Molecular and cellular pediatrics最新文献

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Imaging of peripheral vascular malformations - current concepts and future perspectives. 外周血管畸形的影像学-目前的概念和未来的展望。
Molecular and cellular pediatrics Pub Date : 2021-12-07 DOI: 10.1186/s40348-021-00132-w
Vanessa F Schmidt, Max Masthoff, Michael Czihal, Beatrix Cucuruz, Beate Häberle, Richard Brill, Walter A Wohlgemuth, Moritz Wildgruber
{"title":"Imaging of peripheral vascular malformations - current concepts and future perspectives.","authors":"Vanessa F Schmidt,&nbsp;Max Masthoff,&nbsp;Michael Czihal,&nbsp;Beatrix Cucuruz,&nbsp;Beate Häberle,&nbsp;Richard Brill,&nbsp;Walter A Wohlgemuth,&nbsp;Moritz Wildgruber","doi":"10.1186/s40348-021-00132-w","DOIUrl":"https://doi.org/10.1186/s40348-021-00132-w","url":null,"abstract":"<p><p>Vascular Malformations belong to the spectrum of orphan diseases and can involve all segments of the vascular tree: arteries, capillaries, and veins, and similarly the lymphatic vasculature. The classification according to the International Society for the Study of Vascular Anomalies (ISSVA) is of major importance to guide proper treatment. Imaging plays a crucial role to classify vascular malformations according to their dominant vessel type, anatomical extension, and flow pattern. Several imaging concepts including color-coded Duplex ultrasound/contrast-enhanced ultrasound (CDUS/CEUS), 4D computed tomography angiography (CTA), magnetic resonance imaging (MRI) including dynamic contrast-enhanced MR-angiography (DCE-MRA), and conventional arterial and venous angiography are established in the current clinical routine. Besides the very heterogenous phenotypes of vascular malformations, molecular and genetic profiling has recently offered an advanced understanding of the pathogenesis and progression of these lesions. As distinct molecular subtypes may be suitable for targeted therapies, capturing certain patterns by means of molecular imaging could enhance non-invasive diagnostics of vascular malformations. This review provides an overview of subtype-specific imaging and established imaging modalities, as well as future perspectives of novel functional and molecular imaging approaches. We highlight recent pioneering imaging studies including thermography, positron emission tomography (PET), and multispectral optoacoustic tomography (MSOT), which have successfully targeted specific biomarkers of vascular malformations.</p>","PeriodicalId":74215,"journal":{"name":"Molecular and cellular pediatrics","volume":"8 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8651875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39576736","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}
引用次数: 12
The role of the immune system in idiopathic nephrotic syndrome. 免疫系统在特发性肾病综合征中的作用。
Molecular and cellular pediatrics Pub Date : 2021-11-18 DOI: 10.1186/s40348-021-00128-6
Agnes Hackl, Seif El Din Abo Zed, Paul Diefenhardt, Julia Binz-Lotter, Rasmus Ehren, Lutz Thorsten Weber
{"title":"The role of the immune system in idiopathic nephrotic syndrome.","authors":"Agnes Hackl,&nbsp;Seif El Din Abo Zed,&nbsp;Paul Diefenhardt,&nbsp;Julia Binz-Lotter,&nbsp;Rasmus Ehren,&nbsp;Lutz Thorsten Weber","doi":"10.1186/s40348-021-00128-6","DOIUrl":"https://doi.org/10.1186/s40348-021-00128-6","url":null,"abstract":"<p><p>Idiopathic nephrotic syndrome (INS) in children is characterized by massive proteinuria and hypoalbuminemia and usually responds well to steroids. However, relapses are frequent, which can require multi-drug therapy with deleterious long-term side effects. In the last decades, different hypotheses on molecular mechanisms underlying INS have been proposed and several lines of evidences strongly indicate a crucial role of the immune system in the pathogenesis of non-genetic INS. INS is traditionally considered a T-cell-mediated disorder triggered by a circulating factor, which causes the impairment of the glomerular filtration barrier and subsequent proteinuria. Additionally, the imbalance between Th17/Tregs as well as Th2/Th1 has been implicated in the pathomechanism