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Background: Thymic stromal lymphopoietin (TSLP), an epithelium-derived pro-inflammatory cytokine, activates distinct immune and non-immune cells. It has been shown to be a master regulator of type 2 immune responses. Limited information is available on TSLP in childhood asthma. The aim of the present study was to find out whether there is association between TSLP concentrations and asthma phenotypes or disease activity. Methods: A total of 207 children with asthma and 100 healthy children aged 1–13 years were enrolled. This study examined serum TSLP concentrations using ELISA Kit in asthma patients and controls, analyzed its correlation with asthma phenotypes and pulmonary function. We also examined TSLP concentrations in 23 patients during stable asthma and in acute asthma exacerbation. Results: The serum concentrations of TSLP were significantly elevated in asthma patients compared with healthy controls (p < 0.05), but there was no significant difference (p > 0.05) in TSLP concentrations between three different asthma phenotypes (allergic asthma, virus induced asthma and nonallergic asthma). There was no significant correlation between TSLP concentrations and FEV1pred% (r = 0.01, p > 0.05). In the acute asthma exacerbation TSLP concentrations were not significantly different than in stable phase of disease (p > 0.05). Conclusion: Children with asthma have higher serum TSLP concentrations when compared to healthy controls. TSLP does not seem to be a biomarker of disease exacerbation in children. Different asthma phenotypes have similar TSLP concentration profile in peripheral blood and TSLP does not seem to be useful biomarker in asthma phenotyping in children.

The perplexing interactions between an organism and it’s gut commensal microbiota have both potentiating and detrimental effects on innate and adaptive immunity and consequentially the development of several immune-mediated diseases. Juvenile idiopathic (JIA) and reactive arthritis (ReA) are two adverse outcomes of such disorder in children. This study aimed to assess the differences in the presence of subtypes of Escherichia coli (E coli), one of the most abundant bacteria in the microbiota, in the stool of JIA and ReA patients. Stool samples of 14 patients with joint swelling were collected during their first visit to Pediatric Rheumatology Clinic in Sestre milosrdnice University Hospital Center in Zagreb, Croatia. Three months later, the diagnosis of JIA was made in seven patients, while the others were classified as ReA. The samples were analyzed by mass spectrometry on nanoLC- Synapt G2 Si instrument. To identify the most abundant E coli subtypes, specialized software named Protein Reader with implemented Dust algorithm have searched through the NCBI nr database, that contains the records of more than 400 E coli subtypes. The median age of patients was 7.14 and 7.11, respectively. Various E coli subtypes (P0301867.1-10, O104:H4, O103:H25, O111:H11, KTE and K) were three times more abundant in patients with JIA, while in children with ReA, the abundance of diarrheagenic E. coli (DEC) was detected. Many studies have speculated the influence of gut microbiota in the development of arthritis in children. Despite the technological advancements in the examination of microbiota composition, there are still many limitations imposed by patient selection, methodology and data analysis. Besides, without the proper definition of ‘healthy’ microbiome as a reference standard, it is challenging to distinguish alterations responsible for diseases development. In our proof-of-the-concept study microbiota was therefore compared in two groups of patients both presenting with arthritis. Since E coli is one of the paramount bacteria in gut microbiota with more than 600 recognized subtypes, it is reasonable to assume that described differences can have a potential impact on the gut environment, with the contribution to the development of the chronic disease in JIA patients or the resolution of symptoms in children with ReA. While this observation needs conformation in multiple time points and larger patient cohorts, it pinpoints gut microbiota as a potential new therapeutic target in the treatment of chronic inflammatory diseases.

