Publications by authors named "Wojciech Feleszko"

Introduction: Current recommendations for early introduction of cow's milk proteins in infants who cannot be breastfed vary and are inconsistent due to a lack of clear evidence. We aim to assess whether early supplementation with various nutritional interventions, including cow's milk formula (CMF), amino acid formula (AAF), donor human milk (DHM) or high-pressure processed 'pascalised' DHM (DHM-P) is effective for the primary prevention of cow's milk allergy (CMA) in breastfed neonates.

Methods And Analysis: We will perform an open-label randomised, controlled, head-to-head trial with four parallel arms in three Polish study centres (Warsaw).

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Severe asthma and allergic bronchopulmonary aspergillosis (ABPA) do not rarely coexist and share several similarities in terms of pathobiological background, together with overlapping clinical manifestations, misleading the correct diagnosis. Within that scenario, severe asthma with fungal sensitization (SAFS) further complicates the correct pheno-endotyping, which still needs to be recognized in the light of the greater burden and higher risk of irreversible damage related to ABPA and SAFS when compared to asthma alone. The identification of pathobiological drivers underlying different conditions remains challenging; in fact, available biomarkers, although accurate when related to each specific condition, do not always fully support a clear-cut differential diagnosis.

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Inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) are essential in asthma management, but the guidelines for treatment in preschool children remain heterogeneous worldwide. This systematic review evaluates the efficacy and safety of LABA + ICS therapy in asthmatic children under six years. We searched four databases, identifying six eligible studies (n = 1415 preschoolers), and in all the LABA used was salmeterol.

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Introduction: Severe bronchiolitis (i.e., bronchiolitis requiring hospitalization) is linked to childhood asthma development.

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In recent years, there has been abundant research concerning human microbiome and its impact on the host's health. Studies have shown that not only the commensal bacteria itself, but also postbiotics, understood as inanimate microorganisms, possibly with the presence of their components, may themselves have an effect on various elements of human physiology. In this review, we take a closer look at the specific ways in which postbiotics can alter immune response in allergic asthma, which is one of the most prevalent allergic diseases in today's world and a serious subject of concern.

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Background: Multisystem inflammatory syndrome in children (MIS-C) is a rare, severe complication of coronavirus disease 2019, commonly involving the gastrointestinal tract. Some children with MIS-C undergo appendectomy before the final diagnosis. There are several hypotheses explaining the pathomechanism of MIS-C, including the central role of the viral antigen persistence in the gut, associated with lymphocyte exhaustion.

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Monitoring is a major component of asthma management in children. Regular monitoring allows for diagnosis confirmation, treatment optimization, and natural history review. Numerous factors that may affect disease activity and patient well-being need to be monitored: response and adherence to treatment, disease control, disease progression, comorbidities, quality of life, medication side-effects, allergen and irritant exposures, diet and more.

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Article Synopsis
  • Guidelines for treating asthma exacerbations typically recommend bronchodilators and corticosteroids, but antibiotic use is often overlooked despite frequent prescriptions in practice.
  • A survey involving 252 healthcare professionals revealed a 19% antibiotic prescription rate for asthma exacerbations, with significant variation among different specialties like pediatrics, pulmonology, general practice, and allergy.
  • The study highlights the need for evidence-based guidelines to ensure more rational use of antibiotics in treating asthma exacerbations, especially considering factors like purulent sputum, fever, and comorbidities that influence prescription decisions.
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Background: Asthma is the most prevalent chronic disease in children and constitutes a significant healthcare burden. First-line therapy for acute asthma exacerbations is well established. However, secondary treatments, including intravenous magnesium sulfate (IV-MgSO4), remain variable due to scarcity of data on its efficacy and safety.

