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Neurodevelopmental disorders are a group of diseases with cognitive, motor, and emotional development deficits. Alpha-synuclein (α-syn) is a synaptic protein involved in transmission and neurodevelopment. This protein was previously shown to be associated with several disorders, including Parkinson's disease. Furthermore, a close link between neurodevelopmental disorders and Parkinson's has also been found. Changes in synaptic function have been noticed in neurodevelopmental disorders, including autism spectrum disorder. Impaired neurogenesis and related cognitive problems have been associated with altered expression of α-syn. Various studies reported α-syn in different body fluids and tissues such as blood and serum. Alpha-synuclein can help in better understanding the pathogenesis of neurodevelopmental diseases and facilitating their early diagnosis. This review aims to go over the recent advances in the role of α-syn in the pathophysiology of neurodevelopmental disorders, including autism spectrum disorder, attention deficit hyperactivity disorder, and motor and social impairment, and its value as a diagnostic biomarker.
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INTRODUCTION: Autoimmune disorders affect 4.5% to 9.4% of children, significantly reducing their quality of life. The diagnosis and prognosis of autoimmune diseases are uncertain because of the variety of onset and development. Machine learning can identify clinically relevant patterns from vast amounts of data. Hence, its introduction has been beneficial in the diagnosis and management of patients. AREAS COVERED: This narrative review was conducted through searching various electronic databases, including PubMed, Scopus, and Web of Science. This study thoroughly explores the current knowledge and identifies the remaining gaps in the applications of machine learning specifically in the context of pediatric autoimmune and related diseases. EXPERT OPINION: Machine learning algorithms have the potential to completely change how pediatric autoimmune disorders are identified, treated, and managed. Machine learning can assist physicians in making more precise and fast judgments, identifying new biomarkers and therapeutic targets, and personalizing treatment strategies for each patient by utilizing massive datasets and powerful analytics.
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Background and Aims: Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines have the potential to alter several biological systems concurrently with remolding the immune system, most of which are related to immunization, while some others are known as adverse effects. This review aims to explore the potential effects of vaccination on the oral microenvironment and classifies them as good, bad, or ugly, with a brief review of facial diseases following coronavirus disease 2019 (COVID-19) vaccination. Methods: This study was a comprehensive review conducted through searching related articles in Medline, Scopus, and Google Scholar databases. Results: On one side, the "Good" impacts of vaccination on the oro-nasal mucosa are explained as if the mucosal immune responses followed by SARS-CoV-2 vaccines are enough to provide immunity. On the other side, the possible "Bad" and "Ugly" effects of the vaccine, which manifest as orofacial adverse events and autoimmune reactivations, respectively, should be noted. Exacerbation of pre-existing autoimmune conditions such as lichen planus, pemphigus vulgaris, bullous pemphigoid, and Stevens-Johnson syndrome have been reported. Conclusion: COVID-19 vaccines could affect different biological systems alongside stimulating the immune system, and some of these effects are referred to as adverse effects. Nonetheless, these adverse effects are treatable, and healthcare professionals should not prevent patients from taking the first available vaccination.
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Lymphoma is known as the third most common malignancy in children, and its prevalence and mortality are increasing. Common treatments, including chemotherapy, radiotherapy, and also surgery, despite their efficacy, have many side effects and, have a high chance of disease relapse. Immune Checkpoint Inhibitors (ICIs) offer a promising alternative with potentially fewer risks of relapse and toxicity. This review article aims to investigate the efficacy and safety of ICIs, either as monotherapy or in combination, for pediatric lymphoma patients. ICIs have revolutionized cancer treatment in recent years and have shown remarkable results in several adult cancers. However, their efficacy in treating pediatrics requires further investigation. Nevertheless, some ICIs, including nivolumab, pembrolizumab, and ipilimumab, have demonstrated encouraging outcomes. ICIs therapy is not without risks and can cause side effects, including rash, itching, vitiligo, abdominal pain, diarrhea, dysphagia, epigastric pain, nausea, vomiting, thyroid, and pituitary dysfunction. Overall, this review article highlights the potential benefits and risks of ICIs in treating pediatric lymphoma.