Uvod: Astma je kronična upalna bolest dišnih putova karakterizirana predominacijom pomagačkih limfocita T2. Limfopoetin strome timusa (TSLP) je citokin odgovoran za preusmjeravanje na T2 odgovor u astmi. ----- Cilj: Ispitati koncentraciju TSLP-a u serumu bolesnika s astmom i u zdravih ispitanika, te ustvrditi povezanost koncentracije TSLP u serumu s kliničkim i laboratorijskim karakteristikama naših bolesnika. ----- Ispitanici i metode: U istraživanje je uključeno 207 ispitanika s astmom i 100 zdravih ispitanika dobi od 1 do 13 godina. Svim ispitanicima izmjerena je koncentracija TSLP u serumu metodom ELISA koristeći Human TSLP ELISA Kit (abcam, ab155444), a u 23 ispitanika koncentracija TSLP u serumu izmjerena je i u akutnoj egzacerbaciji astme. ----- Rezultati: Koncentracija TSLP-a u serumu statistički je značajno veća u djece s astmom u usporedbi sa zdravom djecom (p < 0,005). Nije nađena statistički značajna razlika u vrijednosti koncentracije TSLP-a u serumu između tri različita fenotipa astme (astme s alergijskom senzibilizacijom, astme bez alergijske senzibilizacije i astme inducirane virusnim infekcijama), niti između djece s dobro kontroliranom i nekontroliranom astmom (na osnovi upitnika u djece starije od 4 godine, spirometrijskih mjerenja). Koncentracija TSLP-a u serumu nije dobar pokazatelj plućne funkcije, niti je značajno povišena u akutnoj egzacerbaciji astme. Ni protuupalna terapija niti težina bolesti ne utječu na koncentraciju TSLP-a u serumu. Nađena je statistički značajna razlika između kvartilnih skupina TSLP-a ovisno o uhranjenosti (p < 0,05), te je moguća uloga masnih stanica na koncentraciju TSLP-a u serumu. Mršavija djeca imaju niže, a pretila djeca više vrijednosti TSLP-a u serumu. ----- Zaključak: Rezultati ovog istraživanja potvrdili su hipotezu da je serumska koncentracija TSLPa u djece oboljele od astme značajno veća od koncentracije TSLP-a u zdrave djece, no koncentracija TSLP u serumu nije dobar biomarker u rutinskoj dijagnostici jer nam ne pomaže u razvrstavanju djece u različite fenotipove astme, ni u procjeni kontrole astme dječje dobi, niti je dobar pokazatelj plućne funkcije. Ostaje otvoreno pitanje o povezanosti koncentracije TSLP-a u serumu i astme u pretilih osoba., Introduction: Asthma is a chronic inflammatory disorder of the airways characterized by a predominant Th2 response. Thymic stromal lymphopoietin (TSLP) has been considered to switch on the T2 response in asthma. ----- Aim: To evaluate the serum levels of TSLP in children with asthma and healthy controls, and to establish the correlation of serum TSLP with specific clinical and laboratory characteristics of our patients. ----- Patients and methods: The study included 207 children with asthma and 100 healthy controls aged 1 to 13 years. Serum levels of TSLP were measured in all children by enzyme-linked immunosorbent assay (ELISA) using the Human TSLP ELISA Kit (abcam, ab155444). In 23 children with asthma, TSLP were measured in acute asthma exacerbations as well. Results: Serum levels of TSLP were significantly higher in children with asthma compared to healthy children (p

Uvod: Pedijatrijski reumatološki bolesnici često koriste komplementarne i alternativne metode (KAM). Unatoč tome, još uvijek se ne zna dovoljno o njihovim koristima i štetnostima. ----- Cilj: Cilj ovog istraživanja je bio utvrditi učestalost i osobitosti uporabe KAM-a u djece s kroničnim reumatološkim bolestima u KBC Sestre milosrdnice, Zagreb, Republika Hrvatska. ----- Ispitanici i metode: Provedeno je presječno istraživanje putem upitnika na roditeljima djece oboljele od kroničnih bolesti u sklopu dogovorenih liječničkih kontrolnih pregleda. ----- Rezultati: 63 roditelja (63%) su koristili najmanje jednu vrstu KAM-a u liječenju kronične bolesti svoje djece. Najčešće upotrijebljeni KAM-ovi su bile tvari biljnog porijekla (30,49%) i ortomolekularna terapija (25%). Primijećeno je da roditelji često koriste više skupina KAM-a. 4 ispitanika (6%) primijetili su nuspojave vezane za korištenje KAM-a. 43 ispitanika (68,25%) nisu obavijestili liječnika o korištenju KAM-a. Ova studija je pokazala da su jači simptomi bolesti povezani s češćim korištenjem KAM-a (p, Introduction: Complementary and alternative methods (CAM) are commonly used by pediatric rheumatology patients. Nonetheless, their advantages and disadvantages still remain unclear. ----- Aim: The aim of this study was to assess the prevalence and patterns of CAM use in children with rheumatic chronic diseases at The University Hospital Center “Sestre milosrdnice”, Zagreb, Croatia. ----- Subjects and methods: A cross-sectional questionnaire study was conducted with parents of children with chronic diseases during routine pediatric rheumatology clinic visits. ----- Results: Sixty-three parents (63%) had used at least one CAM in management of the child’s chronic disease. The most commonly used CAM included herbal remedies (30.49%) and orthomolecular therapies (25%). It was observed that combinations of therapies were used too. Only four CAM users (6%) reported any side effects. Forty-three (68.25%) did not mention CAM use to their doctors. Stronger symptoms were associated with CAM use (p