of INS. Interestingly, B-cells have gained attention, since rituximab, an anti-CD20 antibody demonstrated a good therapeutic response in the treatment of INS. Finally, recent findings indicate that even podocytes can act as antigen-presenting cells under inflammatory stimuli and play a direct role in activating cellular pathways that cause proteinuria. Even though our knowledge on the underlying mechanisms of INS is still incomplete, it became clear that instead of a traditionally implicated cell subset or one particular molecule as a causative factor for INS, a multi-step control system including soluble factors, immune cells, and podocytes is necessary to prevent the occurrence of INS. This present review aims to provide an overview of the current knowledge on this topic, since advances in our understanding of the immunopathogenesis of INS may help drive new tailored therapeutic approaches forward.</p>","PeriodicalId":74215,"journal":{"name":"Molecular and cellular pediatrics","volume":"8 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8600105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39902466","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}
引用次数: 7
Does allogeneic stem cell transplantation in survivors of pediatric leukemia impact regular physical activity, pulmonary function, and exercise capacity? 同种异体干细胞移植对儿童白血病幸存者的常规身体活动、肺功能和运动能力有影响吗?
Molecular and cellular pediatrics Pub Date : 2021-11-04 DOI: 10.1186/s40348-021-00127-7
Katharina Ruf, Alaa Badran, Céline Siauw, Imme Haubitz, Paul-Gerhardt Schlegel, Helge Hebestreit, Christoph Härtel, Verena Wiegering
{"title":"Does allogeneic stem cell transplantation in survivors of pediatric leukemia impact regular physical activity, pulmonary function, and exercise capacity?","authors":"Katharina Ruf,&nbsp;Alaa Badran,&nbsp;Céline Siauw,&nbsp;Imme Haubitz,&nbsp;Paul-Gerhardt Schlegel,&nbsp;Helge Hebestreit,&nbsp;Christoph Härtel,&nbsp;Verena Wiegering","doi":"10.1186/s40348-021-00127-7","DOIUrl":"https://doi.org/10.1186/s40348-021-00127-7","url":null,"abstract":"<p><strong>Background: </strong>Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has improved survival in high-risk childhood leukemia but is associated with long-term sequelae such as impaired pulmonary function and reduced exercise capacity impacting quality of life.</p><p><strong>Methods: </strong>A convenience sample of 17 patients after allo-HSCT (HSCT-12 male, age 15.7±6.7 years, time after HSCT 5.3±2.8 years) underwent pulmonary function testing, echocardiography, and an incremental exercise test on a bike. Physical activity and health-related quality of life were assessed by questionnaires (7-day physical activity recall, PEDS-QL). Seventeen healthy age- and gender-matched controls served as control group (CG) for results of pulmonary function and exercise testing.</p><p><strong>Results: </strong>HSCT showed reduced pulmonary function (HSCT vs. CG: FEV1 90.5±14.0 vs. 108.0±8.7%pred; FVC 88.4±19.3 vs. 107.6±6.9%pred, DLCO 75.3±23.6 vs. 104.9±12.8%pred) and exercise capacity (VO<sub>2</sub>peak 89±30.8%pred, CG 98±17.5%pred; Wmax 84±21.7%pred, CG 115±22.8%pred), but no relevant cardiac dysfunction and a good quality of life (PEDS-QL mean overall score 83.3±10.7). Differences in peak oxygen uptake between groups were mostly explained by 5 adolescent patients who underwent total body irradiation for conditioning. They showed significantly reduced diffusion capacity and reduced peak oxygen uptake. Patients reported a mean time of inactivity of 777±159min/day, moderate activity of 110±107 min/day, hard activity of 35±36 min/day, and very hard activity of 23±22 min/day. A higher amount of inactivity was associated with a lower peak oxygen uptake (correlation coefficient tau -0.48, p=0.023).</p><p><strong>Conclusions: </strong>This pilot study shows that although patients after allo-HSCT reported a good quality of life, regular physical activity and exercise capacity are reduced in survivors of stem cell transplantation, especially in adolescents who are treated with total body irradiation for conditioning. Factors hindering regular physical activity need to be identified and exercise counseling should be part of follow-up visits in these patients.</p>","PeriodicalId":74215,"journal":{"name":"Molecular and cellular pediatrics","volume":"8 1","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2021-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8569121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39680938","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}
