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Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by eczematous lesions and recurrent pruritus. The pathogenesis of AD involves epidermal barrier impairments, immune dysfunction, and both genetic and environmental factors. This review presents the latest findings regarding the involvement of microRNA (miRNA) molecules in AD pathogenesis and their potential application as diagnostic biomarkers and therapeutic targets. The following miRNAs were analyzed in detail: miR-223, miR-10a-5p, miR-29b, miR-146a-5p, miR-451a, miR-124, miR-143, miR-151a, miR-24, miR-191, and miR-155. Their molecular mechanisms and potential clinical implications are discussed. Understanding the role of specific microRNAs in AD pathogenesis may contribute to the development of new diagnostic and therapeutic strategies for this disease.

Purpose of review: Regulatory B cells (Bregs) are a key component in the regulation of the immune system. Their immunosuppressive function, which includes limiting the inflammatory cascade, occurs through interactions with other immune cells and the secretion of cytokines, primarily IL-10. As knowledge about B cells continues to expand, their diversity is becoming more recognized, with many subpopulations identified in both human and animal models. However, identifying specific transcription factors or markers that could definitively distinguish regulatory B cells remains a challenge. This review summarizes recent findings on the role of B regulatory cells in allergic diseases. Recent findings: In patients with bronchial asthma, atopic dermatitis, and food allergies, the number of regulatory B cells is reduced, and disease severity is inversely proportional to the quantity of these cells. Furthermore, in patients with atopic dermatitis, the ability of regulatory B cells to produce IL-10 in response to IL-6 stimulation is diminished. However, allergen immunotherapy has been shown to induce the formation of regulatory T cells as well as regulatory B cells. Summary: The success of future therapies based on B cells may depend on deepening our current understanding of their phenotypes, induction, differentiation, and function. Research in these areas is essential for understanding the mechanisms regulating Breg activity and for developing potential targeted therapies in the treatment of allergic diseases.

Frequent respiratory tract infections in the paediatric population are associated mainly with immune system immaturity. A child aged up to 5 years can have up to 8 respiratory infections in a year. Immunomodulation through the elimination of negative environmental factors is of limited efficacy in the paediatric population. For this reason, in certain cases there is a need for pharmacological stimulation of immune response mechanisms in order to limit the number of infections. Modulators include medication, vitamins and trace elements, probiotics and plant formulations. Unfortunately, there are insufficient scientific data which confirm the efficacy of many such agents. Bacterial lysates are an exception: their effects have been confirmed in well-designed studies. Such formulations consist of killed bacterial cells or fragments of their organelles. Bacterial lysates contain antigens of the most common human respiratory pathogens. The efficacy of a bacterial lysate is the resultant of two components: patient-specific (individual immune reactivity) and formulation-specific (composition, dosing regime). To date, no reliable studies comparing the efficacy of different formulations have been conducted. One of the most thoroughly studied products is the one containing OM-85 lyophilisate (BV, Broncho-Vaxom®).

Babesiosis is an infectious, tick-borne disease caused by the parasitic species of Babesia. Transmission via blood transfusion or transplacental infections are much rarer. Most cases of human babesiosis occur in the United States, whereas only single cases have been reported in Europe, including Poland. Anaemia due to erythrocyte haemolysis, which in more severe cases may result in multiple organ dysfunction syndrome and death, particularly in immunocompromised patients, is a typical sign of babesiosis. Immunocompetent patients are asymptomatic or develop mild infection accompanied by fever, osteoarticular pain and erythrocyturia. The diagnostics of babesiosis should be considered in patients with flu-like symptoms who live or are temporarily residing in endemic areas as well as in patients diagnosed with other tick-borne diseases. Final diagnosis should be based on microscopic examination of thin blood smears (Wright or Giemsa staining followed by examination under oil immersion) or PCR-based amplification of the babesial genetic material. Treatment with atovaquone and azithromycin or clindamycin and quinine usually allows for a complete recovery and prevents complications. Severe cases of babesiosis require exchange transfusion. The infection is frequently combated by the immune system without the use of antibiotics in patients with mild or asymptomatic babesiosis. The prevention of babesiosis primarily involves protective measures that minimize the exposure to ticks, which are the only source of infection.

Introduction and objective: The subject of the article concerns the role of optimism in coping with stress and the emotions experienced by the parents of children suffering from nocturnal enuresis. The aim of the study was to determine the relationship between coping strategies and emotions experienced by the parents of children with nocturnal enuresis, taking into account the moderating role of optimism. Materials and methods: The study included 70 parents of children experiencing nocturnal enuresis, who were patients of the Department of Paediatrics, Paediatric Nephrology and Allergology of the Military Institute of Medicine – National Research Institute in Warsaw. The participants completed a sociodemographic survey and questionnaires measuring the level of dispositional optimism (Life Orientation Test-Revised, LOT-R), strategies for coping with a stressful situation related to the child’s illness (Coping Inventory for Stressful Situations, CISS-S) and the level of positive and negative emotions (Skala Uczuć Pozytywnych i Negatywnych, SUPIN, S30 – Polish adaptation of the Positive and Negative Affect Schedule, PANAS). The results of the research partially confirmed the assumed hypotheses. Results: A relationship was found between the level of optimism and emotions, and the use of task-focused coping strategies. The relationship between the level of optimism and other strategies could not be confirmed. Also, it has not been proven that all stress coping strategies are associated with negative and positive emotions. Contrary to the assumptions, optimism did not moderate the relationship between coping with stress and emotions, except for one case, namely coping strategies focused on emotions and the level of negative emotions. Conclusions: The obtained results allow to conclude about the prevailing role of the situational context – the child’s illness over personality variables.

