A new autoimmune disease: atopic dermatitis in children

Atopic dermatitis (AD) is mainly considered an allergy, exacerbated by allergic factors. Is there evidence to suggest the existence of autoimmune components in the pathophysiology of the illness? Studies in the literature that dealt with the occurrence of autoimmunity in children with AD were analyzed. We followed the studies published in PubMed for 10 years, from 2001 to 2021. Clinical signs and symptoms were similar to other autoimmune diseases, having periods of remission and relapses. Other correlations between AD and autoimmune diseases have been described, and patients with AD can also present with a wide range of autoimmune comorbidities. Three major factors contribute to the pathogenesis of AD: damage of the skin barrier, disorders of the immune response, and imbalances of the skin microbiome—all based on genetic changes and influenced by environmental factors. Predominant activation of Th 2 cells, with the increase of Th 1, Th 17, and Th 22 subsets, promotes skin inflammation. All this evidence suggests that AD might be classified as an autoimmune disease, not just as an allergic reaction (AU)

Cytokine cascade in Kawasaki disease versus Kawasaki-like syndrome.

Kawasaki disease (KD) is a medium vessel systemic vasculitis that predominantly occurs in children below five years of age. It is an acute febrile condition in which coronary artery aneurysms and myocarditis are the most common cardiovascular complications. It is most often characterized by hypercytokinemia. The etiopathogenesis of KD is not fully understood. The present review synthesizes the recent advances in the pathophysiology and treatment options of KD. According to different studies, the genetic, infections and autoimmunity factors play a major role in pathogenesis. Several susceptibility genes (e.g. caspase 3) and cytokines (e.g. IL-2, IL-4, IL-6, IL-10, IFN-gamma and TNF-alpha) have been identified in KD. Patients with high cytokine levels are predisposed to KD shock syndrome. The importance of respiratory viruses in the pathogenesis of the disease is unclear. Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may induce in children and adults an abnormal systemic inflammatory response. This syndrome shares characteristics with KD. It has been called by many terms like MIS-C (Multisystem Inflammatory Syndrome in Children), PIMS-TS (pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2), hyperinflammatory shock syndrome, cytokine storm (cytokine release syndrome) or simply, Kawasaki-like syndrome. The cytokine's role in the development of KD or Kawasaki-like syndrome being triggered by COVID-19 is controversial. The presences of the antiendothelial cell autoantibodies (AECAs) together with the newly developed hypothesis of immunothrombosis are considered potential pathogenic mechanisms for KD. In consequence, the diagnosis and treatment of KD and Kawasaki-like syndrome, one of the most common causes of acquired heart disease in developed countries, are challenging without a clearly defined protocol.

The relationship between hepatocytes and small bowel after early and short food restriction: What the results show in morphometry.

The objective of this study was to evaluate the relationship between hepatocyte morphometry and small bowel architecture after early and short food restriction. Altogether 48 Hyplus broiler rabbits were divided into three groups. The control group was fed ad libitum (ADL) throughout the experiment (C). The first group were food-restricted between 32 and 39 days of age, when the rabbits received 50g of food per rabbit each day (R1). The second group was restricted between 32 and 39 days and the rabbits received 65g of food per rabbit each day (R2). In 39 and in 81 days eight rabbits from all three groups were euthanized. The diameter of centrilobular, midzonal and periportal hepatocytes and the height of villi, the width of villi and the crypt depth were measured. The hepatocytes grew from centrilobular to perilobular part in the C group, but in the R1 and R2 group, an opposite trend was noticed. On day 39 and daye 81 the elevations of villi were the highest. Interestingly, the nadirs of the crypts were deepest in the C group compared to the R1 and R2 groups. Early short intensive food restriction may play a role in the prevention of liver diseases (Tab. 2, Ref. 20).

Is the evidence of breast feeding protection against coeliac disease real?

Many recent studies discredit breastfeeding protection against coeliac disease. We will try to answer the question: "Is the evidence of breast feeding protection against coeliac disease real?"

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The influence of food restriction on the small bowel: Does intensive short­term food restriction lead to weight loss?

The objective of this study was to show morphological changes in the small intestine of Hyplus broiler rabbits following an eight­day food restriction programme. The control group (C) received food ad libitum (ADL) for the duration of the experiment. Group R1 received 50g of food per day, and group R2 received 65g of food per day. After the food restriction diet had been completed, groups R1 and R2 were returned to ad libitum feeding. After food restriction and at the end of the experiment, the longest small bowel measurement was recorded in the C group. In the C group, after food restriction, the villi height was significantly higher, compared to that in R1 and R2 groups and at the end of the experiment, the villi were significantly higher in R1 and R2 groups. After food restriction, the values of crypts depth were approximately similar in all groups, and the end of experiment, the depth of crypts were deepest in R1and R2 groups, as compared to that in C group. The full process is followed by weight loss to the end of the experiment. These data suggest that intensive short­term food restriction followed by ADL feeding has effect on weight loss (Fig. 3, Ref. 30).

