Cytokine Responses of TNF-α, IL-6, and IL-10 in G6PD-Deficient Infants

G6PD-deficient adults are reported to be susceptible to severe infection, and decreased cytokine responses have been postulated as the underlying mechanism. However, investigating the association of G6PD deficiency and cytokine responses during infancy is lacking. The current study aims to determine whether cytokine responses of tumor necrosis factor ()-α, interleukins (IL)-6, and IL-10 are impaired in the G6PD-deficient infants. Upon agreements with informed consents, peripheral blood mononuclear cells (PBMCs) of enrolled infants were collected twice at 1 month and 1 year of age. PBMCs were then stimulated with toll-like receptor (TLR) agonists—including PAM3csk4 for TLR1–2, poly (I:C) for TLR3, and lipopolysaccharide for TLR4—to analyze the expression of TNF-α, IL-6, and IL-10. Males (P = .004) and phototherapy during neonatal period (P = .008) were more common among G6PD-deficient infants than G6PD-normal subjects. After the stimulation of TLR agonists, there was no significant difference in the expression of TNF-α, IL-6, and IL-10 between PBMCs of G6PD-deficient and -normal infants at both 1 month and 1 year of age. In conclusion, the clinical characteristics of G6PD-deficient infants are different from those of G6PD-normal subjects. The data suggest that the innate immune responses to TLR agonists in G6PD-deficienct infants are not different from those of G6PD-normal infants.     

Intracellular production of IL-2, IL-4, IFN-γ, and TNF-α by peripheral blood CD3+ and CD4+ T cells in children with atopic dermatitis

The role of the type-2 T helper (Th2) cell-mediated immune response in the immunopathogenesis of atopic dermatitis (AD) is well documented. Whether polarized immunoresponse is confined to antigen-specific T cells or is distributed among all T cell subsets is still controversial. We investigated frequencies of interleukin-2 (IL-2), IL-4, interferon-gamma (IFN-γ), and tumor necrosis factor-alpha (TNF-α) producing CD3⁺ and CD4⁺ T cells in peripheral blood from children with atopic dermatitis and healthy subjects with and without in vitro stimulation. Children with severe AD had a significantly lower percentage of CD4⁺ T cells spontaneously expressing IL-4 compared with healthy controls (p <0.01). Polyclonal stimulation significantly increased cytokine production in both AD patients and healthy individuals. Frequencies of CD3⁺ and CD4⁺ producing IL-2, IL-4, IFN-γ, and TNF-α after in vitro stimulation with phorbol-12-myristate 13-acetate (PMA) + ionomycin were comparable in the AD and control groups. In response to PMA/ionomycin, children with AD and asthma symptoms had a significantly lower percentage of CD3⁺ T cells producing TNF-α. We failed to demonstrate evidence of an imbalance with respect to type-2 cytokine productions in children with AD. Comparable induction of Th1 and Th2 cytokines in polyclonally stimulated peripheral CD3⁺ and CD4⁺T cells from AD patients and controls puts into question the polarized Th2 immune response as a general characteristic of T cells in children with atopic dermatitis.     

Plasma endothelial microparticles, TNF-α and IL-6 in Kawasaki disease

We studied the levels of endothelial microparticles (EMPs), IL-6, and TNF-α in patients with Kawasaki disease (KD). EMPs were enumerated by flow cytometry, while IL-6 and TNF-α were measured using enzyme-linked immunosorbent assay. EMPs and IL-6 were elevated in KD, the level of TNF-α in KD was not different from disease controls, but higher than healthy controls. EMPs were positively correlated with TNF-α and negatively correlated with albumin. Elevated level of EMPs, a biomarker of endothelial cells damage, concomitant with increased levels of TNF-α and IL-6, is seen in patients with KD.     

