BACKGROUND: Vitamin D plays essential role in the regulation of inflammation, such as in pathogenesis of Juvenile Idiopathic Arthritis (JIA). Vitamin D deficiency has been reported among JIA patients, but there were conflicting results regarding the correlation with disease activity. This study aimed to assess vitamin D serum level and its correlation with C-Reactive Protein (CRP) and disease activity in JIA patients.METHODS: Children who were diagnosed with JIA according to International League of Associations for Rheumatology (ILAR) criterias were enrolled as JIA group subjects, while age and sex-matched healthy children were enrolled as the control group subjects. Vitamin D and CRP serum level were measured. Disease activity of JIA patients was calculated by Juvenile Arthritis Disease ActivityScore-27 (JADAS-27).RESULTS: Vitamin D serum level was lower in the JIA group compared to the healthy control group (p=0.000). Among 26 JIA patients, 61.5% were deficient, 30.8% were insufficient, and 7.7% had normal vitamin D. No significant different in CRP level between vitamin D group (p=0.441), but there was significant different in JADAS-27 (p=0.001). The mean of CRP and JADAS-27 were found highest in vitamin D deficiency group. Vitamin D serum level was negatively correlate with CRP (p=0.021, r=-0.452) and JADAS-27 (p=0.001 r=-0.595).CONCLUSION: Low level of vitamin D in JIA patients was inversely related to higher CRP and disease activity,suggesting that vitamin D supplementation could be havepotential role in JIA treatment.KEYWORDS: vitamin D, CRP, disease activity,JADAS-27, JIA

Background: Measles vaccinations have been suggested to provide immune protection and decreased measles incidence. However, there was a limited study evaluating how the measles vaccine elicits specific immune responses.Objective: This study aimed to evaluate both humoral and cellular immunity to first-dose measles vaccine Edmonston-Zagreb (EZ) in 9-month-old Indonesian infants.Methods: A cohort study was conducted on 9-month-old infants who got the first-dose of measles vaccine EZ. Measles-specific immunoglobulin G (IgG) antibody serum levels were measured using plaque-reduction microneutralization assay. Peripheral blood mononuclear cells were stimulated with a measles-specific peptide to identify a cellular immune response. Quantification of CD4+ and CD8+ T-cells producing interferon-gamma (IFN-ɣ) and interleu-kin 17-A (IL-17A) were conducted by flow cytometry. Humoral and cellular immune response parameters were analyzed over time.Results: The prevalence of seropositivity rates was 85.8% at 1-month after vaccination and 16.67% at 6-months postvaccination. Measles-specific IgG antibodies increased significantly at 1-month after measles vaccination. However, they decreased significantly 6-months after vaccination. IFN-ɣ and IL-17A secreting T-cells increased significantly at 1-month after measles vaccination. Interestingly, a significant decrease of IFN-ɣ and IL-17A secreting CD4+ T cells was noticed 6-months postvaccination compared to IFN-ɣ and IL-17A secreting CD8+ T cells. Conclusion: Our study suggests that the first-dose measles vaccine on 9-months-old infants seems to induce both humoral and cellular immune responses that decline 6-months after vaccination.

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Introduction: Atopic dermatitis (AD) is an immune-mediated inflammatory skin disease and generally develops in infancy. Studies evaluating the role of vitamin D in immune mechanims in AD showed varying results. Aim: To assess the association between serum vitamin D, cytokine profiles, and disease severity in infants with AD. Material and methods: A cross-sectional study was conducted on infants aged 0-12 months with AD in the Paediatric Allergy and Immunology Department, Saiful Anwar Hospital, Indonesia. The disease severity was assessed by the Scoring of Atopic Dermatitis (SCORAD) index. Blood was drawn to evaluate the total eosinophil count (TEC), total immunoglobulin E (tIgE), 25-hydroxyvitamin D (25(OH)D), interleukin-4 (IL-4), IL-17A, and IL-22 levels.Results: This study enrolled 36 infants including 19 with mild AD and 17 with moderate AD. Vitamin D deficiency and insufficiency were found in 18 (50%) and 9 (25%) subjects, respectively. The mean 25(OH)D level was lower and the mean IL-4, IL-17A, and IL-22 levels were higher in the moderate AD group than in the mild AD group (p < 0.05). A lower level of 25(OH)D was associated with a higher level of IL-17A (r = -0.315, p = 0.041). The SCORAD index was negatively correlated with 25(OH)D (r = -0.714, p < 0.001) and positively correlated with IL-17A (r = 0.522, p = 0.001) and IL-22 (r = 0.612, p < 0.001) but not IL-4 (r = 0.325, p = 0.053). Conclusions: There was a high prevalence of vitamin D deficiency and insufficiency in infants with AD, and a low vitamin D level was correlated with the severity of AD, dependently on IL-17A.

Background: The rapid global spread of coronavirus disease 2019 (COVID-19) infection has become a major health issue with high morbidity and mortality rates. COVID-19 in children showed different unique presentations. Besides respiratory symptoms, a growing body of evidence indicates multi-organ manifestation, including liver involvement. In this regard, several data supported an association between COVID-19 infection and liver injury in adults, while on the other hand, there is compelling but currently limited evidence in children. In this systematic review, we summarize data of updated literature regarding the evidence of acute liver injury in children with COVID-19. Methods: Online scientific articles were explored on PubMed and Google Scholar databases using keywords. The systematic review was performed under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines Results: The literature search yielded 238 articles, of which 16 were identified as relevant to the topic and met the inclusion criteria. A total of 564 pediatric patients were confirmed positive for COVID-19 by PCR examination, involving 298 (52.9%) boys and 266 (47.1%) girls with an age range of 1 day - 17 years. Liver injuries have been reported in pediatric COVID-19 patients, with prevalence ranging from 1.5 to 52%. Conclusion: SARS-CoV-2 virus infection in children shows a unique presentation. Several reports suggest that liver injury correlates with the severity of COVID-19 disease. Therefore, monitoring liver function in COVID-19 patients is important to assess the prognosis.