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World Journal of Gastroenterology 2024年第15期30卷 2081-2086页

作者： michele Nardolillo Fabiola Rescigno Mario Bartiromo Dario Piatto Stefano Guarino Pierluigi Marzuillo Emanuele miraglia del giudice Anna Di Sessa Department of Woman Child and of General and Specialized SurgeryUniversitàdegli Studi della Campania“Luigi Vanvitelli”Naples 80138Italy

Over recent years,the nomenclature of non-alcoholic fatty liver disease has undergone significant ***,in 2020,an expert consensus panel proposed the term“Metabolic(dysfunction)associated fatty liver disease”(MAFLD)to underscore the close association of fatty liver with metabolic abnormalities,thereby highlighting the cardiometabolic risks(such as metabolic syndrome,type 2 diabetes,insulin resistance,and cardiovascular disease)faced by these patients since *** recently,this term has been further replaced with metabolic associated steatotic liver *** is worth noting that emerging evidence not only supports a close and independent association of MAFLD with chronic kidney disease in adults but also indicates its interplay with metabolic ***,comparable pediatric data remain *** the progressive and chronic nature of both diseases and their prognostic cardiometabolic implications,this editorial aims to provide a pediatric perspective on the intriguing relationship between MAFLD and renal function in childhood.

关键词： Metabolic(dysfunction)associated fatty liver disease Renal Function Children Obesity

Non-allergic rhinitis in children: Epidemiological aspects, pathological features, diagnostic methodology and clinical management

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World Journal of Methodology 2016年第4期6卷 200-213页

作者： Dimitri Poddighe Matteo Gelardi Amelia Licari michele miraglia del giudice Gian Luigi Marseglia Department of Pediatrics ASST Melegnanoe Martesana Department of Pediatric Sciences Università degli Studi di Pavia Department of Otolaryngology Università di Bari Department of Pediatrics Fondazione IRCCS Policlinico San Matteo Department of Pediatrics Seconda Università di Napoli Department of Pediatrics Fondazione IRCCS Policlinico San Matteo di Pavia

Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. Allergic rhinitis has been considered to be the most frequent form of chronic rhinitis, as non-allergic rhinitis has been estimated to account for 25%. However, several evidences suggested that non-allergic rhinitis have been underrated, especially in children. In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management.

关键词： Pediatric chronic rhinitis Non-allergic rhinitis Nasal cytology Local allergic rhinitis

The airway epithelium dysfunction in the pathogenesis of asthma: The evidence

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Health 2013年第2期5卷 331-338页

作者： Salvatore Leonardi Alfina Coco michele miraglia del giudice Gianluigi L. Marseglia Mario La Rosa Clinical Pediatric 2nd University of Naples Naples Italy IRCCS University Hospital San Martino University of Pavia Pavia Italy Pediatric Bronchopneumology and Cystic Fibrosis Unit Department of Medical and Paediatric Sciences University of Catania Catania Italy

Asthma is traditionally defined as a chronic, multisystem, multicellular disease characterized by bronchial hyper-responsiveness (BHR) and lung inflammation. In this illness is particularly involving the airway epithelium as the place where the inflammation begins, develops and often returns through airway remodelling. In specific way there is also an evolving awareness of the active participation of structural elements, such as the airway epithelium, airway smooth muscle, and endothelium, in this process. The airway inflammation and remodelling together likely explain the clinical manifestations of asthma that is demonstrated by complicated respiratory manifestations in which wheeze occurring secondary to bronchoconstriction in the setting of airway hyper-responsiveness and mucous hypersecretion. This is confirmed by also the histopathological analyses of bronchial biopsies from asthmatic subjects. For this reason is very important to understand the physiological role of the airway epithelium and their changes during the exacerbation of disease.

