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Original Article
Hematology
Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-γ in pediatric immune thrombocytopenia
Fady Mohamed El-Gendy, Amira M.F. Shehata, Esam Awad Abd El-Kawy, Mahmoud Ahmed El-Hawy
Clin Exp Pediatr. 2023;66(3):127-133.   Published online February 24, 2023
Question: What are the PD-1+ CD4+ T cells percentages and serum interferon gamma (IFN-γ) levels of pediatric patients with immune thrombocytopenia (ITP)?
Finding: Compared with healthy controls, the PD-1+ CD4+ T cells percentages and IFN-γ levels were significantly higher in ITP patients before and 1 month after therapy.
Meaning: Our findings suggest that PD-1+ CD4+ T cells and IFN-γ are involved in the pathophysiological process of ITP.
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.
Original Article
Cardiology
Association of Toll-like receptor 2-positive monocytes with coronary artery lesions and treatment nonresponse in Kawasaki disease
Soo Jung Kang, Nam Su Kim
Clin Exp Pediatr. 2017;60(7):208-215.   Published online July 31, 2017
Purpose

Activation of Toll-like receptor 2 (TLR2) present on circulating monocytes in patients with Kawasaki disease (KD) can lead to the production of proinflammatory cytokines and interleukin-10 (IL-10). We aimed to determine the association of the frequency of circulating TLR2+/CD14+ monocytes (FTLR2%) with the outcomes of KD, as well as to compare FTLR2% to the usefulness of sIL-10.

Methods

The FTLR2% in patients...

Case Report
Neurology
A young child of anti-NMDA receptor encephalitis presenting with epilepsia partialis continua: the first pediatric case in Korea
Eun-Hee Kim, Yeo Jin Kim, Tae-Sung Ko, Mi-Sun Yum, Jun Hwa Lee
Clin Exp Pediatr. 2016;59(Suppl 1):S133-S138.   Published online November 30, 2016

Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis...

Autosomal dominant hypocalcemia with Bartter syndrome due to a novel activating mutation of calcium sensing receptor, Y829C
Keun Hee Choi, Choong Ho Shin, Sei Won Yang, Hae Il Cheong
Clin Exp Pediatr. 2015;58(4):148-153.   Published online April 22, 2015

The calcium sensing receptor (CaSR) plays an important role in calcium homeostasis. Activating mutations of CaSR cause autosomal dominant hypocalcemia by affecting parathyroid hormone secretion in parathyroid gland and calcium resorption in kidney. They can also cause a type 5 Bartter syndrome by inhibiting the apical potassium channel in the thick ascending limb of the loop of Henle in the...

Original Article
The usefulness of soluble transferrin receptor in the diagnosis and treatment of iron deficiency anemia in children
Se Hoon Yoon, Dong Sup Kim, Seung Taek Yu, Sae Ron Shin, Du Young Choi
Clin Exp Pediatr. 2015;58(1):15-19.   Published online January 31, 2015
Purpose

Soluble transferrin receptor (sTfR) is a truncated extracellular form of the membrane transferrin receptor produced by proteolysis. Concentrations of serum sTfR are related to iron status and erythropoiesis in the body. We investigated whether serum sTfR levels can aid in diagnosis and treatment of iron deficiency anemia (IDA) in children.

Methods

Ninety-eight patients with IDA were enrolled and were classified according to...

Expression of peroxisome proliferator-activated receptor (PPAR)-α and PPAR-γ in the lung tissue of obese mice and the effect of rosiglitazone on proinflammatory cytokine expressions in the lung tissue
Seung Lok Ryu, Jae Won Shim, Duk Soo Kim, Hye Lim Jung, Moon Soo Park, Soo-Hee Park, Jinmi Lee, Won-Young Lee, Jung Yeon Shim
Clin Exp Pediatr. 2013;56(4):151-158.   Published online April 22, 2013
Purpose

We investigated the mRNA levels of peroxisome proliferator-activated receptor (PPAR)-α, PPAR-γ, adipokines, and cytokines in the lung tissue of lean and obese mice with and without ovalbumin (OVA) challenge, and the effect of rosiglitazone, a PPAR-γ agonist.

Methods

We developed 6 mice models: OVA-challenged lean mice with and without rosiglitazone; obese mice with and without rosiglitazone; and OVA-challenged obese mice with and...

Transforming growth factor beta receptor II polymorphisms are associated with Kawasaki disease
Yu Mi Choi, Kye Sik Shim, Kyung Lim Yoon, Mi Young Han, Sung Ho Cha, Su Kang Kim, Joo Ho Jung
Clin Exp Pediatr. 2012;55(1):18-23.   Published online January 31, 2012
Purpose

Transforming growth factor beta receptor 2 (TGFBR2) is a tumor suppressor gene that plays a role in the differentiation of striated cells and remodeling of coronary arteries. Single nucleotide polymorphisms (SNPs) of this gene are associated with Marfan syndrome and sudden death in patients with coronary artery disease. Cardiovascular remodeling and T cell activation of TGFBR2 gene suggest that the...