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Antineoplastic Agents, Immunological , Lymphoma , Humans , Child , Immune Checkpoint Inhibitors , Antineoplastic Agents, Immunological/therapeutic use , Neoplasm Recurrence, Local/drug therapy , Lymphoma/drug therapy , RecurrenceABSTRACT
OBJECTIVE: Asthma, a common disease among children and adolescents, poses a great health risk when ignored; therefore, a thorough follow-up to prevent exacerbations is emphasized. The aim of the present study is to investigate asthma exacerbation in children during the Coronavirus disease 2019 (COVID-19) era. DATA SOURCES: This narrative review has been done by searching the PubMed and Embase databases using Asthma, COVID-19, Pandemic, and Symptom flare up as keywords. STUDY SELECTIONS: Studies related to asthma exacerbation in COVID-19 pandemic were included. RESULTS: Based on studies, controlled or mild to moderate asthma has not been considered a risk factor for COVID-19 severity and has not affected hospitalization, intensive care unit (ICU) admission, and mortality. Surprisingly, emergent and non-emergent visits and asthmatic attacks decreased during the pandemic. The three main reasons for decreased incidence and exacerbation of asthma episodes in the COVID-19 era included reduced exposure to environmental allergens, increasing the acceptance of treatment by pediatrics and caregivers, and decreased risk of other respiratory viral infections. Based on the available studies, COVID-19 vaccination had no serious side effects, except in cases of uncontrolled severe asthma, and can be injected in these children. Also, there was no conclusive evidence of asthma exacerbation after the injection of COVID-19 vaccines. CONCLUSION: Further studies are recommended to follow the pattern of asthma in the post-pandemic situation and to become prepared for similar future conditions.
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Asthma , COVID-19 , Adolescent , Child , Humans , Asthma/drug therapy , COVID-19 Vaccines , Pandemics/prevention & control , Disease Progression , COVID-19/epidemiologyABSTRACT
Asthma is a chronic condition that affects children worldwide. Accumulating number of studies reported that the prevalence of pediatric obesity and asthma might be altered through breastfeeding. It has been proposed that Leptin, which exists in human milk, is oppositely associated with weight increase in newborns. It may also influence peripheral immune system by promoting TH1 responses and suppressing TH2 cytokines. Leptin influences body weight and immune responses through complex signaling pathways at molecular level. Although previous studies provide explanations for the protective role of breastfeeding against both obesity and asthma, other factors such as duration of breastfeeding, parental, and prenatal factors may confound this relationship which requires further research.
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BACKGROUND: Miller Fisher syndrome (MFS) is a subtype of Guillain-Barré syndrome (GBS) which is characterized by the three components of ophthalmoplegia, ataxia, and areflexia. Some studies reported MFS as an adverse effect of the COVID-19 vaccination. We aimed to have a detailed evaluation on demographic, clinical, and para-clinical characteristics of subjects with MFS after receiving COVID-19 vaccines. MATERIALS AND METHODS: A thorough search strategy was designed, and PubMed, Web of Science, and Embase were searched to find relevant articles. Each screening step was done by twice, and in case of disagreement, another author was consulted. Data on different characteristics of the patients and types of the vaccines were extracted. The risk of bias of the studies was assessed using Joanna Briggs Institute (JBI) tools. RESULTS: In this study, 15 patients were identified from 15 case studies. The median age of the patients was 64, ranging from 24 to 84 years. Ten patients (66.6%) were men and Pfizer made up 46.7% of the injected vaccines. The median time from vaccination to symptoms onset was 14 days and varied from 7 to 35 days. Furthermore,14 patients had ocular signs, and 78.3% (11/14) of ocular manifestations were bilateral. Among neurological conditions, other than MFS triad, facial weakness or facial nerve palsy was the most frequently reported side effect that was in seven (46.7%) subjects. Intravenous immunoglobulin (IVIg) was the most frequently used treatment (13/15, 86.7%). Six patients received 0.4 g/kg and the four had 2 g/kg. Patients stayed at the hospital from five to 51 days. No fatal outcomes were reported. Finally, 40.0% (4/15) of patients completely recovered, and the rest experienced improvement. CONCLUSION: MFS after COVID-19 immunization has favorable outcomes and good prognosis. However, long interval from disease presentation to treatment in some studies indicates that more attention should be paid to MFS as the adverse effect of the vaccination. Due to the challenging diagnosis, MFS must be considered in list of the differential diagnosis in patients with a history of recent COVID-19 vaccination and any of the ocular complaints, ataxia, or loss of reflexes, specially for male patients in their 60s and 70s.