引用次数: 0
Bacterial metabolites and cardiovascular risk in children with chronic kidney disease. 慢性肾病儿童的细菌代谢物与心血管风险
Molecular and cellular pediatrics Pub Date : 2021-10-22 DOI: 10.1186/s40348-021-00126-8
Julia Schlender, Felix Behrens, Victoria McParland, Dominik Müller, Nicola Wilck, Hendrik Bartolomaeus, Johannes Holle
{"title":"Bacterial metabolites and cardiovascular risk in children with chronic kidney disease.","authors":"Julia Schlender,&nbsp;Felix Behrens,&nbsp;Victoria McParland,&nbsp;Dominik Müller,&nbsp;Nicola Wilck,&nbsp;Hendrik Bartolomaeus,&nbsp;Johannes Holle","doi":"10.1186/s40348-021-00126-8","DOIUrl":"https://doi.org/10.1186/s40348-021-00126-8","url":null,"abstract":"<p><p>Cardiovascular complications are the major cause of the marked morbidity and mortality associated with chronic kidney disease (CKD). The classical cardiovascular risk factors such as diabetes and hypertension undoubtedly play a role in the development of cardiovascular disease (CVD) in adult CKD patients; however, CVD is just as prominent in children with CKD who do not have these risk factors. Hence, the CKD-specific pathophysiology of CVD remains incompletely understood. In light of this, studying children with CKD presents a unique opportunity to analyze CKD-associated mechanisms of CVD more specifically and could help to unveil novel therapeutic targets.Here, we comprehensively review the interaction of the human gut microbiome and the microbial metabolism of nutrients with host immunity and cardiovascular end-organ damage. The human gut microbiome is evolutionary conditioned and modified throughout life by endogenous factors as well as environmental factors. Chronic diseases, such as CKD, cause significant disruption to the composition and function of the gut microbiome and lead to disease-associated dysbiosis. This dysbiosis and the accompanying loss of biochemical homeostasis in the epithelial cells of the colon can be the result of poor diet (e.g., low-fiber intake), medications, and underlying disease. As a result of dysbiosis, bacteria promoting proteolytic fermentation increase and those for saccharolytic fermentation decrease and the integrity of the gut barrier is perturbed (leaky gut). These changes disrupt local metabolite homeostasis in the gut and decrease productions of the beneficial short-chain fatty acids (SCFAs). Moreover, the enhanced proteolytic fermentation generates unhealthy levels of microbially derived toxic metabolites, which further accumulate in the systemic circulation as a consequence of impaired kidney function. We describe possible mechanisms involved in the increased systemic inflammation in CKD that is associated with the combined effect of SCFA deficiency and accumulation of uremic toxins. In the future, a more comprehensive and mechanistic understanding of the gut-kidney-heart interaction, mediated largely by immune dysregulation and inflammation, might allow us to target the gut microbiome more specifically in order to attenuate CKD-associated comorbidities.</p>","PeriodicalId":74215,"journal":{"name":"Molecular and cellular pediatrics","volume":"8 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2021-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8536815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39542191","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}
引用次数: 2
Proceedings of the 9th International Symposium on MDS and SAA in Childhood : Athens, Greece. 30 September-2 October 2021. 第九届儿童MDS和SAA国际研讨会论文集:希腊雅典,2021年9月30日至10月2日。
Molecular and cellular pediatrics Pub Date : 2021-10-11 DOI: 10.1186/s40348-021-00125-9