关键词： Airway Epithelium Dysfunction Asthma Evidence

Assessing the effects of alternative fuel treatments to reduce wildfire exposure

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Journal of Forestry Research 2023年第2期34卷 373-386页

作者： Roghayeh Jahdi Liliana del giudice Massimo Melis Raff aella Lovreglio michele Salis Bachisio Arca Pierpaolo Duce Institute of BioEconomy(CNR IBE) National Research Council of ItalySassariItaly Faculty of Agriculture and Natural Resources University of Mohaghegh ArdabiliArdabilIran Sardinia Forest Service LanuseiItaly Department of Agriculture University of SassariSassariItaly

Effective landscape-scale fuel management strategies are essential for reducing wildfire risk in Mediterranean fire-prone *** this study,the minimum travel time(MTT)fire-spread algorithm as implemented in FlamMap was applied to assess the potential of alternative fuel treatments for lowering wildfire losses in a 5,740-ha study area in eastern Sardinia,***-seven wildfires at 10-m resolution were simulated considering three wind speeds(15,18,and 21 km h-1)to compare fuel treatments:no treatment(NT),irrigated agroforestry areas with shrub clearing(T1),prescribed fire in eucalyptus stands(T2),and irrigated grasslands(T3).The simulations replicated a recent large wildfire that occurred in the study area(Orrìwildfire,2019)and considered the weather and fuel moisture conditions associated with this *** average wildfire exposure outputs(burned area,probability of burning,conditional flame length,potential crown fire occurrence,and surfaces withflame lengths above 2.5 m)decreased after fuel treatments,compared to no treatment.T1 was the most effective strategy in mitigating wildfire hazards and provided the most significant performance for several wildfire exposure *** only 0.5%of the study area(~30 ha)resulted in a decrease in all wildfire exposure metrics to~10%within the study *** addition,the total surface characterized by high flame length(average>2.5 m)was the lowest in the T1 *** study can help land and fire managers optimize fuel treatment opportunities and wildfire risk mitigation strategies in Mediterranean areas.

关键词： Fuel treatment strategies Fire prevention Mediterranean areas Minimum travel time(MTT) Wildfi re exposure

Tangled relationship between insulin resistance and microalbuminuria in children with obesity

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World Journal of Clinical Pediatrics 2022年第6期11卷 455-462页

作者： Alberto Maria Colasante Mario Bartiromo michele Nardolillo Stefano Guarino Pierluigi Marzuillo GiuseppeSalvatore R C Mangoni di S Stefano Emanuele miraglia del giudice Anna Di Sessa Department of Woman Childand General and Specialized SurgeryUniversity of Campania Luigi VanvitelliNaples 80138Italy

Childhood obesity represents a complex disease with a well-known cardiometabolic burden including fatty liver,type 2 diabetes,metabolic syndrome,and cardiovascular *** a pathogenic point of view,insulin resistance(IR)represents the key factor underlying the spectrum of these obesity *** observed in adults,recent data supported the occurrence of microalbuminuria(MA)as marker of early kidney dysfunction and its potential link with cardiometabolic factors also in children with *** fact,a well-documented pathophysiological hypothesis both in adults and children supported an intimate correlation with the major feature of obesity such as IR through the influence of insulin on renal *** on the clinical and prognostic relevance of this relationship in daily practice(including an increased risk of chronic kidney disease development overtime),more scientific attention needs to be paid to the evaluation of early kidney damage in children with *** this paper,we attempt to address three debated questions regarding the intriguing liaison between IR and MA in children with obesity:(1)What is the prevalence of pediatric MA?(2)What is the state of art of MA in children with obesity?and(3)Is there a link between IR and MA in children with obesity?

关键词： Kidney damage Microalbuminuria Insulin resistance Children Obesity

Gut microbiota and COVID-19: An intriguing pediatric perspective

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World Journal of Clinical Cases 2022年第23期10卷 8076-8087页

作者： Maria Sole Valentino Claudia Esposito Simone Colosimo Angela Maria Caprio Simona Puzone StefanoGuarino Pierluigi Marzuillo Emanuele miraglia del giudice Anna Di Sessa Department of Woman Childand General and Specialized SurgeryUniversity of Campania Luigi VanvitelliNaples 80138Italy