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COVID-19 Vaccines , COVID-19 , Drug-Related Side Effects and Adverse Reactions , Facial Paralysis , Miller Fisher Syndrome , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Ataxia , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Miller Fisher Syndrome/diagnosis , Miller Fisher Syndrome/etiology , Prognosis , VaccinationABSTRACT
Background: Primary ciliary dyskinesia (PCD), also known as the immotile-cilia syndrome, is a clinically and genetically heterogeneous syndrome. Improper function of the cilia causes impaired mucociliary clearance. Neonatal respiratory distress, rhinosinusitis, recurrent chest infections, wet cough, and otitis media are respiratory presentations of this disease. It could also manifest as infertility in males as well as laterality defects in both sexes, such as situs abnormalities (Kartagener syndrome). During the past decade, numerous pathogenic variants in 40 genes have been identified as the causatives of primary ciliary dyskinesia. DNAH11 (dynein axonemal heavy chain 11) is a gene that is responsible for the production of cilia's protein and encodes the outer dynein arm. Dynein heavy chains are motor proteins of the outer dynein arms and play an essential role in ciliary motility. Case Presentation. A 3-year-old boy, the offspring of consanguineous parents, was referred to the pediatric clinical immunology outpatient department with a history of recurrent respiratory tract infections and periodic fever. Furthermore, on medical examination, situs inversus was recognized. His lab results revealed elevated levels of erythrocyte sedimentation rate (ESR) and C reactive protein (CRP). Serum IgG, IgM, and IgA levels were normal, while IgE levels were elevated. Whole exome sequencing (WES) was performed for the patient. WES demonstrated a novel homozygous nonsense variant in DNAH11 (c.5247G > A; p. Trp1749Ter). Conclusion: We reported a novel homozygous nonsense variant in DNAH11 in a 3-year-old boy with primary ciliary dyskinesia. Biallelic pathogenic variants in one of the many coding genes involved in the process of ciliogenesis lead to PCD.
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The spinal hydatid cyst is a benign pathology but has considerable morbidity. It should be considered as a differential diagnosis in patients having signs and symptoms of spinal compression, particularly in endemic areas.
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Background: Bitter taste-sensing type 2 receptor (T2Rs or TAS2Rs) found on ciliated epithelial cells and solitary chemosensory cells have a role in respiratory tract immunity. T2Rs have shown protection against SARS-CoV-2 by enhancing the innate immune response. The purpose of this review is to outline the current sphere of knowledge regarding this association. Methods: A narrative review of the literature was done by searching (T2R38 OR bitter taste receptor) AND (COVID-19 OR SARS-CoV-2) keywords in PubMed and google scholar. Results: T2R38, an isoform of T2Rs encoded by the TAS2R38 gene, may have a potential association between phenotypic expression of T2R38 and prognosis of COVID-19. Current studies suggest that due to different genotypes and widespread distributions of T2Rs within the respiratory tract and their role in innate immunity, treatment protocols for COVID-19 and other respiratory diseases may change accordingly. Based on the phenotypic expression of T2R38, it varies in innate immunity and host response to respiratory infection, systemic symptoms and hospitalization. Conclusion: This review reveals that patients' innate immune response to SARS-COV-2 could be influenced by T2R38 receptor allelic variations.