{"title":"Proceedings of the 9th International Symposium on MDS and SAA in Childhood : Athens, Greece. 30 September-2 October 2021.","authors":"","doi":"10.1186/s40348-021-00125-9","DOIUrl":"https://doi.org/10.1186/s40348-021-00125-9","url":null,"abstract":"","PeriodicalId":74215,"journal":{"name":"Molecular and cellular pediatrics","volume":"8 Suppl 1","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2021-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8505554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39504998","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}
引用次数: 1
Exome sequencing implicates a novel heterozygous missense variant in DSTYK in autosomal dominant lower urinary tract dysfunction and mild hereditary spastic paraparesis. 外显子组测序提示常染色体显性下尿路功能障碍和轻度遗传性痉挛性截瘫中DSTYK的一种新的杂合错义变异。
Molecular and cellular pediatrics Pub Date : 2021-10-04 DOI: 10.1186/s40348-021-00122-y
Clara Vidic, Marcin Zaniew, Szymon Jurga, Holger Thiele, Heiko Reutter, Alina C Hilger
{"title":"Exome sequencing implicates a novel heterozygous missense variant in DSTYK in autosomal dominant lower urinary tract dysfunction and mild hereditary spastic paraparesis.","authors":"Clara Vidic,&nbsp;Marcin Zaniew,&nbsp;Szymon Jurga,&nbsp;Holger Thiele,&nbsp;Heiko Reutter,&nbsp;Alina C Hilger","doi":"10.1186/s40348-021-00122-y","DOIUrl":"https://doi.org/10.1186/s40348-021-00122-y","url":null,"abstract":"<p><strong>Introduction: </strong>DSTYK encodes dual serine/threonine and tyrosine protein kinase. DSTYK has been associated with autosomal-dominant congenital anomalies of the kidney and urinary tract and with autosomal-recessive hereditary spastic paraplegia type 23. Here, we report a father and his two dizygotic twin sons carrying a novel heterozygous missense variant in DSTYK, presenting with early onset lower urinary tract dysfunction due to dysfunctional voiding. Moreover, in the later course of the disease, both sons presented with bilateral spasticity in their lower limbs, brisk reflexes, and absence seizures.</p><p><strong>Materials and methods: </strong>Exome sequencing in the affected father and his affected sons was performed. The sons presented clinically with urinary hesitancy, dysfunctional voiding, and night incontinence till adolescence, while the father reported difficulty in voiding. In the sons, cystoscopy excluded urethral valves and revealed hypertrophy of the bladder neck and trabeculated bladder. Additionally, both sons were diagnosed with absence epilepsy in early childhood. Filtering of exome data focused on rare (MAF < 0.01%), autosomal-dominant variants, predicted to be deleterious, residing in highly conserved regions of the exome.</p><p><strong>Results: </strong>Exome analysis identified a novel, heterozygous missense variant (c.271C>A (p.Leu91Met)) in DSTYK segregating with the disease. In silico prediction analyses uniformly rated the variant to be deleterious suggesting the variant to be disease-causing in the family.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first report of early onset dysfunctional voiding, seizures, and bilateral spasticity of the lower limbs associated with a novel heterozygous dominant missense variant in DSTYK.</p>","PeriodicalId":74215,"journal":{"name":"Molecular and cellular pediatrics","volume":"8 1","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2021-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39485753","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}
引用次数: 1
Correction to: Novel ways to monitor immunosuppression in pediatric kidney transplant recipients-underlying concepts and emerging data. 修正:监测儿童肾移植受者免疫抑制的新方法——基本概念和新数据。
Molecular and cellular pediatrics Pub Date : 2021-09-30 DOI: 10.1186/s40348-021-00124-w
Thurid Ahlenstiel-Grunow, Lars Pape
{"title":"Correction to: Novel ways to monitor immunosuppression in pediatric kidney transplant recipients-underlying concepts and emerging data.","authors":"Thurid Ahlenstiel-Grunow,&nbsp;Lars Pape","doi":"10.1186/s40348-021-00124-w","DOIUrl":"https://doi.org/10.1186/s40348-021-00124-w","url":null,"abstract":"","PeriodicalId":74215,"journal":{"name":"Molecular and cellular pediatrics","volume":"8 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8484395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39472684","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}
