Editorial: Dietary Interventions and Nutritional Factors in the Prevention of Allergic Diseases in Infants

Since allergic diseases represent a great public health, there is a strong need for a better understanding of modifiable risk factors. The present Research Topic discusses the main topic related to allergic disease prevention and addresses possible intervention strategies, since pregnancy to postnatal period. Both primary prevention, which prevents the sensitization development, and secondary prevention, aiming to decrease the development of further disease after sensitization, are addressed. Primary prevention may play a role in reducing the burden of allergic disease, especially in high-risk infants, although some preventive measures should be considered as useful preventive strategies for general population

Oral Lactoferrin in HIV-1 Vertically Infected Children: An Observational Follow-up of Plasma Viral Load and Immune Parameters

Lactoferrin (LF) is a mammalian iron-binding glycoprotein with antiviral effects. This preliminary study evaluated 6 months' LF (3 g/day, orally) treatment in 22 human immunodeficiency virus type 1 (HIV-1) vertically infected children. Plasma viral load and CD4+ cell counts were assessed every 3 months; before, during and after LF administration. No significant changes were observed during the pre-treatment period. By 6 months, mean (± SD) plasma viral load (log10) declined from 4.54 (± 0.65) to 4.28 (± 0.60); median percentage CD4+ cell count increased from 21.5% to 24.5%. Two months after treatment discontinuation, mean plasma viral load did not differ significantly from baseline or month 6 levels, but the percentage CD4+ cell count remained significantly higher than the baseline value. LF plus antiretroviral (ARV) therapy was more effective at increasing CD4+ cell count than LF alone. None of the patients showed any new HIV-1-related symptoms at follow-up. LF might be a useful addition to ARV therapy, ..

385 Congenital cytomegalovirus infection or genetic syndrome? A two-case-report comparison

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sensor augmented pump and down syndrome a new tool in tricky patients

W e read with great interest the paper by Piccini and cols. (1) published in the July issue of this Journal. Some years ago, we published the first report ever (to the best of our knowledge) of successful treatment of a girl with Down syndrome, Hashimoto's thyroiditis and celiac disease with continuous subcutaneous insulin infusion (2). Since then, her glycemic control was kept constant and, most of the time, in the target range (HbA1c in 2009: 7.75 ± 0.21%; HbA1c in 2010: 7.35 ± 0.19%; HbA1c in 2011: 7.42 ± 0.30%). At the end of 2011, sensor-augmented pump was initiated (Animas® VibeTM, West Chester, PA, USA) because of both a quite high glycemic variability and the parents' request, and her HbA1c kept improving (HbA1c in 2012: 7.30 ± 0.20%; HbA1c in 2013: 7.10 ± 0.28%). CSII has been recognized as effective and safe in pediatric (3) and in adult patients (4), not only in the short run, but even after many years (5). In patients with Down syndrome and type 1 diabetes, glycemic control may sometimes be particularly tricky (6,7). In our patient, as well as in the one of Piccini and cols. (1), CSII was a safe and effective way to manage diabetes. For a successful CSII therapy in a patient with Down syndrome, whose mental function may be impaired, the collaboration of a highly motivated and compliant family is essential, as well as a skilled multidisciplinary diabetes team (8). Given all of this, pump increased the patient's and family's flexibility, as we had previously reported (2). The significant improvement in the glycemic control observed, and the high level of acceptance of CSII therapy observed in both our case and in that of Piccini and cols. is worth the effort of the patient's family and of the diabetes team in ensuring that the patient has a flexible life. Perhaps CSII therapy might be taken into account when considering insulin therapy in patients with Down's syndrome

Necrobiosis Lipoidica Diabeticorum

Necrobiosis lipoidica is a rare disorder that usually appears in the lower extremities and it is often related to diabetes mellitus. There are few reported cases of necrobiosis lipoidica in children. We present an interesting case in that the patient developed lesions on the abdomen, which is an unusual location

Discovering Genotype Variants in an Infant with VACTERL through Clinical Exome Sequencing: A Support for Personalized Risk Assessment and Disease Prevention

Abstract: Congenital anomalies may have an increased risk of noncommunicable diseases (NCDs) We performed a clinical exome analysis in an infant affected by “Vertebral, Anorectal, Cardiac, Tracheoesophageal, Genitourinary, and Limb” (VACTERL) malformation association to identify potential biomarkers that may be helpful for preventing malignancy risk or other chronic processes. Among the variants, six variants that may be linked with VACTERL were identified in the exome analysis. The variants c.501G>C on OLR1 and c.-8C>G on PSMA6 were previously associated with myocardial infarction. The variants c.1936A>G on AKAP10 and c.575A>G on PON1 are linked to defects in cardiac conduction and artery disease, respectively. Alterations in metabolism were also suggested by the variants c.860G>A on EPHX2 and c.214C>A on GHRL. In addition, three variants associated with colon cancer were discovered. Specifically, the reported variants were c.723G>A on CCND1 and c.91T>A on AURKA proto-oncogenes as well as c.827A>C in the tumor suppressor PTPRJ. A further inspection identified 15 rare variants carried by cancer genes. Specifically, these mutations are located on five tumor suppressors (SDHA, RB1CC1, PTCH1, DMBT1, BCR) and eight proto-oncogenes (MERTK, CSF1R, MYB, ROS1, PCM1, FGFR2, MYH11, BRCC3) and have an allele frequency lower than 0.01 in the Genome Aggregation Database (GnomAD).We observed that the cardiac and metabolic phenotypic traits are linked with the genotype of the patient. In addition, the risk of developing neoplasia cannot be excluded a priori. Long-term surgical issues of patients with VATER syndrome could benefit from the clinical exome sequencing of a personalized risk assessment for the appearance of further disease in pubertal timing and adult age