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BACKGROUND: Glanzmann thrombasthenia (GT) is a rare bleeding disorder with a high prevalence in communities where consanguineous marriages are mainstream. Endometriosis is a chronic inflammatory disease, and its risk increases in women with menstrual periods of longer than six days. The phenotypic expression of endometriosis is determined by the frequency and rate of the menstrual flow, as well as genetic and environmental factors. RESULT AND CASE PRESENTATION: 14-year-old monozygotic twin sisters with GT who developed ovarian endometriosis were referred to Hazrat Rasoul Hospital due to severe dysmenorrhea. In ultrasonic examination, endometrioma cysts were reported in both patients. They both went under endometrioma cystectomy, and the bleeding was managed using antifibrinolytic drugs, followed by recombinant activated coagulation factor VII. Both were discharged after 3 days. In the ultrasound examination performed one year after the surgery, ovaries were normal in the first twin, while the second twin had a 28 × 30 hemorrhagic cyst in the left ovary. DISCUSSION AND CONCLUSION: Menstrual bleeding and genetic factors are two theories that could be related to GT and endometriosis association, and GT could be considered a risk factor for endometriosis.
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Cysts , Endometriosis , Ovarian Neoplasms , Thrombasthenia , Humans , Female , Adolescent , Thrombasthenia/genetics , Endometriosis/genetics , Endometriosis/complications , Endometriosis/diagnosis , Twins, Monozygotic , Hemorrhage , Cysts/complicationsABSTRACT
Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has taken a toll on humans, and the development of effective vaccines has been a promising tool to end the pandemic. However, for a vaccination program to be successful, a considerable proportion of the community must be vaccinated. Hence, public acceptance of coronavirus disease 2019 (COVID-19) vaccines has become the key to controlling the pandemic. Recent studies have shown vaccine hesitancy increasing over time. This systematic review aims to evaluate the COVID-19 vaccine hesitancy rate and related factors in different communities. Method: A comprehensive search was performed in MEDLINE (via PubMed), Scopus, and Web of Science from January 1, 2019 to January 31, 2022. All relevant descriptive and observational studies (cross-sectional and longitudinal) on vaccine hesitancy and acceptance were included in this systematic review. In the meta-analysis, odds ratio (OR) was used to assess the effects of population characteristics on vaccine hesitancy, and event rate (acceptance rate) was the effect measure for overall acceptance. Publication bias was assessed using the funnel plot, Egger's test, and trim-and-fill methods. Result: A total of 135 out of 6,417 studies were included after screening. A meta-analysis of 114 studies, including 849,911 participants, showed an overall acceptance rate of 63.1%. In addition, men, married individuals, educated people, those with a history of flu vaccination, those with higher income levels, those with comorbidities, and people living in urban areas were less hesitant. Conclusion: Increasing public awareness of the importance of COVID-19 vaccines in overcoming the pandemic is crucial. Being men, living in an urban region, being married or educated, having a history of influenza vaccination, having a higher level of income status, and having a history of comorbidities are associated with higher COVID-19 vaccine acceptance.
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It is well-documented that diabetes is an inflammatory and oxidative disease, with an escalating global burden. Still, there is no definite treatment for diabetes or even prevention of its harmful complications. Therefore, understanding the molecular pathways associated with diabetes might help in finding a solution. p66Shc is a member of Shc family proteins, and it is considered as an oxidative stress sensor and regulator in cells. There are inconsistent data about the role of p66Shc in inducing diabetes, but accumulating evidence supports its role in the pathogenesis of diabetes-related complications, including macro and microangiopathies. There is growing hope that by understanding and targeting molecular pathways involved in this network, prevention of diabetes or its complications would be achievable. This review provides an overview about the role of p66Shc in the development of diabetes and its complications.