Since the synthesis of histamine in 1907, new reports about its properties and role in the human body have periodically appeared. Its blood levels remain constantly low, almost undetectable, under normal physiological conditions. Increasing histamine levels lead to serious clinical symptoms, including cardiac arrest. Histamine is involved in many processes and allergic reactions. It exerts its effects by acting on receptors, of which four types have been described so far. They are found in numerous tissues, both those in direct contact with the external environment, such as the skin, gastrointestinal and respiratory mucous membranes, as well as those located in internal organs, such as the heart, the brain and on immune cells. The word “antihistamines” is most often used to refer to agents that block the type 1 receptor. These are classified as first- and second-generation antihistamines. The first generation includes non-selective hydrophobic substances that can cross the blood–brain barrier and affect many other types of receptors. Second-generation antihistamines are selective hydrophilic preparations with a long half-life, which means they can be used once daily. Due to their better safety profile, second-generation antihistamines are the treatment of choice in the chronic management of allergic diseases, such as allergic rhinitis and urticaria. First-generation drugs are only for short-term use.

Perinatal mental disorders constitute an important health and social problem. Pre- and postnatal depression affects both the mother and her child. The most common postpartum mental health disorders include the so-called baby blues, postpartum depression and postpartum psychosis. Depression in pregnancy is associated with a greater risk of premature birth and low birth weight. Depression during pregnancy has also been linked to diabetes and preeclampsia. Furthermore, the influence of maternal mental disorders on the development of allergic diseases and neurodevelopmental disorders in the child has been proven. Perinatal depression can lead to impaired bonding between mother and child, which has a long-term impact on the child’s emotional and social development. Perinatal depression may also affect both mental development and the occurrence of somatic diseases in children. The main mental disorders observed in the children of mothers with perinatal depression include behavioural problems, destructive behaviour, anxiety disorders and insecurity. An increased risk of atopic dermatitis and recurrent upper and lower airway infections has been proven in children of depressed mothers. Considering the above, it seems obvious that the protection of the mental health of pregnant and postpartum women and children should be multifaceted and multi-tracked. Untreated depression may have long-term consequences on the child’s development.

Introduction and objective: Asthma is one of the most common chronic diseases in the paediatric population. The aim of this study was to evaluate selected biomarkers: fractional exhaled nitric oxide (FeNO), eosinophil count, periostin; and potential biomarkers: progranulin, matrix metalloproteinase-9 (MMP-9) and tumour necrosis factor alpha (TNFα) in the diagnosis of asthma in children. Materials and methods: The study group consisted of 25 children with atopic asthma in a stable period of the disease, aged 6–17 years. The control group consisted of 21 healthy children aged 6–18 years with no history of allergic diseases. Results: Significantly higher serum periostin levels were observed in children with asthma compared to the control group. There were no statistically significant differences in progranulin, periostin and MMP-9 levels between asthmatic children vs. healthy controls, or between patients with controlled vs. uncontrolled asthma. Children with uncontrolled asthma had significantly higher FeNO levels compared to children with controlled asthma. Exhaled FeNO levels were significantly higher in children with eosinophil levels above 0.3 × 103/µL than in those with eosinophil levels below 0.3 × 103/µL. Children with elevated FeNO had higher progranulin levels compared to children with normal FeNO values. There was a statistically significant positive correlation between FeNO and serum progranulin levels. Conclusions: Periostin may be used as a biomarker of atopic asthma in children. The applicability of FeNO and eosinophil count in the diagnosis of asthma in children has been confirmed. The role of progranulin and MMP-9 in the pathogenesis of asthma and their usefulness as a biomarker in children requires further study.

Abdominal pain in children is a common, atypical symptom. The vast majority of abdominal pain is functional, non-life threatening and does not require extensive diagnostics. However, it should be remembered that the abdominal cavity is one of the most common locations of solid tumours in children. Carefully collected information and physical examination with oncological vigilance allow for the identification of alarming symptoms accompanying abdominal pain. These include: pain waking up from sleep, palpable mass in the abdominal cavity, vomiting, change in the rhythm of bowel movements, weight loss, fever, dysphagia, weakness, anaemia. The article presents a case report of a teenager with ovarian teratoma. It aims to illustrate the pitfalls and diagnostic difficulties associated with determining the causes of abdominal pain in children and adolescents. The discussion also summarises information on the epidemiology, aetiology and clinical symptoms of teratoma.

Background: The main source of vitamin D is skin synthesis, which depends on sunlight exposure. During the pandemic, COVID-19 children were obliged to home confinement, which potentially limiting sunlight exposure. The aim of this study was to evaluate whether home confinement led to decreased vitamin D serum levels in children in Warsaw, Poland. Methods: The study included 1472 children who were divided into two groups, based on the date of 25(OH)D level blood sampling: before and during the pandemic. Children under 1 year of age (infants) were analysed separately. Results: A statistically significant decrease in the average level of vitamin D was observed between groups of children over 1 year of age (35 ng/mL ± 18 vs. 31 ng/mL ± 14). In infants from both groups, the mean vitamin D levels were within the normal range (Group 1 inf 54 ng/mL ± 21 vs. Group 2 inf 47 ng/mL ± 15). The characteristic seasonal variability was observed before the pandemic, with maximal vitamin D levels in summer (40 ng/mL ± 17) and minimal levels in winter (30 ng/mL ± 14). During the pandemic, no seasonal variability was observed (summer 30 ng/mL ± 11 vs. winter 30 ng/mL ± 19). Conclusions: The COVID-19 pandemic restrictions led to a significant decrease in vitamin D serum levels in children.