Association between type 2 inflammatory diseases and neurodevelopmental disorders in low-birth-weight children and adolescents

Bidirectional association between atopic dermatitis and attention deficit hyperactivity disorder: a systematic review and meta-analysis

BACKGROUND

Our objective is to elucidate the reciprocal association between atopic dermatitis (AD) and attention deficit hyperactivity disorder (ADHD) by prespecified subgroups and determine potential modified factors.

MATERIALS AND METHODS

Adhering to PRISMA 2020, we conducted a comprehensive database search up until March 11, 2024. Observational studies reporting on AD and ADHD as either exposure or outcome variables were included. A random-effects model meta-analysis was conducted to calculate pooled estimates. Subgroup and meta-regression analyses were undertaken to explore heterogeneity. Publication bias was investigated via funnel plots and Egger's test.

RESULTS

Overall, 49 studies were determined to meet the inclusion criteria after rigorous screening. Patients with AD were more likely to have ADHD (ORs = 1.34, 95% CI 1.25-1.44, p < 0.01; HRs = 1.42, 95% CI 1.20-1.68, p < 0.01), while patients with ADHD also had an increased risk of developing AD (ORs = 1.45, 95% CI 1.21-1.73, p < 0.01). Subgroup analyses indicated that the associations were particularly pronounced among studies that assessed patients with severe AD (ORs = 2.62, 95% CI 1.76-3.92, p < 0.01), suffered from multiple allergic conditions (ORs = 2.89, 95% CI 1.18-7.10, p < 0.01) and sleep disturbances (ORs = 2.43, 95% CI 2.14-2.76, p < 0.01) simultaneously.

CONCLUSION

This review substantiates the significant bidirectional association between AD and ADHD, indicating that they serve as mutually independent risk factors and may either exacerbate each other. These findings underscore the necessity for heightened awareness and early targeted interventions, especially in individuals with severe AD manifestations, sleep problems, and multiple allergic diseases.

Correlation between mixed exposure to several heavy metals during early pregnancy and fetal low birth weight: Possible mediating effect of mitochondrial DNA copy number

BACKGROUND

Epidemiological investigations regarding the correlation between mixed heavy metals (HMs) exposure in early pregnancy and low birth weight (LBW) have shown contradictory findings. Moreover, investigations into the fundamental mechanisms, including the possible impacts of HMs exposure on mitochondrial DNA copy number (mtDNAcn), are limited.

OBJECTIVES

This study sought to examine the influence of mixed HMs exposure during early gestation on the prevalence of LBW and to ascertain whether mtDNAcn mediates this relationship.

METHODS

The Second Affiliated Hospital of Guilin Medical University conducted a nested case-control study involving 49 pregnant women who delivered LBW infants and 196 matched controls. Urine and blood samples were collected during early pregnancy, along with placental and umbilical cord blood samples at delivery. Concentrations of ten metals-magnesium(Mg), manganese(Mn), copper(Cu), arsenic(As), selenium(Se), strontium(Sr), molybdenum(Mo), cadmium(Cd), thallium(Tl), and lead(Pb)-were quantified. mtDNAcn was measured using real-time quantitative polymerase chain reaction (qPCR). Random forest analysis identified five metals-As, Se, Tl, Mn and Cd -as most strongly associated with the risk of preterm birth in LBW cases. These were selected for further analysis. Conditional logistic regression was applied to examine associations between early maternal urinary metal levels and infant malformations. To assess the combined effect of these metals on LBW, weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were used. Finally, mediation analysis was conducted to explore whether mtDNAcn mediated the relationship between Mn exposure and LBW.

RESULTS

The results of the study revealed a significant association between urinary Mn concentrations and LBW, with a p-value of0.015 and an odds ratio (OR) of 2.33 (95%CI:1.18-4.58) before adjusting for confounders. After adjusting for confounders, urinary manganese concentration remained significantly associated with LBW (p=0.017), with an OR of 2.36(95%CI:1.16-4.80). The odds of LBW significantly increased as exposure levels moved from the 25th to the 75th percentile for metal combinations, with the effect becoming more pronounced when the exposure index exceeded the 60th percentile. Notably, mtDNAcn levels mediated 27%of the association between Mn exposure and the incidence of umbilical cord bypass syndrome.

CONCLUSION

In conclusion, our data suggest that changes in mtDNAcn may mediate the association between Mn exposure during early pregnancy and the development of LBW. This study not only provides new evidence of the relationship between HMs exposure and fetal developmental disorders in China, but also serves as a valuable reference for global awareness regarding the effects of environmental pollution during pregnancy on fetal health.

An Updated Scoping Review of Disparities in Pediatric Atopic Dermatitis

BACKGROUND/OBJECTIVES

Health disparities are preventable differences in various aspects of health and encompass a wide range of inequitable outcomes experienced by marginalized patient populations. The objective of this systematic scoping review was to provide an updated summary of published research on disparities within pediatric atopic dermatitis (AD) in the United States.

METHODS

We performed a systematic search of full studies and abstracts according to PRISMA guidelines. Searches were developed with and performed by a medical librarian on various electronic databases for studies published from January 2021 through May 2024. Two authors independently screened titles and abstracts, followed by full-text review.

RESULTS

Fifty-three studies met our inclusion criteria, of which 49 examined disparities due to race/ethnicity, 18 due to socioeconomic factors (SES), 6 due to region/environment, 11 due to sex/gender, and 1 due to preferred language. Disparities discussed included AD prevalence, health outcomes, and access to health care.

CONCLUSION

With an increasing focus on health disparities research, particularly within the context of the COVID-19 pandemic, an update on disparities within pediatric AD is needed. Examining the results of these studies can help point us to interventions that aim to reduce disparities and allow us to identify current knowledge gaps in disparities within pediatric AD.