World Journal of Pediatrics最新文献

{"title":"Potential gut-brain axis-targeted therapies for autism spectrum disorder in children: opportunities and challenges.","authors":"Min Kyung Shin, Yejun Son, Dong Keon Yon, Jinseok Lee","doi":"10.1007/s12519-025-00924-4","DOIUrl":"https://doi.org/10.1007/s12519-025-00924-4","url":null,"abstract":"<p><strong>Background: </strong>Autism spectrum disorder (ASD) lacks definitive treatment, but recent research has highlighted the potential of gut‒brain axis-targeted therapies for managing ASD symptoms in children. This review evaluated the effects of microbiota transplantation (MT), probiotics, dietary interventions, and nutritional supplements on ASD symptoms in children.</p><p><strong>Data sources: </strong>A systematic review was conducted via PubMed/MEDLINE, Scopus, and Web of Science to identify studies published up to June 2024. The inclusion criteria consisted of peer-reviewed articles encompassing both observational studies and interventional trials, and studies specifically targeted symptoms of ASD and included patients under the age of 18, with a minimum sample size of 20 participants.</p><p><strong>Results: </strong>Of the 3424 identified studies, 31 met the inclusion criteria. MT emerged as the most consistently effective intervention, showing improvements across multiple symptom domains, including behavior and social interaction, particularly for individuals with severe gastrointestinal (GI) issues. Probiotics have reported strain-specific efficacy, with some studies reporting behavioral improvements, but the results have been inconsistent. Dietary interventions, such as gluten-free casein-free and modified Atkins diets, have shown partial efficacy, particularly for individuals with cooccurring GI symptoms, with adherence challenges and variability in outcomes. Nutritional supplements yielded mixed outcomes, highlighting the need for personalized approaches. Despite promising findings, significant heterogeneity in study protocols and outcome measures underscores the need for standardized methodologies. Future research should prioritize standardization of these protocols. Long-term studies and longitudinal designs can help increase the reliability and practicality. Precision strategies based on individual microbiota compositions and genomics could optimize outcomes. Combined therapies should undergo rigorous evaluation. Reliable markers could improve cost-effectiveness by targeting therapies to responders. Broader research populations, economic evaluations, new technologies and interdisciplinary research will contribute to achieving a broader application and better outcomes.</p><p><strong>Conclusions: </strong>This review emphasizes the potential of gut‒brain axis-targeted therapies to improve the quality of life of children with ASD and their families. MT showed the most consistent improvements in managing pediatric ASD symptoms, with probiotics, dietary interventions, and nutritional supplements offering additional, albeit variable benefits. Efforts should be made to standardize the protocols, to conduct long-term studies, and to explore cost-effective solutions to ensure accessibility, particularly in resource-limited settings.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative therapies for childhood-onset systemic lupus erythematosus.","authors":"Dimitri Poddighe, Anh Thi Van Nguyen, Lan Tuyet Phung, Chi Quynh Le, Michelle Lynn Hermiston","doi":"10.1007/s12519-025-00913-7","DOIUrl":"https://doi.org/10.1007/s12519-025-00913-7","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal inflammation during the second trimester of pregnancy with adverse birth outcomes: a prospective cohort study.","authors":"Wan-Qing Xiao, Si-Chi Zhu, Zhu-Gu Huang, Qi-Wen He, Zi-Yin Lyu, Xu-Tao Li, Qing-Qun Lyu, Ya-Shu Kuang, Xue-Ling Wei, Dong-Mei Wei, Jin-Hua Lu, Jian-Rong He, Xiu Qiu","doi":"10.1007/s12519-025-00909-3","DOIUrl":"https://doi.org/10.1007/s12519-025-00909-3","url":null,"abstract":"<p><strong>Background: </strong>Distinct characteristics of maternal inflammation at midgestation related to fetal and neonatal health are not clear. This study aims to explore the associations between the maternal circulating inflammatory profile during the second trimester of pregnancy and a series of adverse birth outcomes.</p><p><strong>Methods: </strong>The present study was a prospective cohort study based on the Born in Guangzhou Cohort Study conducted in Guangzhou, China. Peripheral blood samples from women were obtained during the second trimester. Adverse newborn outcomes were collected through electronic medical records at birth and within the first week after birth. We used logistic, Poisson and generalized linear regressions to assess the impact of inflammatory indicators during pregnancy on different outcomes.