Search

Recently, the morbidity of acute severe hepatitis of unknown origin in children (SHIC) has tended to decrease, but this condition should not be ignored because of its uncertain but severe nature. The current study briefly summarizes updated information regarding the epidemiological, clinical, and etiological aspects of SHIC based on the newest information available. Opinions from pediatricians are also presented. In light of the status quo of SHIC and COVID-19 globally, several suggestions are proposed to improve future studies, which could help to further explore the underlying mechanisms of SHIC in the context of COVID-19.

Recent data show that maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) are associated with offspring neurobehavior in childhood. However, little is known about the effect on infants that less than 20 months of age, and whether this association has sex differences. In this birth cohort study, a total of 661 mother–infant pairs were enrolled in Shanghai, China, between February 2017 and April 2019. Maternal prepregnancy BMI was categorized according to the Chinese classification and GWG according to the 2009 Institute of Medicine (IOM). Neurobehavioral development for infants of 12 months of age was assessed by Gesell Developmental Scale (GDS), which contained five subscales of gross motor, fine motor, adaptive behavior, language, and social behavior. Abnormal maternal prepregnancy BMI and excessive GWG were associated with infant birth weight and/or birth length (p < .05), while no influence was found on yearling weight or length. Women who were overweight/obese prior to pregnancy or excessive GWG during pregnancy had infants who were more deficient in neurobehavioral developmental including language (p < .01) and/or social behavior (p < .05). Specifically, excessive GWG was associated with lower language ability in girls but not boys (p < .05). Aberrant prepregnancy BMI and excessive GWG not only affect the body size of newborn infants, but also impair their neurobehavioral development, suggesting that general guidance to the women should be advised to attain optimal prepregnancy BMI and GWG.

Phenylketonuria (PKU), one of the most prevalent autosomal recessive disorders of amino acid metabolism, is characterized by abnormal accumulation of phenylalanine, which can lead to intellectual disability. The main pathologic changes in the central nervous system of untreated phenylketonuric patients are reductions in the number of axons, dendrites, and synapses in the brain. Such alterations are thought to be mainly associated with the toxic effects caused by phenylalanine. However, the underlying molecular mechanisms have not been fully elucidated. The present study shows that a high concentration of phenylalanine remarkably inhibited neuronal neurite formation in vitro. Interestingly, AMP-activated protein kinase (AMPK), the energy status sensor, was activated in cultured cerebral cortical neurons upon phenylalanine treatment. Pretreatment with an AMPK inhibitor ameliorated the reduction of neurite formation caused by phenylalanine. In addition, the levels of the phosphorylated AMPK, the active form of AMPK, were significantly higher in the cerebral cortices of PKU mice with elevated phenylalanine levels in this brain region compared to those in wild-type control mice, whereas the density of dendritic spines on basal secondary dendrites of pyramidal neurons in prefrontal cortices of PKU mice was significantly decreased. Collectively, these findings indicate that AMPK activation is a key event in impaired neuronal dendritic development in PKU and consequently, a potential therapeutic target for developing neuroprotective strategies against phenylalanine-evoked brain injury in PKU.

Recent data suggests that abnormal maternal pre-pregnancy body mass index (BMI) or gestational weight gain (GWG) is associated with unfavorable delivery outcomes. However, limited clinical evidence is available to support this correlation in China. Participating 510 mother-infant pairs were recruited from the Shanghai First Maternity and Infant Hospital, China, between January 1st and 30th 2016. Maternal pre-pregnancy BMI was categorized according to the China’s classification and GWG according to the 2009 Institute of Medicine recommendations (IOM). Linear regression tested the associations between pre-pregnancy BMI or GWG and length of gestation, birthweight, length, and head circumference. Logistic regression assessed the associations between pre-pregnancy BMI or GWG and macrosomic, small- (SGA) and large- (LGA) for-gestational-age infants. Overweight/obese women showed increased length of gestation and birthweight, but did not have a higher risk of macrosomic and LGA infants compared with normal weight women. Women with excessive GWG showed increased length of gestation, birthweight, length, and head circumference, and were more likely to deliver macrosomic and LGA infants compared with women with adequate GWG. Although a relatively low proportion of women from Shanghai area are overweight/obese or exhibit excessive GWG, both high pre-pregnancy BMI and excessive GWG influence perinatal outcomes.

The gastrointestinal (GI) tract of a fetus in utero is sterile but it becomes colonized with environmental microorganisms shortly after birth. Since the gut microbiota undergoes substantial changes in early life, healthy gut microflora is essential to an infant's gut health and immune system and probably also has an effect on overall health status in later life. Probiotics, defined as viable microbial preparations that have a beneficial effect on the health of the host, represent a rapidly expanding field. Although randomized controlled trials using probiotics in infants have shown promising results in the prevention and treatment of common diseases such as diarrhea and allergy, little is known about whether probiotics could offer benefits to healthy infants. We have designed a randomized controlled trial to test the hypothesis that an oral preparation of probiotics is superior to placebo in improving digestive and immune function in healthy infants.The trial will be a randomized, double-blind, placebo-controlled, 2-parallel-group study in Shanghai, China. After a 2-week run-in period, 200 exclusively formula-fed healthy infants aged 4 to 6 months will be randomly allocated to receive either a probiotic product containing Bifidobacterium infantis R0033, Bifidobacterium bifidum R0071, and Lactobacillus helveticus R0052 or an identical placebo once daily for 4 weeks and will be followed up for 8 weeks. The duration of the subject's participation will be 14 weeks, with a total of 5 visits: inclusion (Visit 1, Day 1), start of intervention (V2, D15), end of intervention (V3, D44), and follow-up (V4 and V5, D72 and D100). Stool and saliva samples will be collected at the first 3 visits to measure microbial populations and secretory immunoglobulin A (SIgA), respectively. Physical examination will be performed at each visit, and tolerance records will be completed 1 day prior to each visit. The primary endpoints will be the changes in the composition of fecal microbiota, particularly the Bifidobacterium bifidum population. The secondary endpoints will include the change in salivary SIgA level, growth parameters, digestive tolerance, and adverse events.An effective, practical, and acceptable probiotic intervention in manipulating the gut microbiota and boosting the immune system in formula-fed infants would represent a major clinical advance. The administration of probiotic supplementation or follow-on formula to infant may be associated with some clinic benefits.

Non-adherent bone marrow cell-derived mesenchymal stem cells from C57BL/6J mice were separated and cultured using the “pour-off” method. Non-adherent bone marrow cell-derived mesenchymal stem cells developed colony-forming unit-fibroblasts, and could be expanded by supplementation with epidermal growth factor. Immunocytochemistry showed that the non-adherent bone marrow cell-derived mesenchymal stem cells exposed to basic fibroblast growth factor/epidermal growth factor/nerve growth factor expressed the neuron specific markers, neurofilament-200 and NeuN, in vitro. Non-adherent bone marrow cell-derived mesenchymal stem cells from β-galactosidase transgenic mice were also transplanted into focal ischemic brain (right corpus striatum) of C57BL/6J mice. At 8 weeks, cells positive for LacZ and β-galactosidase staining were observed in the ischemic tissues, and cells co-labeled with both β-galactosidase and NeuN were seen by double immunohistochemical staining. These findings suggest that the non-adherent bone marrow cell-derived mesenchymal stem cells could differentiate into neuronal-like cells in vitro and in vivo.