No abstract

Recently, there has been growing interest in the relationship between allergic and autoimmune diseases. Allergy and autoimmunity can be considered two potential outcomes of dysregulated immunity and analysis of literature data shows a strong positive association between a history of Th2-mediated allergic disorders and Th1-mediated autoimmune disorders.Autoimmune thyroid diseases are the most common of all autoimmune pathological conditions.Currently, the mechanisms explaining an association among atopy, autoimmunity, and thyroid diseases are not fully understood.There are data in literature pointing to the relationship between melatonin and thyroid activity. Several studies have suggested a paracrine role for this molecule in the regulation of thyroid activity, documenting that administration, as an antioxidant, in thyroid tissues under conditions of increased oxidative stress, could be helpful to reduce the oxidative processes involved in autoimmune thyroid diseases.Although thyroid autoimmunity has been regularly associated with atopic conditions in children, the possible protective role of melatonin has not yet been investigated.This review summarizes what is known regarding the connection between atopy and autoimmune thyroid diseases, and analyses the probable beneficial action of melatonin.

Recurrent respiratory infections (RRIs) are a common problem in children. In Western countries, around 25% of children suffer from RRI in the first year of life, and 18% in the age between 1 and 4 years. RRIs affect the quality of life of children and their parents, also concerning school attendance. Antibiotics are widely used in the therapy of upper respiratory tract infections, despite a viral etiology is estimated in the 70%-80% of cases. 1 This medical behavior is an important cause of antibiotic resistance.RRIs are defined by the presence of more than 6 airway infections in 1 year, or more than 1 upper airway infection per month in the period between September and April, or more than 3 lower airway infections in 1 year. 2 There are different predisposing factors for RRIs in the child, such as reduced airway size, poor cough reflex, and immaturity of the immune system. Environmental factors are early schooling, exposure to second-hand smoke, high number of cohabitants, and pollution.The RRIs are often secondary to the aforementioned predisposing factors and usually disappear at school age. However, it is important to identify the children in whom RRIs imply a more complex pathogenesis. Red flags for these conditions are the onset of symptoms in the first year of life, the involvement of other systems, unusual pathogens, slowing of growth, severe infections of the lower airways, and recurrence in the same infection site. 1,2 To help the pediatrician in the differential diagnosis, we have created a roadmap of the RRIs based on scientific literature data and clinical practice. Our roadmap identifies six macro areas: 1.1 | RRIs and immunodeficiency Ten red flags for a possible primary immunodeficiency have been identified: family history of immunodeficiency or unexplained early death Abstract Recurrent respiratory infections (RRIs) are frequent in children and are characterized by more than 6 airway infections in 1 year or more than 1 upper airway infection per month in the period between September and April or more than 3 lower airway infections in 1 year. Often pediatric RRIs are related to predisposing factors, such as reduced airway size, poor tussive reflex, and immaturity of the immune system. RRIs due to immature immune system are a transient condition, with spontaneous resolution in the school age. However, some RRIs are expression of more complex diseases. Red flags are the onset of symptoms in the first year of life, the involvement of other systems, unusual pathogens, slowing of growth, severe infections of the lower airways, and recurrence of the infection site. To help the pediatrician in the RRI differential diagnosis, we have created a roadmap based on scientific literature data and clinical practice that identifies 6 macro areas: immunodeficiencies, simple minimal genetic immunodeficiency, atopy, obesity, nutritional deficiencies, autoinflammatory diseases, and complex diseases. K E Y W O R D S immunity, recurrent respiratory infections (RRIs) Edited by Salvatore Leonardi. The peer review history...

High-mobility group box 1 (HMGB1) is a high conserved nuclear protein (215 residues, 30 kD) encoded by a gene located on chromosome 13 (13q12), and it is part of high-mobility group (HMG)

HMGB1 represents a useful biomarker for peritoneum evaluation in PD patients. A prognostic role of this alarmin, as a marker of response to therapy, could be hypothesized. TGF-β could predict the peritoneal transport status and dialysis technique adequacy.