Clinical and Experimental Pediatrics

Review Article

Immunology

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.

DOI: https://doi.org/10.3345/cep.2024.01935

Editorial

Neonatology (Perinatology)

Intermittent sigh breaths during high-frequency oscillatory ventilation among newborn infants

Ga Won Jeon

Clin Exp Pediatr. 2025;68(7):486-488. Published online April 16, 2025

Intermittent sigh breaths during high-frequency oscillatory ventilation can improve ventilation and oxygenation by enhancing lung recruitment. Although research on this approach in newborn infants is limited, some published studies suggest that sigh breaths are generally applied at a rate of 2–3 breaths/min with an inspiratory time of 0.5–1 second and pressure of current mean airway pressure + 5 cmH₂O (maximum, 30 cmH₂O).

DOI: https://doi.org/10.3345/cep.2025.00549

Original Articles

Pulmonology

Nonlinear association between neutrophil-to-lymphocyte ratio and asthma in children and adolescents in the United States: a cross-sectional study

Chuhan Cheng, Liyan Zhang

Clin Exp Pediatr. 2025;68(7):489-496. Published online March 11, 2025

Crossref 1

Question: Is there a nonlinear relationship between neutrophil-to-lymphocyte ratio (NLR) and asthma in children and adolescents?
Finding: NLR showed a nonlinear association with asthma, with an NLR threshold of 2.23 identifying individuals at higher risk.
Meaning: An NLR<2.23 may serve as a potential biomarker for asthma risk assessment and management in pediatric populations, thereby offering a simple tool for the early identification of at-risk individuals.

DOI: https://doi.org/10.3345/cep.2024.01844

Clinical course of children with postinfectious bronchiolitis obliterans with versus without comorbid bronchopulmonary dysplasia

Lamia Medghoul, Julien Grosjean, Christophe Marguet, Hortense Petat

Clin Exp Pediatr. 2025;68(7):497-502. Published online April 1, 2025

Question: Postinfectious bronchiolitis obliterans (PIBO) is a chronic respiratory disease that typically develops in children after a severe respiratory infection. Bronchopulmonary dysplasia (BPD) is often comorbid in patients with PIBO.
Finding: Corticosteroid pulse therapy effectively manages PIBO with or without comorbid BPD, significantly reducing exacerbations and decreasing the daily requirement for inhaled corticosteroids.
Meaning: Therapeutic effects of corticosteroid pulses are rapid and sustained over time, in both groups.

DOI: https://doi.org/10.3345/cep.2025.00122

Neonatology (Perinatology)

Characterization of gut microbiota in very low birth weight infants with versus without bronchopulmonary dysplasia

Anucha Thatrimontrichai, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate, Kamonnut Singkhamanan, Komwit Surachat

Clin Exp Pediatr. 2025;68(7):503-511. Published online February 26, 2025

Question: Does the gut microbiota differ between very low birth weight (VLBW) infants with versus without bronchopulmonary dysplasia (BPD)?
Finding: Common respiratory pathogens were notably elevated in the BPD group, whereas anaerobic and butyrate-producing taxa, key components of postbiotics, were dominant in the non-BPD group.
Meaning: In gut-lung communication, the interplay between the intestinal and respiratory systems may implicate pro- and postbiotics in VLBW infants with BPD.

DOI: https://doi.org/10.3345/cep.2024.01718

Genetics and Metabolism

Role of microRNA-498 and microRNA-410 in neonatal hypoxic-ischemic encephalopathy

Eman Salah Eldeen Arafat, Hasnaa Hesham Abotaleb, Dina Abdel Razek Midan, Abdel Hamid Abdo Ismail, Zeinab Sabri Abouzouna

Clin Exp Pediatr. 2025;68(7):512-521. Published online February 26, 2025

Question: Is it role of microRNA-410 (miRNA-410) and microRNA-498 (miRNA-498) in neonatal hypoxic-ischemic encephalopathy (HIE)?
Findings: miRNA-498 and miRNA-410 can be auxiliary diagnostic and prognostic tools for neonatal HIE.
Meaning: we can use miRNA-498 and miRNA-410 as markers and indicator for HIE.

DOI: https://doi.org/10.3345/cep.2024.01669

Hematology

Treatment and clinical outcomes of pediatric autoimmune hemolytic anemia: real-world single-center data from Korea

Young Dai Kwon, Eun Sun Jung, Yeon Jung Lim

Clin Exp Pediatr. 2025;68(7):522-529. Published online April 16, 2025

Question: Can pediatric autoimmune hemolytic anemia (AIHA) be effectively managed using first-line steroids?
Finding: In this single-center study, pediatric patients with AIHA achieved normal hemoglobin levels within 16.5 days (range, 9.0–22.0 days) of first-line steroid treatment and maintained effective responses for 2 months.
Meaning: These outcomes highlight the efficacy of steroid treatment in pediatric versus adult AIHA and underscore the need for multicenter trials to establish standardized treatment guidelines.

DOI: https://doi.org/10.3345/cep.2024.02026

Neonatology (Perinatology)

Incidence of neural tube defects in tertiary care university hospital in Bangladesh

Ismat Jahan, Arif Hossain, Shah Nizam Uddin Shaon, Sadeka Choudhury Moni, Mohammad Kamrul Hassan Shabuj, Sanjoy Kumer Dey, Mohammad Abdul Mannan, Mohammod Shahidullah

Clin Exp Pediatr. 2025;68(7):530-538. Published online April 1, 2025

Question: What is the burden of neural tube defects (NTDs) in a tertiary care neonatal intensive care unit in Bangladesh?
Finding: The overall incidence of NTD was 6.4 (range, 4.59–11.2) per 1,000 live births, and the meningomyelocele complex was the most frequent location.
Meaning: The high incidence of NTD found in a leading tertiary care multidisciplinary referral hospital in Bangladesh may not reflect that of the wider population.

DOI: https://doi.org/10.3345/cep.2024.01578

Evaluation of total serum bilirubin thresholds for discontinuing phototherapy in jaundiced neonates: a randomized study

Ajay Kumar, Nidhi Jain

Clin Exp Pediatr. 2025;68(7):539-545. Published online February 26, 2025

Question: What are the outcomes of jaundiced neonates when phototherapy is discontinued at 2 different total serum bilirubin (TSB) thresholds?
Findings: The study involved 80 neonates, comparing a recommended TSB threshold and a lower threshold for phototherapy discontinuation. Results showed a 14.3% reinstitution rate of treatment, with no adverse outcomes.
Meaning: Careful posttreatment monitoring is essential when discontinuing phototherapy, and future research should consider updated guidelines like those from the American Academy of Pediatrics.

DOI: https://doi.org/10.3345/cep.2024.01249

Perspective

Gastroenterology

Metabolic dysfunction-associated steatotic liver disease in children: a practical update based on Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition (ISPGHAN) 2024 guidelines

Ankit Agrawal, Arghya Samanta

Clin Exp Pediatr. 2025;68(7):546-550. Published online May 12, 2025

DOI: https://doi.org/10.3345/cep.2025.00157

Letter to the Editor

General Pediatrics

Debate around and impact of digital screen time and media parenting on children’s development

Gowda Parameshwara Prashanth

Clin Exp Pediatr. 2025;68(7):551-553. Published online March 11, 2025

DOI: https://doi.org/10.3345/cep.2025.00073

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Cited By 18	Nonalcoholic fatty liver disease and insulin resistance in children

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