引用次数: 0
How FGF23 shapes multiple organs in chronic kidney disease. 慢性肾脏疾病中FGF23如何影响多个器官。
Molecular and cellular pediatrics Pub Date : 2021-09-18 DOI: 10.1186/s40348-021-00123-x
Maren Leifheit-Nestler, Dieter Haffner
{"title":"How FGF23 shapes multiple organs in chronic kidney disease.","authors":"Maren Leifheit-Nestler,&nbsp;Dieter Haffner","doi":"10.1186/s40348-021-00123-x","DOIUrl":"https://doi.org/10.1186/s40348-021-00123-x","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is associated with distinct alterations in mineral metabolism in children and adults resulting in multiple organ dysfunctions. Children with advanced CKD often suffer from impaired bone mineralization, bone deformities and fractures, growth failure, muscle weakness, and vascular and soft tissue calcification, a complex which was recently termed CKD-mineral and bone disorder (CKD-MBD). The latter is a major contributor to the enhanced cardiovascular disease comorbidity and mortality in these patients. Elevated circulating levels of the endocrine-acting phosphaturic hormone fibroblast growth factor (FGF) 23 are the first detectable alteration of mineral metabolism and thus CKD-MBD. FGF23 is expressed and secreted from osteocytes and osteoblasts and rises, most likely due to increased phosphate load, progressively as kidney function declines in order to maintain phosphate homeostasis. Although not measured in clinical routine yet, CKD-mediated increased circulating levels of FGF23 in children are associated with pathological cardiac remodeling, vascular alterations, and increased cognitive risk. Clinical and experimental studies addressing other FGF23-mediated complications of kidney failure, such as hypertension and impaired bone mineralization, show partly conflicting results, and the causal relationships are not always entirely clear. This short review summarizes regulators of FGF23 synthesis altered in CKD and the main CKD-mediated organ dysfunctions related to high FGF23 levels.</p>","PeriodicalId":74215,"journal":{"name":"Molecular and cellular pediatrics","volume":"8 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39427624","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}
引用次数: 8
ESPED survey on newly diagnosed immune thrombocytopenia in childhood: how much treatment do we give? 儿童新诊断的免疫性血小板减少症的ESPED调查:我们给予多少治疗?
Molecular and cellular pediatrics Pub Date : 2021-09-05 DOI: 10.1186/s40348-021-00121-z
Hannah von Lukowicz, Paul-Gerhardt Schlegel, Christoph Härtel, Henner Morbach, Imme Haubitz, Verena Wiegering
{"title":"ESPED survey on newly diagnosed immune thrombocytopenia in childhood: how much treatment do we give?","authors":"Hannah von Lukowicz,&nbsp;Paul-Gerhardt Schlegel,&nbsp;Christoph Härtel,&nbsp;Henner Morbach,&nbsp;Imme Haubitz,&nbsp;Verena Wiegering","doi":"10.1186/s40348-021-00121-z","DOIUrl":"https://doi.org/10.1186/s40348-021-00121-z","url":null,"abstract":"<p><strong>Background: </strong>Immune thrombocytopenia (ITP) is an autoimmune disease associated with isolated thrombocytopenia, which is caused by an imbalance between platelet production and platelet destruction. Petechial and mucous membrane hemorrhages are characteristic of ITP, but life-threatening bleeding rarely occurs. Depending on the bleeding symptoms, ITP can be treated with glucocorticoids (GC), intravenous immunoglobulins (IVIG), or in severe cases, platelet transfusions. Mild bleeding does not necessarily require therapy. Using the German Surveillance Unit for rare Pediatric Diseases (ESPED) we conducted a prospective survey on ITP patients in all German Children's Hospitals between September 2018 and August 2019. We collected data on ITP, including the clinical course, therapy implementation recommendations (according to the Association of German Scientific Medical Societies guidelines), outcome, and influence of treatment regimens depending on the treating physician´s experience with ITP patients.