Publications by authors named "Enrico Verrina"

Background: Urinary tract infections (UTIs) are among the most common bacterial infections in children, and the antibiotic susceptibility in the youngest patients remains poorly understood. This study aimed to describe the distribution of uropathogens and their antibiotic susceptibility, focusing on oral formulations.

Methods: Data from the first microbiological isolation, between January 2007 and December 2023, at Istituto Gaslini, in young infants (aged <6 months), were analyzed.

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The complement cascade and Neutrophil Extracellular Traps (NETs) represent fundamental tools in protecting the host from foreign pathogens. Complement components and relative fragments, classically assigned to the innate immunity, represent a key link with the humoral immune response. NETs are a crucial component of the innate immune response, consisting of chromatin release from activated neutrophils.

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Peritoneal dialysis (PD) remains a cornerstone treatment for children with stage 5 chronic kidney disease, offering significant benefits in terms of quality of life and patient autonomy compared to hemodialysis. Recent advances in care protocols, particularly in infection prevention, have led to a substantial reduction in peritonitis and other infectious complications in pediatric patients on PD. Despite these improvements, non-infectious complications continue to pose significant challenges to the long-term efficacy of PD.

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Lupus nephritis (LN), present in 30%-50% of systemic lupus erythematosus (SLE) patients, often necessitates standard immunosuppressive therapy (glucocorticoids, MMF, CYC) as suggested by the European League Against Rheumatism/European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) and Kidney Disease Improving Global Outcomes (KDIGO) guidelines. However, a subset of subjects remains refractory. Recent findings suggested the efficacy of targeting CD38-long-lived plasma cells in LN and SLE refractory to standard treatment.

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Polyomavirus BK (BKPyV)-associated nephropathy (BKPyV-nephropathy) remains a significant cause of premature kidney allograft failure. In the absence of effective antiviral treatments, current therapeutic approaches rely on immunosuppression (IS) reduction, possibly at the risk of inducing alloimmunity. Therefore, we sought to explore the long-term effects of a tailored viro-immunologic surveillance and treatment program for BKPyV on the development of alloimmunity and kidney graft outcome.

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Background: The application of international recommendations for paediatric maintenance haemodialysis (HD) could be strengthened by national laws or written recommendations. Our aim was therefore to describe the national rules governing paediatric maintenance HD in European countries.

Methods: A national representative, approved by the president of each paediatric nephrology society, was contacted in all 42 European countries to complete two online questionnaires.

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Aims: This study aims to assess the diagnostic accuracy of diffusion-weighted Magnetic Resonance Imaging (DW-MRI) and determine the inter-reader agreement between two expert radiologists in detecting pyelonephritic foci during the initial episode of febrile urinary tract infection (fUTI) in children aged 0-5 years. Also, we aim to establish the correlation between clinical data and DW-MRI findings.

Methods: Children aged 0-5 years presenting with their first episode of fUTI were included in the study and underwent DW-MRI and Ultrasound (US) examinations within 72 h of admission.

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Article Synopsis
  • * In this study, human kidney cells exposed to both polyethylene microplastics and BPA showed decreased cell viability and increased pro-oxidant and pro-inflammatory responses compared to those exposed to either substance alone.
  • * Additionally, the research found that exposure reduced levels of heat shock protein (HSP90) while increasing aryl hydrocarbon receptor (AHR) expression, highlighting the need for further investigation into how these pollutants interact and affect kidney health.
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  • Hemolytic uremic syndrome (HUS) is a serious condition that can happen after an infection or due to problems in the body's immune system, and there are two types: typical and atypical.
  • This text discusses a 9-year-old boy who had a rare form of aHUS caused by specific genetic issues, which made his body produce autoantibodies that affected his kidneys and brain.
  • The study found that many kids with aHUS needed kidney treatment and that early treatment with special therapy may help prevent kidney failure, even if the patient has infections like STEC.
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Infection-related complications remain the most significant cause for morbidity and technique failure in infants, children and adolescents who receive maintenance peritoneal dialysis (PD). The 2024 update of the Clinical Practice Guideline for the Prevention and Management of Peritoneal Dialysis Associated Infection in Children builds upon previous such guidelines published in 2000 and 2012 and provides comprehensive treatment guidance as recommended by an international group of pediatric PD experts based upon a review of published literature and pediatric PD registry data. The workgroup prioritized updating key clinical issues contained in the 2012 guidelines, in addition to addressing additional questions developed using the PICO format.

