IgA levels ≥10 times the upper limit of normal (ULN) was significantly elevated in the Pandemic Group (75.4%) compared to the controls (47.4%) (<i>p</i>=0.011). A significant difference was also noted in anti-tTG IgG levels (<i>p</i>=0.032). However, no statistically significant differences were observed between the periods regarding clinical presentation phenotypes (<i>p</i>=0.084) or the severity of duodenal mucosal damage based on Modified Marsh scores (<i>p</i>=0.076).</p><p><strong>Conclusion: </strong>The COVID-19 pandemic resulted in a significant delay in diagnosis age and an increased serological load in pediatric CD cases. However, this increased load did not correspond to a significant worsening in duodenal mucosal damage. These results underscore the critical importance of maintaining diagnostic pathways for chronic conditions during health crises.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 5","pages":"351-358"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Insights into the Composition of the Early-Life Gut Microbiome: A Metagenomic Analysis of Fecal Samples in Children Up to 18 Months of Age.","authors":"Egija Zelca, Dita Gudra, Daiga Karklina, Maija Ustinova, Megija Lunge, Davids Fridmanis, Ingrida Rumba-Rozenfelde, Ilva Daugule","doi":"10.5223/pghn.2026.29.5.359","DOIUrl":"10.5223/pghn.2026.29.5.359","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the gut microbiome composition and associated factors in infants.</p><p><strong>Methods: </strong>Cross-sectional study was conducted in primary healthcare centers including healthy children up to 18 months of age. Parents of children answered a questionnaire and bring a fecal sample of their child. Fecal samples were analyzed using shotgun sequencing. The relative abundances of taxonomic profile were detected and compared with associated factors.</p><p><strong>Results: </strong>In the study were included 91 children. The most abundant taxonomic units belonged to phyla: Bacillota, Bacteroidota, Actinobacteria. In contrast, the most abundant species were Bifidobacterium longum and Bifidobacterium breve, demonstrating an age-appropriate microbial composition. The viral fraction mainly consisted of bacteriophages, with the most abundant viral family being Tospoviridae. Nevertheless, more than 50 rather new taxonomic entities were observed to cause shifts in the taxonomic units of the infant gut microbiome in association with perinatal antibacterial therapy, type of delivery, feeding type in the first 6 months of life. Higher relative abundance of Kitasatospora spp. MMS16 BH015 was associated with C-section and antibacterial treatment during delivery. A total of 302 antimicrobial resistance genes were identified, the most frequently encountered genes were associated with glycopeptide antibiotic resistance: vanG, vanT, vanW, vanY and adeF. The distribution of ARGs did not differ among different age groups.</p><p><strong>Conclusion: </strong>Metagenomic sequencing provides broader insights into the composition of the gut microbiome, emphasizing the presence of unusual species associated with environmental and perinatal factors. Perinatal antibacterial treatment may have a greater impact on the infant microbiome than was previously estimated.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 5","pages":"359-373"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Specific Differences in Dyspeptic Symptoms in Children Are Attenuated by <i>Helicobacter pylori</i> Seropositivity.","authors":"Dragana Ilic, Nikola Jovanovic, Bojko Bjelakovic","doi":"10.5223/pghn.2026.29.5.413","DOIUrl":"10.5223/pghn.2026.29.5.413","url":null,"abstract":"<p><strong>Purpose: </strong>Age- and sex-related differences are important but often underestimated factors in pediatric gastrointestinal disorders. When consistently observed and statistically confirmed, these differences may reflect underlying differences in disease pathophysiology and warrant further clinical attention. This study aimed to investigate age- and sex-related differences in the presentation of dyspeptic symptoms among children with and without serological evidence of <i>Helicobacter pylori</i> infection.</p><p><strong>Methods: </strong>We retrospectively analyzed clinical data from 213 pediatric patients aged 6-18 years who presented with dyspeptic symptoms. A subgroup of 65 patients tested positive for <i>H. pylori</i>. Symptom patterns were compared by sex and infection status.</p><p><strong>Results: </strong><i>H. pylori</i> infection was significantly more common among male patients (<i>p<</i>0.05). In the overall cohort, abdominal pain was reported more frequently by males, whereas nausea was more common among females (<i>p<</i>0.01). However, symptom distribution did not differ significantly by sex in the <i>H. pylori</i>-seropositive subgroup.</p><p><strong>Conclusion: </strong>Sex-specific differences in the reporting of nausea and abdominal pain in pediatric dyspepsia were present among <i>H. pylori</i>-seronegative children but absent among seropositive children, suggesting that <i>H. pylori</i>-associated gastric inflammation overrides sex-related differences in symptom perception.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 5","pages":"413-419"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Sulfasalazine Therapy Following Mesalazine Treatment Failure in Children with Ulcerative Colitis.","authors":"Paola Ruška, Ines Doder, Ana Močić Pavić, Zrinjka Mišak, Sanja Kolaček, Iva Hojsak","doi":"10.5223/pghn.2026.29.5.374","DOIUrl":"10.5223/pghn.2026.29.5.374","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the effectiveness of sulfasalazine therapy in children with ulcerative colitis (UC) after mesalazine treatment failure and to compare its effectiveness with that of mesalazine and azathioprine used after the first relapse.