</p><p><strong>Results: </strong>A total of 1567 singleton pregnant women were included. The proportions of preterm birth, small for gestational age (SGA), low birth weight (LBW), neonatal asphyxia and hyperbilirubinemia cases were 4.3%, 6.6%, 3.9%, 1.1% and 12.6%, respectively. The maternal circulating level of log2-transformed interleukin (IL)-7 was positively associated with preterm birth [adjusted odds ratio (OR) = 1.58, 95% confidence interval (CI) = 1.03-2.41]. A higher level of log2-transformed IL-2 was correlated with increased LBW risk (adjusted OR = 1.48, 95% CI = 1.09-2.02) and a decreased birth weight Z-score (adjusted β = - 0.06, 95% CI = - 0.11, - 0.01). IL-7 was associated with an increased risk of LBW (adjusted OR = 1.80, 95% CI = 1.14-2.86), whereas log2-transformed IL-15 was positively related to SGA (adjusted OR = 1.39, 95% CI = 1.02-1.91). There were no significant associations of maternal inflammatory indicators with neonatal asphyxia or hyperbilirubinemia.</p><p><strong>Conclusion: </strong>Maternal circulating IL-2, IL-7 and IL-15 levels during the second trimester of pregnancy were associated with preterm birth or birth weight.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric lung transplantation in China, 2019-2023.","authors":"Xiao-Shan Li, Zi-Tao Wang, Bo Wu, Shu-Gao Ye, Feng Liu, Chun-Xiao Hu, Yi Lu, Wen-Jie Hua, Wei-Wei Xu, Man Huang, Jing-Yu Chen","doi":"10.1007/s12519-025-00916-4","DOIUrl":"https://doi.org/10.1007/s12519-025-00916-4","url":null,"abstract":"<p><strong>Background: </strong>Pediatric lung transplant (pLTX) is a rare procedure globally; its characteristics and survival outcomes in China remain unknown.</p><p><strong>Methods: </strong>This retrospective study analyzed data from pLTX recipients aged ≤ 17 years between January 2019 and December 2023 from the China Lung Transplantation Registry. Pre-, intra-, and post-operative characteristics were described and compared between children aged 2-11 years and 12-17 years and between pLTX conducted in centers with high and low transplant volumes. The Kaplan‒Meier method was used to estimate the postoperative survival rates and 95% confidence intervals (CIs). One-year postoperative survival rates were compared between pediatric and adult lung transplant (LTX) patients via log-rank tests.</p><p><strong>Results: </strong>Between 2019 and 2023, 63 transplants were performed in 62 pediatric patients, accounting for 1.8% of the total LTX in China. The primary indication for pLTX was bronchiolitis obliterans syndrome (46.0%), followed by cystic fibrosis (12.7%) and idiopathic pulmonary arterial hypertension (11.1%). Infection was the most common complication after pLTX (63.9%), and the incidence of bronchial anastomotic stenosis was slightly higher among recipients aged 2-11 years than among those aged 12-17 years (14.3% vs. 2.9%, P = 0.244). High-volume hospitals had a higher incidence of infections (72.7% vs. 41.2%, P = 0.021) and primary graft failure (20.0% vs. 5.9%, P = 0.260) among pediatric recipients. However, acute rejection was exclusively observed in low-volume hospitals (0.0% vs. 17.6%, P = 0.018). The in-hospital mortality rate was 16.1% (95% CI = 6.7-25.5). The 30-day and one-year survival rates after pLTX were 93.5% (95% CI = 87.6-99.9) and 80.6% (95% CI = 71.4-91.1), respectively, and were significantly higher than those of adult recipients (82.0% and 58.7%, all P < 0.05).</p><p><strong>Conclusions: </strong>This research identified the trends, indications, donor and recipient characteristics, and complications of pLTX in China. Despite its small size, pLTX is growing gradually and has favorable outcomes. Future research on the long-term follow-up of pLTX recipients is needed to identify factors associated with the prognosis of pLTX patients.