Innate immunity and urinary tract response play a central role in the development of urinary tract infection (UTI). Heat shock protein (HSP) 72 and Toll-like receptor (TLR) 4 are among the key elements of innate defence mechanisms. This study assesses the role of HSPA1B A(1267)G and TLR4 A(896)G polymorphisms using allele-specific polymerase chain reaction in 103 patients treated with recurrent UTI. Allelic prevalence was compared with reference values of 235 healthy controls. Clinical data were also statistically evaluated. TLR4 (896)AG genotype and TLR4 (896)G allele had also higher prevalence in UTI patients versus controls (p = 0.031 and 0.041, respectively). Our data indicates a relationship between the carrier status of HSPA1B (1267)G and TLR4 (896)G alleles and the development of recurrent UTI in childhood independently of other renal abnormalities, while raising further questions about the clinical and therapeutic relevance of these polymorphisms in everyday pediatric nephrology.

OBJECTIVE Approved treatments for type 2 diabetes in pediatric patients include metformin, liraglutide, and insulin. However, approximately one-half of the youth fail metformin monotherapy within 1 year, insulin therapy is associated with challenges, and liraglutide requires daily injections. Consequently, the efficacy and safety of once-weekly injections of exenatide for the treatment of youth with type 2 diabetes was evaluated. RESEARCH DESIGN AND METHODS Participants (aged 10 to <18 years) were randomized (5:2) to once-weekly exenatide 2 mg or placebo, respectively. The primary efficacy end point was change in glycated hemoglobin from baseline to week 24. Secondary efficacy end points were also evaluated, and the frequency of adverse events (AEs) was assessed. RESULTS A total of 83 participants were randomized (exenatide, 59; placebo, 24) and 72 completed 24-week treatment (exenatide, 49; placebo, 23). At 24 weeks, the least squares mean change in glycated hemoglobin was −0.36% for the exenatide and +0.49% for the placebo groups (between-group difference, −0.85%; 95% CI −1.51, −0.19; P = 0.012). Nonsignificant least squares mean differences from baseline to 24 weeks favoring exenatide were observed: fasting glucose −21.6 mg/dL (−49.0, 5.7; P = 0.119), systolic blood pressure −2.8 mmHg (−8.0, 2.4; P = 0.284), and body weight −1.22 kg (−3.59, 1.15; P = 0.307). AEs occurred in 36 (61.0%) and 17 (73.9%) participants in the exenatide and placebo groups, respectively. CONCLUSIONS In youth with type 2 diabetes suboptimally controlled with current treatments, once-weekly exenatide reduced glycated hemoglobin at 24 weeks and was well tolerated.

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<p><strong>OBJECTIVE:</strong> Approved treatments for type 2 diabetes in pediatric patients include metformin, liraglutide, and insulin. However, approximately half of the youth fail metformin monotherapy within 1 year, and insulin therapy is associated with challenges. Consequently, the efficacy and safety of once‑weekly injections of exenatide for the treatment of youth with type 2 diabetes was evaluated. </p> <p><strong>RESEARCH DESIGN AND METHODS:</strong> Participants (aged 10 to <18 years) were randomized (5:2) to once‑weekly exenatide 2 mg or placebo, respectively. The primary efficacy endpoint was change in glycated hemoglobin from baseline to week 24. Secondary efficacy endpoints were also evaluated and the frequency of adverse events (AEs) assessed.</p> <p><strong>RESULTS:</strong> 83 participants were randomized (exenatide, 59; placebo, 24) and 72 completed 24-week treatment (exenatide, 49; placebo, 23). At 24 weeks, the least squares mean change in glycated hemoglobin was −0.36% for the exenatide and +0.49% for the placebo groups (between-group difference, −0.85%; 95% CI: −1.51, −0.19; <em>P</em>=0.012). Nonsignificant least squares mean differences from baseline to 24 weeks favoring exenatide were observed: fasting glucose (−21.6 mg/dL; 95% CI: −49.0, 5.7; <em>P</em>=0.119), systolic blood pressure (−2.8 mm Hg; 95% CI: −8.0, 2.4; <em>P</em>=0.284), and body weight (−1.22 kg; 95% CI: −3.59, 1.15; <em>P</em>=0.307). AEs occurred in 36 (61.0%) and 17 (73.9%) participants in the exenatide and placebo groups, respectively.</p> <p><strong>CONCLUSIONS:</strong> In youth with type 2 diabetes sub-optimally controlled with current treatments, once‑weekly exenatide reduced glycated hemoglobin at 24 weeks and was well tolerated. </p>

<p><strong>OBJECTIVE:</strong> Approved treatments for type 2 diabetes in pediatric patients include metformin, liraglutide, and insulin. However, approximately half of the youth fail metformin monotherapy within 1 year, and insulin therapy is associated with challenges. Consequently, the efficacy and safety of once‑weekly injections of exenatide for the treatment of youth with type 2 diabetes was evaluated. </p> <p><strong>RESEARCH DESIGN AND METHODS:</strong> Participants (aged 10 to <18 years) were randomized (5:2) to once‑weekly exenatide 2 mg or placebo, respectively. The primary efficacy endpoint was change in glycated hemoglobin from baseline to week 24. Secondary efficacy endpoints were also evaluated and the frequency of adverse events (AEs) assessed.</p> <p><strong>RESULTS:</strong> 83 participants were randomized (exenatide, 59; placebo, 24) and 72 completed 24-week treatment (exenatide, 49; placebo, 23). At 24 weeks, the least squares mean change in glycated hemoglobin was −0.36% for the exenatide and +0.49% for the placebo groups (between-group difference, −0.85%; 95% CI: −1.51, −0.19; <em>P</em>=0.012). Nonsignificant least squares mean differences from baseline to 24 weeks favoring exenatide were observed: fasting glucose (−21.6 mg/dL; 95% CI: −49.0, 5.7; <em>P</em>=0.119), systolic blood pressure (−2.8 mm Hg; 95% CI: −8.0, 2.4; <em>P</em>=0.284), and body weight (−1.22 kg; 95% CI: −3.59, 1.15; <em>P</em>=0.307). AEs occurred in 36 (61.0%) and 17 (73.9%) participants in the exenatide and placebo groups, respectively.</p> <p><strong>CONCLUSIONS:</strong> In youth with type 2 diabetes sub-optimally controlled with current treatments, once‑weekly exenatide reduced glycated hemoglobin at 24 weeks and was well tolerated. </p>