Immunology

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Review Article
Immunology
Multiomics approaches in Kawasaki disease: insights into pathogenesis and emerging directions for diagnosis and treatment
Jong Gyun Ahn, Insoo Kang
Clin Exp Pediatr. 2026;69(3):197-210.   Published online February 25, 2026
Kawasaki disease (KD) is an acute febrile vasculitis and the leading cause of acquired heart disease in children. Despite decades of research, the etiology remains unknown and key mechanisms linking systemic inflammation to coronary artery lesions are incompletely defined. High-throughput technologies—including genomics, transcriptomics, proteomics, metabolomics, epigenomics, and immunomics—have enabled systems-level profiling of KD and highlighted reproducible inflammatory and vascular pathways....
NLRP3 inflammasome: a key player in neonatal brain injury
Cagla Kiser, Ilkcan Ercan, Defne Engur, Sermin Genc
Clin Exp Pediatr. 2025;68(7):475-485.   Published online April 1, 2025
Hypoxic-ischemic encephalopathy is the major cause of neonatal brain injury. NOD-like receptor family pyrin domain containing 3 inflammasome activation leads to neuroinflammation, which significantly affects newborn mortality. The establishment of preventive and therapeutic strategies against brain damage requires a thorough understanding of the mechanisms underlying neuroinflammation and inflammasome activation in the neonatal brain.
Original Article
Immunology
Serum bactericidal activity against meningococcus in patients with systemic lupus erythematosus
Soyoung Lee, Kyung-Hyo Kim, Ji Hyen Lee, Han Wool Kim
Clin Exp Pediatr. 2025;68(5):362-369.   Published online January 13, 2025
Question: What is the level of immunity against meningococcal infections in patients with systemic lupus erythematosus (SLE) under the age of 19, and is vaccination against meningococcus necessary for these patients, given their susceptibility to infections due to immunosuppressive treatments and disease characteristics?
Finding: Although some of our study patients exhibited serum bactericidal activity against meningococci, most remained seronegative.
Meaning: These findings suggest that patients with SLE who are at risk of meningococcal infection receive appropriate vaccinations.
Clinical Note
Immunology
Comparative analysis of rare periodic fever syndromes including the first Korean case of hyperimmunoglobulinemia D and periodic fever syndrome
Yoonsun Yoon, Hyun Seo Kim, Jung Ok Shim, JungHwa Lee
Clin Exp Pediatr. 2024;67(10):550-552.   Published online September 24, 2024
Editorial
Immunology
Utility of eosinophil granule proteins in management of pediatric chronic cough
Chang-Keun Kim
Clin Exp Pediatr. 2024;67(10):519-520.   Published online April 17, 2024
· Pediatric chronic cough often involves eosinophilic inflammation; however, objective measurements are not routinely used in treatment decisions.
· Accurate biomarkers of eosinophil activity, such as eosinophil-derived neurotoxin (EDN) and cationic proteins (ECP), should be used. EDN, which overcomes the shortcomings of ECP, recently received approval for use in Korean healthcare settings.
· EDN and ECP can play a role in treatment period and drug selection decisions.
Systemic autoinflammatory disorders: autoinflammatory and autoimmune disorders
Young Dae Kim
Clin Exp Pediatr. 2023;66(10):439-440.   Published online July 4, 2023
· Systemic autoinflammatory disorders (SAIDs) typically have an early onset in life, and may have close relatives may have similar disease.
· SAIDs should be suspected in any patient, especially children, who experience persistent or recurrent inflammatory episodes that fail to fit the pattern of other established diseases.
· Advancements in the understanding of autoinflammation will provide novel diagnostic and therapeutic options for SAIDs patients.
Review Article
Immunology
Systemic autoinflammatory disorders
Dae Chul Jeong
Clin Exp Pediatr. 2023;66(10):432-438.   Published online June 14, 2023
· Systemic autoinflammatory disorders (SAID) are disorders caused by dysregulation of the innate immunity with genetic background, leading to recurrent episodes of systemic inflammation.
· SAID is characterized by recurrent acute inflammatory responses including fever or skin manifestations, unrelated with infection or malignancy.
· Diagnosis is based on family and long-term history with detailed clinical and laboratory manifestations during febrile periods.
Editorial
Immunology
Importance of neonatal screening for primary immunodeficiencies
Jung Woo Rhim