</p><p><strong>Methods: </strong>Data from all children newly diagnosed with UC between January 2010 and December 2021 who had at least 12 months of follow-up were retrospectively analyzed.</p><p><strong>Results: </strong>Of 189 children newly diagnosed with UC, 99 (52.4%) were treated with mesalazine alone, experienced a relapse, and were included in the study. The mean age was 12.8 years (standard deviation, 0.45), and 56 patients (56.6%) were male. After relapse, 35 children (35.4%) switched to sulfasalazine. Sulfasalazine treatment was effective in 28 patients (80.0%), and 19 patients (54.3%) remained relapse-free at 12 months. Patients who switched to sulfasalazine had more extensive disease and a higher Pediatric Ulcerative Colitis Activity Index than those who continued mesalamine treatment, but both disease extent and the index were lower than in patients who received azathioprine. Relapse-free survival did not differ among mesalazine, sulfasalazine, and azathioprine treatments (<i>p</i>=0.182).</p><p><strong>Conclusion: </strong>Switching from mesalazine to sulfasalazine may be a viable therapeutic option for carefully selected children with mild to moderate UC, even after mesalazine treatment failure.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 5","pages":"374-380"},"PeriodicalIF":1.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Necrotizing Enterocolitis Totalis a Distinct Disease Process?","authors":"Pengjian Zou, Wenhai Fang, Peizhi Zhao, Junjian Lv, Tulian Lin, Zhe Wang, Wenjie Luo, Peipei Wu, Wei Zhong, Qiuming He","doi":"10.5223/pghn.2026.29.4.330","DOIUrl":"10.5223/pghn.2026.29.4.330","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to characterize the clinical features of necrotizing enterocolitis totalis (NEC-T) in infants compared with NEC non-totalis (NEC-non-T) and to identify associated risk factors, thereby providing insights into its management for clinicians and parents.</p><p><strong>Methods: </strong>A retrospective study was conducted at the Guangzhou Women and Children's Medical Centre and included infants with Bell's Stage II or III NEC from January 2015 to March 2021. Infants were divided into NEC-T and NEC-non-T groups based on intraoperative findings. Clinical data were collected and compared between the two groups. Logistic regression was used to identify independent risk factors for NEC-T.</p><p><strong>Results: </strong>Among 195 infants who underwent surgery for NEC, 30 (15.4%) had NEC-T. Significant differences were observed in gestational age, time from onset to surgery (8 hours vs. 46 hours, <i>p</i><0.001), survival, and intestinal failure. Risk factors for NEC-T included neonatal respiratory distress syndrome (NRDS) (OR, 12.85; <i>p</i>=0.004), ventilatory support after birth (OR, 13.36; <i>p</i><0.001), bacteremia (odds ratio [OR], 10.98; <i>p</i><0.001), transfusion (OR, 4.62; <i>p</i>=0.004), increased ventilatory support (OR, 7.34; <i>p</i>=0.001), and portal venous gas (PVG) (OR, 4.78; <i>p</i>=0.007).</p><p><strong>Conclusion: </strong>NEC-T in neonates is characterized by sudden onset, rapid progression, and high mortality. NRDS, ventilatory support after birth, bacteremia, transfusion, increased ventilatory support, and PVG significantly increased the risk of NEC-T. Aggressive surgical decision-making may be a crucial approach to improving survival rates in patients with NEC-T.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 4","pages":"330-339"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Rationale for Determining Energy Requirement in Hospitalized Patients: A Narrative Review.","authors":"Suk-Kyung Hong, Kyung Mo Kim","doi":"10.5223/pghn.2026.29.4.349","DOIUrl":"https://doi.org/10.5223/pghn.2026.29.4.349","url":null,"abstract":"<p><p>[This corrects the article on p. 212 in vol. 29, PMID: 42148177.].</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 4","pages":"349"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbial Profile Alteration as a Potential Biomarker and Therapeutic Target in Children with Celiac Disease: A Narrative Review.","authors":"Fahimeh Sadat Mostafaei, Nikoo Hossein-Khannazer, Somayeh Jahani Sherafat, Asal Noruzpur, Amir Sadeghi, Mohammad Rostami Nejad","doi":"10.5223/pghn.2026.29.4.275","DOIUrl":"10.5223/pghn.2026.29.4.275","url":null,"abstract":"<p><p>Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion in genetically susceptible individuals. While gluten exposure is a necessary environmental trigger, its interaction with the intestinal microbiota has recently been recognized as a critical factor in modulating the onset and progression of the disease. Emerging evidence suggests that compositional and functional alterations in the microbial community may contribute to CD's pathogenesis by influencing intestinal barrier integrity, antigen presentation, and the balance between pro- and anti-inflammatory immune responses. Consequently, detailed characterization of microbial signatures holds promise for the identification of biomarkers for early diagnosis and development of microbiota-targeted interventions. This narrative review comprehensively analyzed observational human studies and controlled clinical trials to assess the role of microbiota in pediatric CD. Moreover, dysbiosis patterns across gastrointestinal niches in children with CD were compared and discussed. These findings have the potential for use in novel diagnostic and therapeutic strategies.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":"29 4","pages":"275-287"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}