Antimicrobial resistance of nasopharyngeal isolates of Streptococcus pneumoniae in healthy carriers: report of a study in 5-year-olds in Marcory, Abidjan, Côte d'Ivoire

The increasing prevalence of antibiotic-resistant Streptococcus pneumoniae is of growing public health concern. The aim of this study was to assess resistance rates of S. pneumoniae to penicillin and other antimicrobial agents. Between November 1997 and February 1998 in a community health centre in Marcory, an Abidjan suburb, 138 S. pneumoniae strains were isolated from the nasopharynxes of 218 apparently healthy children aged 3-60 months. The sensitivity of the isolates was tested using the Kirby-Bauer method. In isolates with a possibly abnormal sensitivity to the Kirby-Bauer test, minimum inhibitory concentrations (MIC) were estimated using the E-test. Antimicrobials tested included penicillin G, amoxycillin, cefotaxime, cotrimoxazole, tetracycline, chloramphenicol, erythromycin, rifampicin and vancomycin. Twelve of 108 isolates (8.7%) had reduced sensitivity to penicillin G, and in three of them the MIC for penicillin reached at least 2 micrograms/ml. Resistance to amoxycillin and cefotaxime was lower than to penicillin (2.2%). With regard to cotrimoxazole, 37% were moderately resistant and 15.2% highly resistant. The lowest resistance rate observed was to rifampicin (2.2%) and the highest was to tetracycline (57.2%). Rates of resistance to erythromycin and chloramphenicol were 11.6% and 2.9%. All strains were sensitive to vancomycin. Multidrug resistance (MDR) was detected in 9.4% of S. pneumoniae isolates. In children, epidemiological surveillance of resistance can be monitored by bacteriological surveys, as shown in this study.     

Prevalence of asthma related to BMI in adolescents in Tehran, Iran, 2004–2005

Both asthma and obesity have become more common in affluent societies during the recent decades, and several studies have shown a correlation between the presence of asthma and obesity.     

Patterns of childhood mortality in a region of Belarus, 1980–2000

The public health infrastructure of the former Soviet Union was impacted by both the Chernobyl disaster in 1986 and the Soviet breakup in 1991. This paper examines mortality patterns among children aged 1–14 years within the Mogilev region of Belarus between 1980 and 2000. This study utilized a regional cohort design that included all childhood deaths (ages 1–14 years) occurring among persons residing within the Mogilev oblast of Belarus between 1980 and 2000. Patterns of death and death rates were examined across three intervals: 1980–1985 (pre-Chernobyl), 1986–1991 (post-Chernobyl and pre-Former Soviet Union (FSU) breakup) and 1992–2000 (post-Chernobyl and post-FSU breakup) based upon administrative death files. Annual death rates among children aged 1–4 years declined between 1980 and 2000, while mortality rates among children aged 5–9 years and 10–14 years remained steady over this time period. Average annual mortality rates among males aged 5-9 years and 10–14 years increased significantly between 1986 and 1991. Compared to the baseline interval, mortality among both males and females aged 1–4 years was significantly decreased during 1986–1990 and 1992–2000. In general, mortality rates among males were 24%–95% greater compared to females. Injuries and poisonings accounted for the largest proportion of deaths across all age and gender groups examined. Subsequent to the Chernobyl disaster, significant decreases were noted in mortality rates among children aged 1–4 years while mortality rates among children aged 5–9 and 10–14 remained stable. Conclusion: Similar to the findings in other countries, injuries and poisonings predominated as the leading cause of death among Belarussian children.     

Prevention of anemia in the first year of life in health centers of Santo André, São Paulo

The aim of this study was to evaluate the efficacy of an iron prophylactic supplementation program, in three health centers of Santo André, in S?o Paulo state. The prevalence of anemia was identified in a control group consisting of 201 children of 1 year old. The intervention group consisted of 308 children younger than 3 months, but 55% of them gave up during the survey. The mothers were instructed to give them daily prophylactic doses of iron sulfate (6 mg of iron/day) when they were 4 or 6 months old, according to the kind of breast-feeding. The mothers were also instructed about feeding and anemia and its risk to children's health. When the children were 12 months old, the diagnosis of anemia was made through dosage of hemoglobin concentration and the results were compared with those of the control group. It was verified that the 2 groups presented similar prevalences. It is important to realize that children with low frequency of visits to the health centers had prevalence of anemia significantly higher than those with high frequency. Some factors that possibly contributed to the result of the intervention are discussed.     

