OBJECTIVES: The risk factors and role of mother‒child gut microbiota in pediatric inflammatory bowel disease (PIBD) remain unclear. We aimed to explore the clinical risk factors associated with PIBD, analyze the characteristics of gut microbiota of children and their mothers, and examine the correlation of the microbial composition in mother‒child pairs. METHODS: We conducted a case-control study including children with PIBD and their mothers as the case group, as well as healthy children and their mothers as the control group. Questionnaires were used to collect information such as family illness history and maternal and early-life events. Fecal samples were collected from the children and mothers for microbiota 16S ribosomal RNA (rRNA) sequencing to analyze the composition and its potential association with PIBD. RESULTS: A total of 54 pairs of cases and 122 pairs of controls were recruited. A family history of autoimmune disease and antibiotic use during pregnancy were associated with an increased risk of PIBD, and a higher education level of the father was associated with a decreased risk of PIBD. Children with PIBD and mothers exhibited different gut microbiota compared to healthy children and mothers. Similarities were observed in the gut microbiota of mothers and children in the same groups. Some bacterial biomarkers of mothers discovered in this study had the power to predict PIBD in their offspring. CONCLUSIONS PIBD is influenced by maternal risk factors and has unique gut microbiota characteristics. The mother‒child gut microbiota is closely related, suggesting the transmission and influence of the gut microbiota between mothers and children. This study highlights the potential pathogenesis of PIBD and provides a basis for developing targeted interventions.
Humans ; Gastrointestinal Microbiome ; Female ; Risk Factors ; Case-Control Studies ; Male ; Child ; Inflammatory Bowel Diseases/etiology* ; Adult ; RNA, Ribosomal, 16S/genetics* ; Feces/microbiology* ; Mothers ; Pregnancy ; Child, Preschool

Eosinophil-derived neurotoxin（EDN）is an intracellular protein released during eosinophil activation，possessing ribonuclease activity.As a pivotal immunoregulatory molecule，EDN exerts significant influence on the immune response of the organism.Serving as a biomarker，it can reflect the activation state of eosinophils，providing robust support for the diagnosis and dynamic monitoring of allergic diseases.This article focuses on the application of EDN in various allergic diseases，including its effectiveness as a diagnostic tool，assessment of disease severity，and prognosis.By reviewing existing research findings，this review aims to provide references for further research and clinical practice in related fields.

【Objective】 To dynamically monitor and analyze the changes of platelets and related indicators in infants with cow′s milk protein allergy (CMPA) during clinical treatment, in order to provide clues for further diagnosis and treatment of CMPA. 【Methods】 From August to November in 2022, 59 children aged from 1 month to 3 years old with CMPA in the pediatric outpatient clinic were selected as the CMPA group, and 29 healthy children who took physical examination were selected as the control group. The differences in platelet related indicators from a routine blood test were compared between the two groups, and their diagnostic value for CMPA was analyzed by receiver operating characteristic (ROC) curves. 【Results】 The mean platelet count (PLT) and plateletcrit (PCT) at baseline in the CMPA group were (374.68±113.21)×10⁹/L and 0.37±0.10, significantly higher than those in control group[(271.07±40.32)×10⁹/L, 0.26±0.05] (t=6.27, 6.43, P<0.001). In the CMPA group, after treatment, the mean PLT level was (316.39±94.68)×10⁹/L, and the mean PCT level was 0.31±0.10, indicating a statistically significant decrease in PLT and PCT levels after treatment compared to baseline (t=4.32,4.75,P<0.05). The diagnostic performance, indicated by the area under the curve (AUC), for PLT and PCT in diagnosing CMPA was 0.811 and 0.823, respectively. The cutoff values for PLT and PCT were determined to be 304.5×10⁹/L and 0.305, respectively. 【Conclusion】 The PLT and PCT levels in children with CMPA are found to be higher than those in healthy controls, suggesting their potential diagnostic value in the diagnosis of CMPA.

Gastrointestinal motility disorder is a common disease in the gastroenterology department. Its incidence is increasing year by year，which seriously affects people's quality of life.Its pathogenesis is complex. Nitric oxide（NO）and hydrogen sulfide（H 2S）are two types of gas signaling molecules. NO is an important neurotransmitter in the gastrointestinal nervous system，which is involved in the transmission of nerve signals and thus regulates smooth muscle.H 2S plays an important role in regulating oxidative stress and maintaining cell balance，normal cell activity and body survival.At present，studies on NO and H 2S are gradually emerging.This paper focuses on the relationship between NO and H 2S and four primary dynamic diseases of digestive tract，such as achalasia of cardia，gastroesophageal reflux disease，gastroparesis syndrome，and false intestinal obstruction.

Helicobacter pylori (Hp) plays an important role in the development of a variety of digestive diseases in children, but in addition to Hp, there are many other gastric microbiota also critical for children′s health.At present, the characteristics of children′s gastric microbiota may be still relatively unclear.This artical summarizes the composition, succession process and function of children′s gastric microbiota, and reviews the relationship between gastric microbiota and Helicobacter pylori infection in children.