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undiagnosed pediatric type 2 diabetes mellitus: the giant hidden iceberg.","authors":"Jia-Qi Pu, Jun-Fen Fu","doi":"10.1007/s12519-025-00917-3","DOIUrl":"https://doi.org/10.1007/s12519-025-00917-3","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advocacy needed for pediatric sepsis in resource-limited countries.","authors":"Umadevi Subramanian, Baskar Venkidasamy","doi":"10.1007/s12519-025-00921-7","DOIUrl":"https://doi.org/10.1007/s12519-025-00921-7","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in magnetic resonance imaging of the developing brain and its applications in pediatrics.","authors":"Rui-Ke Chen, Ming-Yang Li, Zhi-Yong Zhao, Hao-An Xu, Cheng-Lin Ning, Jie Lu, Qin-Feng Zhu, Yong-Quan Huang, Ruo-Ke Zhao, Ling-Xuan Zhang, Tian-Li Tao, Kai-Bo Tang, Jia-Le Cheng, Can Lai, Hong-Xi Zhang, Xiao-Hui Ma, Hosung Kim, Zhi-Hua Ren, Chun-Feng Lian, Fan Wang, Geng Chen, Min-Hui Ouyang, An-Qi Qiu, Han Zhang, Xiao-Qi Huang, Xu-Jun Duan, Gang Li, Jian Yang, Hao Huang, Kenichi Oishi, Ellen Grant, Wei-Li Lin, Duan Xu, Dan Wu","doi":"10.1007/s12519-025-00905-7","DOIUrl":"https://doi.org/10.1007/s12519-025-00905-7","url":null,"abstract":"<p><p>The human brain undergoes a complex and dynamic developmental process from birth through adolescence, driven by molecular and cellular mechanisms that shape its structure and function. Magnetic resonance imaging (MRI) has become an essential non-invasive tool for studying pediatric brain development and detecting neurological disorders. However, pediatric neuroimaging presents unique challenges, including motion artifacts, small anatomical structures, and immature tissue properties, necessitating specialized MRI techniques. This review provides an overview of recent advancements in MRI hardware, acquisition strategies, and analytical methods optimized for pediatric brain imaging. Furthermore, it summarizes the applications of these techniques in understanding normal brain development, neurodevelopmental disorders, and the impact of early-life risk factors. This review highlights the progresses in pediatric MRI, emphasizing its critical role in advancing our understanding of pediatric brain development and neurological health. It also outlines the challenges and future directions in pediatric MRI to further improve imaging precision and clinical utility.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional relationship between child happiness and sleep quality and the predictive role of prenatal psychosocial support: results from U.S. and China cohort studies.","authors":"Ying Dai, Naixue Cui, Xiaopeng Ji, Adrian Raine, Therese S Richmond, Jianghong Liu","doi":"10.1007/s12519-025-00903-9","DOIUrl":"https://doi.org/10.1007/s12519-025-00903-9","url":null,"abstract":"<p><strong>Background: </strong>The relationship between daily affective states and subjective sleep measures is known to be reciprocal in both adults and children. However, its consistency across infancy to early adolescence and varying sociocultural contexts remain unclear. We investigated the bidirectional relationship between happiness and sleep quality in children from the U.S. and China and examined the predictive role of maternal prenatal psychosocial support.</p><p><strong>Methods: </strong>A total of 1300 children aged 11-12 years in the U.S. Healthy Brain and Behavior Study (HBBS) and China Jintan Child Cohort (CJCC) studies were included in the analyses. Happiness and sleep quality from infancy to early adolescence were retrospectively reported by mothers. Prenatal psychosocial factors were recalled by mothers through a structured interview. Random-intercept cross-lagged panel modeling was conducted to analyze the data.</p><p><strong>Results: </strong>Happiness and sleep quality trajectories differed significantly between U.S. adolescents in the HBBS and Chinese adolescents in the CJCC (P < 0.001). In both cohorts, cross-lagged effects showed consistent associations between happiness and subsequent sleep quality across the five time points (coefficients: 0.086-0.154, P < 0.01). The relationship between sleep quality and subsequent happiness was significant from 1-3 to 11 years. The bidirectional relationship was stronger in the Chinese cohort. Maternal prenatal psychosocial support positively predicted children's happiness (β = 0.072, P < 0.001) and sleep quality (β = 0.056, P < 0.001) trajectories.</p><p><strong>Conclusions: </strong>A bidirectional relationship exists between children's happiness and sleep quality, with potential cultural variations. Maternal prenatal psychosocial support plays a key role in fostering children's long-term emotional well-being and sleep quality.