Gastrointestinal(GI)involvement has been reported in approximately 50%of patients with coronavirus disease 2019(COVID-19),which is due to the pathogenic role of inflammation and the intestinal function of the angiotensinconverting enzyme 2 and its *** adult data has pointed out that gut dysbiosis might occur in these patients with a potential impact on the severity of the disease,however the role of gut microbiota in susceptibility and severity of COVID-19 disease in children is still poorly *** the last decades,the crosstalk between gut and lung has been largely recognized resulting in the concept of“gut-lung axis”as a central player in modulating the development of several *** organs are involved in the common mucosal immune system(including bronchus-associated and gut-associated lymphoid tissues)and their homeostasis is crucial for human *** this framework,it has been found that the role of GI dysbiosis is affecting the homeostasis of the gutliver *** note,a gut microbiome imbalance has been linked to COVID-19 severity in adult subjects,but it remains to be *** on the increased risk of inflammatory diseases in children with COVID-19,the potential correlation between gut microbiota dysfunction and COVID-19 needs to be studied in this *** aimed to summarize the most recent evidence on this striking aspect of COVID-19 in childhood.

关键词： Gut Microbiota Dysbiosis Microbiome COVID-19 Children

Advances in pediatric non-alcoholic fatty liver disease: From genetics to lipidomics

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World Journal of Clinical Pediatrics 2022年第3期11卷 221-238页

作者： Simona Riccio Rosa Melone Caterina Vitulano Pierfrancesco Guida Ivan Maddaluno Stefano Guarino Pierluigi Marzuillo Emanuele miraglia del giudice Anna Di Sessa Department of Woman ChildGeneral and Specialized SurgeryUniversity of Campania Luigi VanvitelliNaples 80138Italy

As a result of the obesity epidemic,non-alcoholic fatty liver disease(NAFLD)represents a global medical concern in childhood with a closely related increased cardiometabolic *** on NAFLD pathophysiology has been largely expanded over the last *** the well-known key NAFLD genes(including the I148M variant of the PNPLA3 gene,the E167K allele of the TM6SF2,the GCKR gene,the MBOAT7-TMC4 rs641738 variant,and the rs72613567:TA variant in the HSD17B13 gene),an intriguing pathogenic role has also been demonstrated for the gut *** interestingly,evidence has added new factors involved in the“multiple hits”*** particular,omics determinants have been highlighted as potential innovative markers for NAFLD diagnosis and *** fact,different branches of omics including metabolomics,lipidomics(in particular sphingolipids and ceramides),transcriptomics(including micro RNAs),epigenomics(such as DNA methylation),proteomics,and glycomics represent the most attractive pathogenic elements in NAFLD development,by providing insightful perspectives in this *** this perspective,we aimed to provide a comprehensive overview of NAFLD pathophysiology in children,from the oldest pathogenic elements(including genetics)to the newest intriguing perspectives(such as omics branches).

关键词： Fatty Liver Genetics Lipidomics Pediatric

Metabolic-associated fatty liver disease from childhood to adulthood:State of art and future directions

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World Journal of Hepatology 2022年第6期14卷 1087-1098页

作者： Francesca Lanzaro Stefano Guarino Elisabetta D'Addio Alessandra Salvatori JosèAlberto D'Anna Pierluigi Marzuillo Emanuele miraglia del giudice Anna Di Sessa Department of Woman Childand General and Specialized SurgeryUniversity of Campania“Luigi Vanvitelli”Naples 80138Italy

In 2020,an international group of experts proposed to replace the term of nonalcoholic fatty liver disease with metabolic-associated fatty liver disease(MAFLD).This recent proposal reflects the close association of fatty liver with metabolic derangements,as demonstrated by previous robust *** factors[including genetics,inflammation,metabolic abnormalities,insulin resistance(IR),obesity,prenatal determinants,and gut–liver axis]have been found to be involved in MAFLD pathophysiology,but this tangled puzzle remains to be clearly *** particular,IR has been recognized as a key player in metabolic impairments development in children with fatty *** this ground,MAFLD definition focuses on the pathophysiological basis of the disease,by emphasizing the crucial role of metabolic impairments in this *** primarily developed for adults,MAFLD diagnostic criteria have been recently updated with an age-appropriate definition for sex and age percentiles,because of the increasing attention to cardiometabolic risk in *** date,accumulating evidence is available on the feasibility of MAFLD definition in clinical practice,but some data are still conflicting in highly selected *** the growing prevalence worldwide of fatty liver and its close relationship with metabolic dysfunction both in children and adults with subsequent increased cardiovascular risk,early strategies for MAFLD identification,treatment and prevention are *** therapeutic insights for MAFLD based on promising innovative biological techniques are also *** aimed to summarize the most recent evidence in this intriguing research area both in children and adults.