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Article Synopsis
  • - Preschool children with wheezing disorders face significant diagnostic and treatment challenges and have high healthcare costs associated with their care.
  • - A review by the EAACI aimed to assess the relationship between elevated peripheral eosinophil blood count (EBC) and the likelihood of developing asthma later in life, revealing that higher EBC levels are linked to an increased asthma risk.
  • - The analysis included 10 studies with 1225 preschool participants which suggested a cutoff of >300 EBC cells/μL correlates with higher asthma risk, but the consistency of defining specific cutoff points needs more research.
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Introduction: Food allergy is a common concomitant disease in patients with atopic dermatitis. Sensitisation and subsequent development of food allergy might result from the application of skincare products containing food allergens, particularly when the skin barrier is impaired and inflamed. Emollients are the mainstay of the management of atopic dermatitis; however, the prevalence of food allergens in skincare products used for atopic dermatitis is unknown.

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Purpose: To determine the utility of interferon-gamma-inducible protein 10 (IP-10) for identifying active tuberculosis (TB) and TB infection (TBI) in children in BCG-vaccinated populations, establish its diagnostic performance characteristics, and evaluate changes in IP-10 level during anti-TB chemotherapy.

Methods: Concentrations of IP-10 and IFN-γ were measured in QuantiFERON-TB Gold (QFT) supernatants in children with suspected TB or due to recent TB contact. A total of 225 children were investigated: 33 with active TB, 48 with TBI, 83 TB contacts, 20 with suspected TB but other final diagnoses, and 41 controls.

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Background: Bronchiolitis is a leading cause of infant hospitalization, linked to respiratory syncytial virus (RSV) and rhinovirus (RV). Guidelines lack specific viral testing for bronchiolitis management. To establish effective management strategies, it is crucial to assess whether specific respiratory virus types are correlated with distinct examination features.

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Bronchiolitis is the most common respiratory infection leading to hospitalization and constitutes a significant healthcare burden. The two main viral agents causing bronchiolitis, respiratory syncytial virus (RSV) and rhinovirus (RV), have distinct cytopathic, immune response, and clinical characteristics. Different approaches have been suggested for subtyping bronchiolitis based on viral etiology, atopic status, transcriptome profiles in blood, airway metabolome, lipidomic data, and airway microbiota.

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Article Synopsis
  • Multisystem inflammatory syndrome in children (MIS-C) is a serious condition linked to COVID-19, developing around 4 weeks after infection, characterized by hyperinflammation and potential shock.* -
  • The European Academy of Allergy and Clinical Immunology formed a task force to create guidelines for diagnosing, treating, and monitoring MIS-C, focusing on its unclear immunological mechanisms.* -
  • Current treatment involves supportive care and immunosuppressive agents like steroids, and regular follow-ups are essential to monitor for complications, with vaccination against COVID-19 shown to help prevent MIS-C.*
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Background: There is no consensus on the benefits of physical activity (PA) regarding upper respiratory tract infections (URTIs) among children. This study aimed to determine an association between the PA level and URTIs in preschoolers.

Methods: In 4-7-year-old participants, URTI symptoms were monitored using the Polish version of the Wisconsin Upper Respiratory System Survey for Kids.

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Respiratory tract infections (RTI) are mainly viral in origin and among the leading cause of childhood morbidity globally. Associated wheezing illness and asthma are still a clear unmet medical need. Despite the continuous progress in understanding the processes involved in their pathogenesis, preventive measures and treatments failed to demonstrate any significant disease-modifying effect.

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Extracellular vesicles (EVs) have emerged as vital mediators in intracellular communication in the lung microenvironment. Environmental exposure to various triggers (e.g.

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Unlabelled: It has become clear that severe bronchiolitis is a heterogeneous disease; even so, current bronchiolitis management guidelines rely on the one-size-fits-all approach regarding achieving both short-term and chronic outcomes. It has been speculated that the use of molecular markers could guide more effective pharmacological management and achieve the prevention of chronic respiratory sequelae. Existing data suggest that asthma-like treatment (systemic corticosteroids and beta2-agonists) in infants with rhinovirus-induced bronchiolitis is associated with improved short-term and chronic outcomes, but robust data is still lacking.

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