</p><p><strong>Results: </strong>Of the 287 recorded cases of children with ITP, 268 questionnaires were sent to the authors. Two hundred seventeen of the questionnaires fulfilled the inclusion criteria. ITP affected boys and girls similarly, and the median age of manifestation was 3.5 years. The main reasons for hospitalization were thrombocytopenia, bleeding signs, hematomas, and/or petechiae. Bleeding scores were ≤ 3 in 96% of children, which corresponded to a low-to-moderately low risk of bleeding. No life-threatening bleeding was documented. The most common therapies were IVIG (n = 59), GC (n = 33), or a combination of these (n = 17). Blood products (i.e., red blood cells, platelet concentrate, and fresh frozen plasma) were given to 13 patients. Compared to the established guidelines, 67 patients were over-treated, and 2 patients were under-treated.</p><p><strong>Conclusions: </strong>Adherence to German ITP treatment guidelines is currently limited. To improve patient safety and medical care, better medical training and dissemination of the guidelines are required in line with targeted analyses of patients with serious bleeding events to identify potential risk constellations.</p>","PeriodicalId":74215,"journal":{"name":"Molecular and cellular pediatrics","volume":"8 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39387895","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}
引用次数: 0
A fresh look to the phenotype in mono-allelic likely pathogenic variants of the leptin and the leptin receptor gene. 对瘦素和瘦素受体基因的单等位基因可能致病变异的表型进行了新的观察。
Molecular and cellular pediatrics Pub Date : 2021-08-26 DOI: 10.1186/s40348-021-00119-7
Ingrid Koerber-Rosso, Stephanie Brandt, Julia von Schnurbein, Pamela Fischer-Posovszky, Josef Hoegel, Hannah Rabenstein, Reiner Siebert, Martin Wabitsch
{"title":"A fresh look to the phenotype in mono-allelic likely pathogenic variants of the leptin and the leptin receptor gene.","authors":"Ingrid Koerber-Rosso,&nbsp;Stephanie Brandt,&nbsp;Julia von Schnurbein,&nbsp;Pamela Fischer-Posovszky,&nbsp;Josef Hoegel,&nbsp;Hannah Rabenstein,&nbsp;Reiner Siebert,&nbsp;Martin Wabitsch","doi":"10.1186/s40348-021-00119-7","DOIUrl":"https://doi.org/10.1186/s40348-021-00119-7","url":null,"abstract":"<p><p>Leptin (LEP) and leptin receptor (LEPR) play a major role in energy homeostasis, metabolism, and reproductive function. While effects of biallelic likely pathogenic variants (-/-) on the phenotype are well characterized, effects of mono-allelic likely pathogenic variants (wt/-) in the LEP and LEPR gene on the phenotype compared to wild-type homozygosity (wt/wt) have not been systematically investigated. We identified in our systematic review 44 animal studies (15 on Lep, 29 on Lepr) and 39 studies in humans reporting on 130 mono-allelic likely pathogenic variant carriers with 20 distinct LEP variants and 108 heterozygous mono-allelic likely pathogenic variant carriers with 35 distinct LEPR variants. We found indications for a higher weight status in carriers of mono-allelic likely pathogenic variant in the leptin and in the leptin receptor gene compared to wt/wt, in both animal and human studies. In addition, animal studies showed higher body fat percentage in Lep and Lepr wt/- vs wt/wt. Animal studies provided indications for lower leptin levels in Lep wt/- vs. wt/wt and indications for higher leptin levels in Lepr wt/- vs wt/wt. Data on leptin levels in human studies was limited. Evidence for an impaired metabolism in mono-allelic likely pathogenic variants of the leptin and in leptin receptor gene was not conclusive (animal and human studies). Mono-allelic likely pathogenic variants in the leptin and in leptin receptor gene have phenotypic effects disposing to increased body weight and fat accumulation.</p>","PeriodicalId":74215,"journal":{"name":"Molecular and cellular pediatrics","volume":"8 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2021-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39356575","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}
引用次数: 4
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