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Diabetes Mellitus , Humans , Src Homology 2 Domain-Containing, Transforming Protein 1/genetics , Diabetes Mellitus/therapy , Oxidative StressABSTRACT
Background: The COVID-19 pandemic has affected many aspects of human life, including physical and mental health. The public health measures to prevent COVID-19 transmission led to social isolation, physical inactivity, anxiety, depression, sleep disorders, obesity, and consumption of unhealthy food. Aims: To evaluate changes in lifestyle behaviour during the fifth wave of COVID-19 in Iranian medical students. Methods: This was a cross-sectional descriptive study. In September 2021, an online questionnaire containing 32 questions was administered to 1143 medical students in Teheran universities. Some 286 completed copies of the questionnaire were excluded because of incomplete answers. Descriptive statistics of central tendency measures and dispersion were used and independent t-test and a Chi-square test between two variables were conducted. Statistical analysis was performed using SPSS version 24. Results: A total of 462 (53.9%) students had COVID-19 during the fifth wave of the disease, 657 (76.7%) were deprived of social and sports activities, and 278 (32.4%) had difficulty completing their academic studies. Students who took vitamin supplements experienced lower levels of stress and 711 (83.0%) reported bodyweight change. There were significant relationships between bodyweight change, stress level and hospitalization due to COVID-19. There was a significant relationship between smoking, bodyweight change and hospitalization rate. A total of 426 (50.3%) students did not have a regular sleep-wake pattern, 701 (81.8%) spent more time using social media, 197 (23.0%) consumed more fast food, and 674 (78.6%) experienced stress or anxiety. Conclusion: There was an increased tendency towards unhealthy lifestyle among medical students in Tehran during COVID-19 lockdown. These findings can be useful in assessing lifestyle behaviours among students and in planning for improvements.
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COVID-19 , Students, Medical , Humans , Iran/epidemiology , Cross-Sectional Studies , Pandemics , Communicable Disease Control , Life Style , Dietary SupplementsABSTRACT
Asthma, as a chronic inflammatory condition of the airways, has a considerable prevalence among children. Vitamin D might play a role in asthma pathogenesis by affecting the development of the lung, regulating the immune responses, and remodeling of airway smooth muscle (ASM). Study results on the association between the serum level of vitamin D and asthma severity have suggested a converse relationship between lower vitamin D levels and more severe clinical courses. However, they are not consistent in these findings and have shown insignificant correlations, as well. The possible effects of vitamin D on asthma have led researchers to consider this vitamin a potential prophylactic and therapeutic tool for managing children with variant degrees of asthma. Adding vitamin D to the routine corticosteroid therapy of asthmatic children is another field of interest that has shown promising results. In this narrative review study, we aim to elaborate on the existing knowledge on the role of vitamin D in asthma pathogenesis and prognosis, explain the controversies that exist on the effectiveness of treating patients with vitamin D supplements, and make a general conclusion about how vitamin D actually is linked to asthma in children.
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Asthma , Vitamin D Deficiency , Asthma/epidemiology , Asthma/etiology , Child , Dietary Supplements , Humans , Vitamin D/therapeutic use , Vitamin D Deficiency/drug therapy , Vitamin D Deficiency/epidemiology , Vitamins/therapeutic useABSTRACT
The SARS-CoV-2 genome has undergone several mutations since the beginning of the pandemic in December 2019. A number of these mutants were associated with higher transmissibility, higher mortality, or hospitalization rates, which were named the variants of concern. B.1.617.2 or the Delta variant has made a lot of concern as it has been responsible for the most recent COVID-19 outbreaks throughout the world. Higher transmissibility, a 60 percent increase in hospitalization rates compared to the wild type, higher viral loads, and reduced response to available vaccines are among the key factors why this variant has become a variant of concern. 148 countries are currently fighting with this variant, hoping to better understand the epidemiological, immunological, and clinical characteristics of this disease in order to find the best way to overcome these new outbreaks. Although reduced efficiency of vaccines on this variant and its higher pre-symptomatic transmissibility have made it complicated to control the disease, higher vaccination coverage and following sanitation rules can help control the outbreaks.
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COVID-19 , Pandemics , Disease Outbreaks , Humans , SARS-CoV-2ABSTRACT
BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is a common disease among children; it affected 5-7% of the population in 2015. ADHD is a multifactorial disease, and its etiology is still not clearly understood. DATA SOURCES: This narrative review has been done by searching the PubMed and Embase databases using attention deficit/hyperactivity disorder, ADHD, risk factors; genetics; pediatrics; psychiatrics as keywords. RESULTS: ADHD is considered to be a hereditary disorder in which genes play the fundamental role in the pathogenesis; however, findings from genetic-environmental studies support the hypothesis that genetic factors can exert effects on an individual's condition by determining his/her responses to environmental exposures, especially those during the prenatal stage. CONCLUSION: ADHD is considered as a hereditary disorder in which genes and prenatal risk factors play fundamental roles in the pathogenesis.