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Introduction: Secondary hyperparathyroidism (sHPT) is particularly severe in rapidly growing infants in dialysis. Although cinacalcet is effective and licensed in dialysis in children aged >3 years, its efficacy and safety for children aged <3 years is unknown.

Methods: We identified 26 children aged <3 years who were on dialysis and treated with cinacalcet between 2009 and 2021 in 8 European pediatric centers.

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Article Synopsis
  • Gram-negative peritonitis (GNP) significantly affects children on long-term peritoneal dialysis, with a study analyzing 379 cases from 308 children across 28 countries showing that 74% responded well to initial treatment.
  • Risk factors for treatment failure include severe abdominal pain and bacterial resistance, while monotherapy with cefazolin yielded similar recovery rates as broader-spectrum antibiotics.
  • The study advocates for personalized empiric treatment based on susceptibility data and suggests that narrowing antibiotic therapy does not compromise patient outcomes.
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  • Immunoglobulin A nephropathy (IgAN) is the most common cause of glomerulonephritis globally, potentially leading to kidney failure in both kids and adults.
  • Current treatments like immunosuppressive drugs often do not provide long-lasting improvements and can have serious side effects.
  • New biologic therapies targeting specific immune functions show promise for safer and more effective treatments, but research must include pediatric patients to meet their specific health needs.
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Article Synopsis
  • * Recent research indicates that the connection between anti-dsDNA antibodies and kidney problems is weak, and it showcases a variety of other renal-targeting autoantibodies, including increased attention to the IgG2 isotype, which was previously overlooked.
  • * New "second wave antibodies" have emerged, which play a role in modulating inflammation in the kidneys, suggesting they could be key in refining treatment strategies and monitoring therapeutic responses in LN patients.
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Pediatric pilocytic astrocytoma (PA) is the most common brain tumor in children. Complete resection provides a favorable prognosis, except for unresectable PA forms. There is an incomplete understanding of the molecular and cellular pathogenesis of PA.

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Background: Congenital anomalies of the kidney and urinary tract (CAKUT) represent 20-30% of all birth defects and are often associated with extra-renal malformations. We investigated the frequency of brain/spine malformations and neurological features in children with CAKUT.

Methods: We reviewed the clinico-radiological and genetic data of 199 out of 1,165 children with CAKUT evaluated from 2006 to 2023 (99 males, mean age at MRI 6.

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Research on membranous nephropathy truly exploded in the last 15 years. This happened because of the application of new techniques (laser capture microdissection, mass spectrometry, protein G immunoprecipitation, arrays) to the study of its pathogenesis. After the discovery of PLA2R as the major target antigen, many other antigens were identified and others are probably ongoing.

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Plastic pollution became a main challenge for human beings as demonstrated by the increasing dispersion of plastic waste into the environment. Microplastics (MPs) have become ubiquitous and humans are exposed daily to inhalation or ingestion of plastic microparticles. Recent studies performed using mainly spectroscopy or spectrometry-based techniques have shown astounding evidence for the presence of MPs in human tissues, organs and fluids.

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Nephrotic syndrome affects about 2-7 per 100,000 children yearly and accounts for less than 15% of end stage kidney disease. Steroids still represent the cornerstone of therapy achieving remission in 75-90% of the cases The remaining part result as steroid resistant nephrotic syndrome, characterized by the elevated risk of developing end stage kidney disease and frequently presenting disease recurrence in case of kidney transplant. The pathogenesis of nephrotic syndrome is still far to be elucidated, however, efficacy of immune treatments provided the basis to suggest the involvement of the immune system in the pathogenesis of the disease.

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Introduction: SARS-CoV-2 infection in the pediatric population can be associated with a multiorgan inflammatory syndrome called children's multisystem inflammatory syndrome (MIS-C). The kidneys can be affected by a broad spectrum of possible injuries, whose pathogenetic mechanisms are still unclear. We report the case of a 5-year-old boy with severe cardiac involvement in the context of MIS-C.

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