Clin Exp Pediatr. 2021;64(10):519-520.   Published online May 4, 2021
· Early detection of asymptomatic infants with primary immunodeficiencies before the onset of infections enables effective treatment and intervention to prevent serious sequelae.
· T-cell receptor excision circles and kappa-deleting recombination excision circles have recently been used to detect T- or B-cell lymphopenia in neonates.
Review Article
Immunology
Modern diagnostic capabilities of neonatal screening for primary immunodeficiencies in newborns
Evgenia Olegovna Khalturina, Natalia Dmitrievna Degtyareva, Anastasiia Vasi’evna Bairashevskaia, Alena Valerievna Mulenkova, Anna Vladimirovna Degtyareva
Clin Exp Pediatr. 2021;64(10):504-510.   Published online March 25, 2021
· Neonatal screening for primary immunodeficiency diseases (PIDs) enables early diagnosis and subsequent initiation of therapy.
· Excision of T-cell receptors and kappa-recombination excision circles are cheaper alternative PID screening methods.
· Sanger DNA sequencing remains the reference method for detecting PID; however, next-generation sequencing technology is increasingly used to diagnose it.
· Here we developed a graphical algorithm for diagnosing primary immunodeficiency syndrome based on modern methods of screening for primary immunodeficiencies in newborns.
Review article
Immunology
Systematic review of literature and analysis of big data from the National Health Insurance System on primary immunodeficiencies in Korea
Sohee Son, Ji-Man Kang, Younsoo Hahn, Kangmo Ahn, Yae-Jean Kim
Clin Exp Pediatr. 2021;64(4):141-148.   Published online July 13, 2020
In this article, a systematic review of reported primary immunodeficiency disease (PID) cases in Korea was performed and we attempted to estimate the number of PID patients and healthcare costs for the first time in Korea. Our review revealed that Korean PID cases are greatly underreported in the literature based on health insurance. Physicians in the field and health care policymakers should be aware of the disease burden of PID.
Clinical note
Immunology
Salivary and lacrimal gland enlargement with serum immunoglobulin G4 elevation
Jinseok Lee, Da-Eun Kim, Jeong-Hwan Yang, Misun Lim, Hye Yung Yum, JoongGon Kim
Clin Exp Pediatr. 2021;64(2):93-95.   Published online December 8, 2020
Question: What diseases should be considered in a 15-year-old girl presenting enlarged lacrimal and salivary glands?
Finding: Laboratory tests revealed elevated IgG4 levels. A submandibular gland biopsy showed lymphoplasmacytic infiltration and more than 40 immunoglobulin G4 (IgG4)-positive cells per high-power field. The patient was diagnosed with IgG4-related disease.
Meaning: Although rare in children, IgG4-related disease should be considered a differential diagnosis in children with enlarged salivary and lacrimal glands.
Original Article
Immunology
Immunogenicity and safety of a 12-valent pneumococcal conjugate vaccine in infants aged 6–10 weeks: a randomized double-blind active-controlled trial
Jonghoon Shin, Jamaree Teeratakulpisarn, Thanyawee Puthanakit, Tuangtip Theerawit, Ji Hwa Ryu, Jinhwan Shin, Seulgi Lee, Hayoung Lee, Kyungjun An, Hun Kim
Clin Exp Pediatr. 2020;63(7):265-271.   Published online December 6, 2019
Question: The immunogenicity and safety of GBP411 when administered to healthy infants are not understood.
Finding: The intergroup differences were not significant for all 12 serotypes after the booster dose. The overall incidence of solicited local adverse events between the groups did not differ significantly.
Meaning: GBP411 with a 2p+1 dosing schedule induced a substantial immune response, and may be safe for administration to healthy infants.
Review Article
Immunology
Immunopathogenesis of COVID-19 and early immunomodulators
Kyung-Yil Lee, Jung-Woo Rhim, Jin-Han Kang
Clin Exp Pediatr. 2020;63(7):239-250.   Published online June 18, 2020
The novel coronavirus disease 2019 (COVID-19) is spreading globally. Although its etiologic agent is discovered as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), there are many unsolved issues in COVID-19 and other infectious diseases. The causes of different clinical phenotypes and incubation periods among individuals, species specificity, and cytokine storm with lymphopenia as well as the mechanism of damage to organ...
Case Report
Immunology
A familial case of Blau syndrome caused by a novel NOD2 genetic mutation
Woojoong Kim, Eujin Park, Yo Han Ahn, Jiwon M. Lee, Hee Gyung Kang, Byung Joo Kim, Il-Soo Ha, Hae Il Cheong
Clin Exp Pediatr. 2016;59(Suppl 1):S5-S9.   Published online November 30, 2016