Objective:To analyze skin manifestations of pediatric inflammatory bowel disease (IBD) .Methods:Children with IBD were collected from pediatric wards in Peking University Third Hospital from January 2010 to January 2022, and their skin manifestations were retrospectively analyzed.Results:A total of 50 children with IBD were included, including 27 with Crohn′s disease and 23 with ulcerative colitis. Twenty-five (50%) patients had skin manifestations, including specific skin manifestations in 11 (22%) and relevant skin manifestations in 11 (22%) . Specific skin manifestations included cutaneous perianal Crohn′s disease in 2 cases, and anal fistula and/or perianal abscess in 9 cases; relevant skin manifestations included erythema nodosum in 5 cases, aphthous stomatitis in 3 cases, psoriasis in 1 case, polyarteritis nodosa in 1 case, and Henoch-Sch?nlein purpura in 1 case. Compared with the ulcerative colitis group, the Crohn′s disease group was more prone to suffer from specific skin manifestations and relevant skin manifestations, and there were significant differences in the prevalence of specific and relevant skin manifestations between the two groups (both P < 0.05) . Of the 27 children with Crohn′s disease, 19 (70%) had one or more skin manifestations, 2 of whom successively presented with 4 different skin manifestations. One child with Crohn′s disease and 1 with ulcerative colitis had 3 different skin manifestations in different periods. The fecal calprotectin level was elevated in all children with skin manifestations, and in 12 (48%) children without skin manifestations. The skin lesions of 5 children were improved or subsided after dose adjustment (1 case) or switch (4 cases) of biological agents. Conclusions:Half of the children with IBD have skin manifestations, and children with Crohn′s disease are more prone to have specific and relevant skin manifestations. Different skin manifestations could be observed in the same child in different periods. Multidisciplinary teamwork is conducive to the overall control of this disease.

The diagnosis of food allergy in children is one hotspot attracting people′s attention in recent years.The incidence of it shows an increasing trend which exposes problems in the understanding of children′s food allergy in China, especially in the misdiagnosis and missed diagnosis.To further standardize the diagnosis and treatment of food allergy in children, based on the current domestic, foreign guidelines and relevant research evidence, the guideline recommends 16 clinical hot-button issues in the 4 aspects of diagnosis, treatment, prognosis, and prevention.Finally, a diagnosis flowchart has been formulated.The guideline aims to improve the standard diagnosis and treatment of food allergies in children in China.

The immune mechanism of non-IgE-mediated food allergy is quite complex.Due to the lack of specific laboratory indicators and limited diagnosis and treatment methods, non-IgE-mediated food allergy is usually misdiagnosed.Therefore, it is urgent to clarify the pathogenesis of the disease and search for specific biomarkers and novel therapeutic targets.This review aims to summarize current research results on the immune mechanism of non-IgE-mediated food allergy from two aspects, including the specific immunity and innate immunity, and to explore the potential diagnostic markers.The results may provide novel ideas for effective therapeutic strategies of non-IgE-mediated food allergy.

Helicobacter pylori infection in children can cause a variety of gastrointestinal and extra-digestive diseases, even the gastric cancer.Most Helicobacter pylori infections are acquired in childhood and can cause various manifestations such as nausea, vomiting, anorexia, idiopathic thrombocytopenic purpura, refractory iron deficiency anemia, and growth retardation.In recent years, many advances have been made in the study of children′s Helicobacter pylori infection.This review focuses on the risk factors of Helicobacter pylori infection in children, containing the perspectives of Helicobacter pylori strains, hosts and environment, and looks forward to further research directions.

Objective:To evaluate the relationship between the timing of complementary feeding for infants and the occurrence of food allergy.Methods:The PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WanFang Data database were searched for randomized controlled trials (RCTs) about the effects of early introduction of complementary foods in infants on the occurrence of food allergy. Papers published from the establishment of the databases to December 31, 2019 were extracted. The quality of the selected literature was evaluated using the risk-of-bias (ROB) tools in the Cochrane Handbook, and the RevMan 5.3 software was used for meta-analysis. For the complementary food analyzed in a few reports in literature, a systematic review was conducted.Results:A total of 8 RCTs were extracted, and the systematic review and Meta-analysis were carried out according to food types. The results of Meta-analysis showed that compared with late introduction (after 6 months of age), early introduction (before 6 months of age) of eggs ( RR=0.60, 95% CI 0.46-0.79) could reduce the risk of egg allergy in infants. The subgroup analysis of the six studies about eggs demonstrated that in infants with a prior or family history of allergic diseases, the introduction of eggs before 6 months of age was associated with reduced risk of egg allergy ( RR=0.55, 95% CI 0.40-0.75), and the introduction of raw eggs ( RR=0.67, 95% CI 0.49-0.93) and small amount of eggs (equivalent to weekly protein 0-4 g) ( RR=0.55, 95% CI 0.36-0.85) before 6 months of age were also associated with reduced risk of egg allergy. In addition, egg supplementation during 4-6 months of age reduced the occurrence of egg allergy compared with supplementation before 4 months of age ( RR=0.58, 95% CI 0.43-0.78). The systematic review found no conclusive relationship between early peanut introduction and peanut allergy, nor the correlation between early cow′s milk protein introduction and cow′s milk protein allergy ( P>0.05). Conclusion:Early introduction (before 6 months of age) of eggs in infants′ complementary foods can prevent infant egg allergy, but the limitations of the study need to be considered.