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guidelines for acute infectious diarrhea in children in China (2024).","authors":"You-Hong Fang, Chao-Min Wan, Si-Tang Gong, Feng Fang, Mei Sun, Yuan Qian, Ying Huang, Bao-Xi Wang, Chun-Di Xu, Yu Jin, Li-Yan Ye, Sai-Nan Shu, Qing-Bin Wu, Jie Wu, Xiao-Qin Li, Jing-Fang Chen, Hong-Mei Xu, Zheng-Hong Li, Hui Yu, Ji-Kui Deng, Jie Chen","doi":"10.1007/s12519-025-00894-7","DOIUrl":"https://doi.org/10.1007/s12519-025-00894-7","url":null,"abstract":"<p><strong>Background: </strong>Some new progress and evidence have been made in the diagnosis and treatment of pediatric acute infectious diarrhea since the publication of the \"Chinese clinical practice guidelines for acute infectious diarrhea in children\" (2018 edition guidelines). The updated \"Chinese clinical practice guidelines for acute infectious diarrhea in children\" incorporates new evidence-based recommendations for managing acute infectious diarrhea in the Chinese pediatric population.</p><p><strong>Data sources: </strong>Building on the 2018 edition guidelines, expert panels reviewed clinical evidence, assessed preliminary recommendations, and conducted open-ended discussions to finalize the updated guidelines. These guidelines are founded on the latest literature and evidence-based practices. A literature review was performed in databases such as PubMed, Cochrane, EMBASE, China Biomedical Database, and the Chinese Journal Full-text Database up to June 2024. The search focused on the terms \"acute diarrhea\" or \"enteritis\", along with \"adolescent\", \"child\", \"pediatric patient\", \"baby\", or \"infant\".</p><p><strong>Results: </strong>The updated guidelines address various aspects of acute infectious diarrhea, including diagnosis, etiological evaluation, dehydration assessment, fluid therapy, diet therapy, medical therapy, and prevention strategies. The main updates focused on etiological diagnosis and the use of probiotics, racecadotril, zinc, and antibiotics in treating acute infectious diarrhea.</p><p><strong>Conclusions: </strong>The updated guidelines address disputed treatments for acute infectious diarrhea through evidence-based revisions. Standardized etiological evaluations guide management. Probiotics are moderately advised for viral watery diarrhea; racecadotril remains unsupported. Zinc supplementation is recommended for children >6 months in deficient regions. Antibiotics are restricted to cases with dysenteric-like symptoms, suspected cholera with severe dehydration, or comorbidities.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of efficacy, safety and tolerability of perampanel monotherapy in children with newly-diagnosed epilepsy in routine clinical practice in China: a multicenter prospective observational study.","authors":"Tao-Yun Ji, Yi-Feng Ding, Yu-Qin Zhang, Li Jiang, Guo Zheng, Rong Luo, Dan Sun, Feng Gao, Yu-Wu Jiang, Yi Wang","doi":"10.1007/s12519-025-00914-6","DOIUrl":"https://doi.org/10.1007/s12519-025-00914-6","url":null,"abstract":"<p><strong>Background: </strong>Perampanel (PER) has gained interest as initial monotherapy for pediatric patients. Currently, there are limited studies on the PER monotherapy in treating pediatric patients with focal-onset seizures (FOS). This study aims to investigate efficacy and safety/tolerability of PER as initial monotherapy in treating pediatric patients with newly-diagnosed FOS in routine clinical practice in China.</p><p><strong>Methods: </strong>This multicenter, prospective, real-world observational study enrolled 210 antiseizure medication-naïve patients aged 4-12 years with newly-diagnosed FOS who visited one of the eight tertiary hospitals in China during March-December 2023. All patients were treated with PER monotherapy. The primary endpoint was seizure-freedom rate (SFR) during weeks 13-26 of PER monotherapy. Furthermore, 50%, 75% responder rates and retention rate were assessed. An electronic seizure diary was used. Treatment-emergent adverse events (TEAEs) were recorded.</p><p><strong>Results: </strong>The full analysis set included 203 patients. The SFR was 158/203, namely, 77.8% (95% confidence interval: 71.6%-83.0%) during weeks 13-26. The 50% and 75% responder rates were 88.2% and 85.2%, respectively, and the 26-week retention rate was 91.1%. Most patients received 2-6 mg/day maintenance PER and the 107 patients receiving 4 mg/day PER had the highest SFR (89.7%). Patients who had > 2 seizures during the three months before their enrollment were significantly less likely to be seizure free during weeks 13-26 than those who had ≤ 2 seizures. Seventy-nine (38.9%) patients had treatment-related TEAEs and most of them were mild and tolerable. Two (1.0%) patients withdrew from the study due to TEAEs. The most common TEAEs were dizziness, irritability, somnolence and fatigue.</p><p><strong>Conclusions: </strong>PER as initial monotherapy was effective and tolerable in Chinese patients aged 4-12 years with newly-diagnosed FOS. No safety issues arose in our study.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}