Blau syndrome (BS) is a rare autosomal dominant, inflammatory syndrome that is characterized by the clinical triad of granulomatous dermatitis, symmetric arthritis, and recurrent uveitis. Mutations in the nucleotide oligomerization domain 2 (NOD2) gene are responsible for causing BS. To date, up to 30 Blau-associated genetic mutations have been identified within this gene. We report a novel NOD2 genetic mutation...

A novel BTK gene mutation, c.82delC (p.Arg28 Alafs*5), in a Korean family with X-linked agammaglobulinemia
Jeongeun Lee, Minhee Rhee, Taek Ki Min, Hae In Bang, Mi-Ae Jang, Eun-Suk Kang, Hee-Jin Kim, Hyeon-Jong Yang, Bok Yang Pyun
Clin Exp Pediatr. 2016;59(Suppl 1):S49-S52.   Published online November 30, 2016

X-linked agammaglobulinemia (XLA) is a hereditary humoral immunodeficiency that results from Bruton’s tyrosine kinase (BTK) gene mutations. These mutations cause defects in B-cell development, resulting in the virtual absence of these lymphocytes from the peripheral circulation. Consequently, this absence leads to a profound deficiency of lg all isotypes, and an increased susceptibility to encapsulated bacterial infections. A 15-month-old Korean boy...

Familial Mediterranean fever presenting as fever of unknown origin in Korea
Jun Hee Lee, Jong Hyun Kim, Jung Ok Shim, Kwang Chul Lee, Joo Won Lee, Jung Hwa Lee, Jae Jin Chae
Clin Exp Pediatr. 2016;59(Suppl 1):S53-S56.   Published online November 30, 2016

Familial Mediterranean fever (FMF) is the most common Mendelian autoinflammatory disease, characterized by uncontrolled activation of the innate immune system that manifests as recurrent brief fever and polyserositis (e.g., peritonitis, pleuritic, and arthritis). FMF is caused by autosomal recessive mutations of the Mediterranean fever gene, MEFV which encodes the pyrin protein. Although FMF predominantly affects people from Mediterranean and Middle...

Concomitant use of corticosteroid and antimicrobials for liver abscesses in patients with chronic granulomatous disease
Kyung-Sue Shin, Mu Suk Lee
Clin Exp Pediatr. 2016;59(4):196-201.   Published online April 30, 2016

Chronic granulomatous disease (CGD) is a rare inherited disorder caused by defective nicotinamide adenine dinucleotide phosphate oxidase enzyme and characterized by recurrent bacterial and fungal infections. Although liver abscess is a common manifestation of CGD, its management in CGD patients is not well-defined. In addition, the generalized guidelines for treating liver abscesses do not necessarily apply to CGD patients. Corticosteroids...


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