关键词： Metabolic dysfunction Fatty Liver Pathophysiology Cardiovascular Risk Adults Children

COVID-19 and pediatric fatty liver disease:Is there interplay?

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World Journal of Gastroenterology 2021年第22期27卷 3064-3072页

作者： Anna Di Sessa Francesca Lanzaro Sarah Zarrilli Vittorio Picone Stefano Guarino Emanuele miraglia del giudice Pierluigi Marzuillo Department of Woman Childand General and Specialized SurgeryUniversity of Campania“Luigi Vanvitelli”Naples 80138Italy

The rapid global spread of coronavirus disease 2019(COVID-19)infection has become a major health issue with higher morbidity and mortality *** respiratory symptoms,a growing body of evidence indicates a variety of gastrointestinal manifestations including liver *** this regard,several data supported an association between COVID-19 infection and liver injury in adults,while in children there is compelling but currently limited *** particular,patients with COVID-19 have shown a higher risk of liver injury(mainly expressed as increased transaminase levels or hepatic steatosis).Conversely,a greater risk of more severe forms of COVID-19 infection has been observed in subjects with pre-existing chronic liver *** dramatic interplay between COVID-19 and liver damage has been related to the inflammatory pathways chronically active in patients with nonalcoholic fatty liver disease and acutely in those affected by COVID-19,but other different pathogenic mechanisms have also been *** note,patients with previous metabolic comorbidities also had a higher risk of severe COVID-19 *** emphasizes the pathogenic interrelation of the inflammatory pathways with a dysregulated metabolic milieu in COVID-19 *** into account the prognostic role of fatty liver in COVID-19 patients and its intrinsic relationship with metabolic abnormalities even in childhood,a strict monitoring of this condition is *** aimed to summarize the most recent evidence regarding the potential interplay between pediatric fatty liver and COVID-19.

关键词： COVID-19 Children Adults Nonalcoholic fatty liver disease

Omics era in type 2 diabetes:From childhood to adulthood

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World Journal of Diabetes 2021年第12期12卷 2027-2035页

作者： Antonio Paride Passaro Pierluigi Marzuillo Stefano Guarino Federica Scaglione Emanuele miraglia del giudice Anna Di Sessa Department of Woman Child and of General and Specialized SurgeryUniversitàdegli Studi della Campania“Luigi Vanvitelli”Napoli 80138Italy

Parallel to the dramatic rise of pediatric obesity, estimates reported an increasedprevalence of type 2 diabetes (T2D) already in childhood. The close relationshipbetween obesity and T2D in children is mainly sustained by insulin resistance(IR). In addition, the cardiometabolic burden of T2D including nonalcoholic fattyliver disease, cardiovascular disease and metabolic syndrome is also strictlyrelated to IR. Although T2D pathophysiology has been largely studied in anattempt to improve therapeutic options, molecular mechanisms are still not fullyelucidated. In this perspective, omics approaches (including lipidomics,metabolomics, proteomics and metagenomics) are providing the most attractivetherapeutic options for T2D. In particular, distinct both lipids and metabolites areemerging as potential therapeutic tools. Of note, among lipid classes, thepathogenic role of ceramides in T2D context has been supported by several ***, selective changes of ceramides expression might represent innovativetherapeutic strategies for T2D treatment. More, distinct metabolomics pathwayshave been also found to be associated with higher T2D risk, by providing novelpotential T2D biomarkers. Taken together, omics data are responsible for theexpanding knowledge of T2D pathophysiology, by providing novel insights toimprove therapeutic strategies for this tangled disease. We aimed to summarizethe most recent evidence in the intriguing field of the omics approaches in T2Dboth in adults and children.

关键词： Omics Diabetes Children Adults Type 2 diabetes