Is the evidence of breast feeding protection against coeliac disease real?

Many recent studies discredit breastfeeding protection against coeliac disease. We will try to answer the question: "Is the evidence of breast feeding protection against coeliac disease real?"

Systolic and Diastolic Function in Congestive Heart Failure Pediatric Patients.

BACKGROUND AND AIMS: Two-dimensional (2D) and Doppler echocardiography are the main methods for the non-invasive evaluation of ventricular function in children. Our study monitored the evaluation of systolic and diastolic function in pediatric patients, using classical echocardiographic parameters and pulsed tissue Doppler parameters, as well as the correlation between these. METHODS: The study included 18 healthy children and 9 children diagnosed with congestive heart failure secondary to congenital heart malformations. The parameters of systolic and diastolic function were measured by 2D echocardiography, 2D guided M mode, color and pulsed Doppler, as well as by pulsed tissue Doppler at the level of the mitral and tricuspid annulus. RESULTS: A relaxation alteration pattern or a pseudonormal pattern of E diastolic velocity compared to the A wave was found (E = A; E > A) in the group of subjects with heart failure. E wave deceleration time had significantly increased values in the case of patients with CHF, being correlated with diastolic dysfunction. Left ventricular flow propagation velocity Vp was decreased in patients with heart failure, the E/Vp ratio being maintained relatively constant in subjects with congestive heart failure and healthy subjects, most probably on account of the concomitant change in the E wave. Associations between the severity of systolic dysfunction and the diastolic dysfunction were found in pediatric patients diagnosed with congestive heart failure (Student test, p < 0.05). CONCLUSIONS: Tissue Doppler measurements proved to be useful for the evaluation of pediatric patients with altered ventricular geometry secondary to congenital heart disease, systolic-diastolic dysfunction and heart failure.

MutL protein homologue 1(MLH1) in colon adenocarcinomas of the dog: minireview.

The mismatch repair gene MLH1 is a gene encoding the mismatch repair protein MutL homolog 1 (MLH1), important for repairing mutations generated during DNA replication. MLH1 absence has been observed in human gastrointestinal tumours as well as tumours of the female reproductive tract. We describe the functions of MLH 1 in cell cycle regulation and DNA mismatch repair. In this sense we discuss foriegn knowledges, in which the canine colon adencarcinoma is less frequently diagnosed in Czech and Slovak regions. We briefly described a molecular mechanism of evolution of MSI+ and MSI- colorectal carcinomas in human, and this was confronted with the current opinion of canine colon adenocarcinomas. We suppose that canine colon adenocarcinomas may occur in higher frequency, but they are underdiagnosed in the clinical veterinary practice. At the end, we describe two cases of dogs diagnosed with colorectal adenocarcinoma. The authors propose the centralized collection of colon adenocarcinoma samples from dogs, in one reference veterinary histopathological laboratory, which would analyse mismatch repair proteins.

Primary eosinophilic esophagitis in children and adults: new aspects for diagnosis.

Eosinophilic esophagitis (EoE) is a chronic, Th2-type immune-mediated disorder. During the past decade, the increasing prevalence of EoE has been recognized in pediatric and adult populations all over the world. EoE diagnosis can be frequent challenging. Three criteria must be met to diagnose EoE: clinical symptoms of esophageal dysfunction, an esophageal biopsy with a peak eosinophil count of at least 15 eosinophils per high-power microscopy field and exclusion of other possible causes of esophageal eosinophilia. Although eosinophils mediate the EoE pathogenesis, proinflammatory cytokines are also critically involved. In the past years biologic therapeutics have revolutionized treatment of EoE.

Eosinophilic esophagitis.

Eosinophilic esophagitis is a chronic, immune-mediated disorder, isolated to the esophagus. Current theory suggests that the former may be caused by cell-mediated food hypersensitivity or may be a subset of eosinophilic gastrointestinal disease, an autoimmune disorder. During the last decade, the increasing prevalence of EoE has been recognized in pediatric populations. Reports support the efficacy of dietary restriction or corticosteroid therapy. Aditional research is needed to determine etiology, allow earlier clinical recognition and improve treatment. Because no single symptom, endoscopic finding or histopathologic feature is pathognomonic, the diagnosis can frequently be challenging. The current article reviews the possible etiology, clinical presentation, diagnosis, and treatment of this disorder, which has been called not only allergic esophagitis (which may be the most important cause), but also eosinophilic esophagitis, primary eosinophilic esophagitis, and idiopathic eosinophilic esophagitis.