Inherited disorders of the IL-12-IFN-γ axis in patients with disseminated BCG infection

Disseminated BCG infection is a rare complication of vaccination that occurs in patients with impaired immunity. In recent years, a series of inherited disorders of the IL-12-IFN- axis have been described that predispose affected individuals to disseminated disease caused by BCG, environmental Mycobacteria, and non-typhoidal Salmonella. The routine immunological work-up of these patients is normal and the diagnosis requires specific investigation of the IL-12-IFN- circuit. We report here the first two such patients originating from and living in Iran. The first child is two years old and suffers from complete IFN- receptor 2 deficiency and disseminated BCG infection. He is currently in clinical remission thanks to prolonged multiple antibiotic therapy. The other, a 28-year-old adult, suffers from IL-12p40 deficiency and presented with disseminated BCG infection followed by recurrent episodes of systemic salmonellosis. He is now doing well. A third patient of Iranian descent, living in North America, was reported elsewhere to suffer from IL-12R1 deficiency. These three patients thus indicate that various inherited defects of the IL-12-IFN- circuit can be found in Iranian people. In conclusion we recommend to consider the disorders of the IL-12-IFN- circuit in all patients with severe BCG infection, disseminated environmental mycobacterial disease, or systemic non-typhoidal salmonellosis, regardless of their ethnic origin and country of residence.     

Rotavirus subgroups, G serotypes, and electrophoretypes in cases of nosocomial infantile diarrhoea in Belém, Brazil.

From November 1992 to November 1994 stool samples were obtained from 237 children admitted to a public hospital in Belém. Rotaviruses were detected in 19.3 per cent (60/310) of faecal samples. Of these, 32.1 per cent (18/56), 20.9 per cent (38/181), and 5.4 per cent (4/73) were recorded in cases of nosocomial diarrhoea, community-acquired diarrhoea, and controls, respectively. Fifty-two (86.7 per cent) of the 60 rotavirus-positive specimens were subgrouped and the G serotypes of 55 (91.7 per cent) of them were determined. Subgroups I and II were detected in 50 per cent each of the 52 subgrouped strains. G type 2 was present in 46 (83.6 per cent) of the 55 serotyped samples; serotypes G1 and (mixed) G1 and G4 were found in 14.5 per cent and 1.8 per cent, respectively, of these specimens. Viral RNA electrophoresis showed 14 distinct patterns, including 56.7 per cent (34/60) and 43.3 per cent (26/60) of long and short profiles, respectively. In 40 (66.6 per cent) of the 60 rotavirus-positive faecal samples no enteropathogens other than rotavirus were detected. There was an increased incidence of rotavirus infection from July 1993 to February 1994. The rotavirus-related episodes of diarrhoea were more severe than those of other aetiology and greater clinical severity was not related to a specific G type, subgroup, or electrophoretype.     

The role of IL-6 572 C/G, 190 C/T,and 174 G/C gene polymorphisms in children’s obesity

The aim of this study was to establish the correlations between the polymorphisms of the genes interleukin (IL)-6 572, 190, and 174 in obese children. We assessed 222 hospitalized children divided into two groups: group I (control) included 110 patients with normal nutritional status, and group II consisted of 102 obesity patients. The two groups underwent IL-6 572 C/G, 190 C/T, and 174 G/C polymorphism testing, measurement of anthropometric parameters (mid-upper arm circumference and tricipital skinfold thickness), and paraclinical evaluation (protein, albumin, leptin, adiponectin, and vascular endothelial growth factor (VEGF)). We observed that phenotype CC was more frequent in obese children for IL-6 572 (p?=?0.0001), whereas CG heterozygotes were more frequent in the obese group for the IL-6 190 gene (62.7 %; p?=?0.0001). Leptin was dependent on IL-6 572 and IL-6 174 gene polymorphisms and albumin, whereas adiponectin was dependent on the IL-6 174 gene polymorphism. Body mass index (BMI), mid-upper arm circumference (MUAC), and tricipital skinfold thickness (TST) serum albumin levels correlated with C allele carriers of the IL-6 572 and IL-6 190 genes in children with obesity, whereas the CC genotype of IL-6 174 was a protective factor for obesity. Conclusion: Obesity is most frequently associated in children with IL-6 174 C allele carriers and with IL-6 190 C allele carriers.     

Outcomes of pediatric gastroesophageal reflux disease: in the first year of life, in childhood, and in adults...oh, and should we really leave Helicobacter pylori alone?

The prevalence of gastroesophageal reflux (GER) in childhood varies by age. As in adults, GER can result in a spectrum of disease manifestations. Children with gastroesophageal reflux disease (GERD) may become adults with GERD, as suggested by the frequency of childhood reflux symptoms reported by adults with reflux disease. Some studies suggest a causative association between Helicobacter pylori infection and GERD, whereas others postulate a protective role for H. pylori. To better understand pediatric GERD, age-appropriate case definitions and multicenter randomized controlled treatment trials are critically needed.