Case Report
A sporadic case of Loeys-Dietz syndrome type I with two novel mutations of the TGFBR2 gene
Jung Sook Ha, Yeo Hyang Kim
Clin Exp Pediatr. 2011;54(6):272-275.   Published online June 30, 2011

A recently recognized connective tissue disorder, Loeys-Dietz syndrome (LDS) is a genetic aortic aneurysm syndrome caused by mutations in the transforming growth factor-receptor type I or II gene (TGFBR1 or TGFBR2). They have distinctive phenotypic abnormalities including widely spaced eyes (hypertelorism), bifid uvula or cleft palate, and arterial tortuosity with aortic aneurysm or dissection throughout the arterial tree. LDS is...

Transient neonatal diabetes mellitus caused by a de novo ABCC8 gene mutation
Jung Hyun Kong, June Bum Kim
Clin Exp Pediatr. 2011;54(4):179-182.   Published online April 30, 2011

Transient neonatal diabetes mellitus (TNDM) is a rare form of diabetes mellitus that presents within the first 6 months of life with remission in infancy or early childhood. TNDM is mainly caused by anomalies in the imprinted region on chromosome 6q24; however, recently, mutations in the ABCC8 gene, which encodes sulfonylurea receptor 1 (SUR1), have also been implicated in TNDM....

A case of pseudohypoaldosteronism type 1 with a mutation in the mineralocorticoid receptor gene
Se Eun Lee, Yun Hye Jung, Kyoung Hee Han, Hyun Kyung Lee, Hee Gyung Kang, Il Soo Ha, Yong Choi, Hae Il Cheong
Clin Exp Pediatr. 2011;54(2):90-93.   Published online February 28, 2011

Pseudohypoaldosteronism type 1 (PHA1) is a rare form of mineralocorticoid resistance characterized in newborns by salt wasting with dehydration, hyperkalemia and failure to thrive. This disease is heterogeneous in etiology and includes autosomal dominant PHA1 owing to mutations of the NR3C2 gene encoding the mineralocorticoid receptor, autosomal recessive PHA1 due to mutations of the epithelial sodium channel (ENaC) gene, and...

A case of thanatophoric dysplasia type I with an R248C mutation in the FGFR3 gene
Eun Jung Noe, Han Wook Yoo, Kwang Nam Kim, So Yeon Lee
Clin Exp Pediatr. 2010;53(12):1022-1025.   Published online December 31, 2010

Thanatophoric dysplasia (TD) is a short-limb neonatal dwarfism syndrome that is usually lethal in the perinatal period. It is characterized by shortening of the limbs, severely small thorax, large head with a prominent forehead, macrocephaly, curved femur, and flattened vertebral bodies. These malformations result from the mutation in fibroblast growth factor receptor 3 (FGFR-3) gene which is located on the...

Review Article
Neonatal innate immunity and Toll-like receptor
Hye Sun Yoon
Clin Exp Pediatr. 2010;53(12):985-988.   Published online December 31, 2010

The innate immune response is the first line of defense against microbial infections. Innate immunity is made up of the surface barrier, cellular immunity and humoral immunity. In newborn, immunologic function and demands are different to adults. Neonatal innate immunity specifically suppresses Th1-type immune responses, and not Th2-type immune responses, which are enhanced. And the impaired response of macrophages is...

Case Report
A case of Pfeiffer syndrome with c833_834GC>TG (Cys278Leu) mutation in the FGFR2 gene
Min Young Lee, Ga Won Jeon, Ji Mi Jung, Jong Beom Sin
Clin Exp Pediatr. 2010;53(7):774-777.   Published online July 31, 2010

Pfeiffer syndrome is a rare autosomal dominant disorder characterized by coronal craniosynostosis, brachycephaly, mid-facial hypoplasia, and broad and deviated thumbs and great toes. Pfeiffer syndrome occurs in approximately 1:100,000 live births. Clinical manifestations and molecular genetic testing are important to confirm the diagnosis. Mutations of the fibroblast growth factor receptor 1 (FGFR1) gene or FGFR2 gene can cause Pfeiffer syndrome....

Original Article
Apoptosis and upregulation of TNF-α and TRAIL receptor 1 (DR4) in the pathogenesis of food protein-induced enterocolitis syndrome
Jin-Bok Hwang, Sang Pyo Kim, Yu Na Kang, Seong-Ryong Lee, Seong-Il Suh, Taeg Kyu Kwon
Clin Exp Pediatr. 2010;53(4):525-531.   Published online April 15, 2010
Purpose : Expression levels of tumor necrosis factor (TNF)-α expression on the mucosa of the small intestine is increased in patients with villous atrophy in food protein-induced enterocolitis syndrome (FPIES). TNF-α has been reported to induce apoptotic cell death in the epithelial cells. We studied the TNF family and TNF-receptor family apoptosis on the duodenal mucosa to investigate their roles in the pathogenesis...
Association between polymorphisms in Interleukin-17 receptor A gene and childhood IgA nephropathy
Seung-Ah Baek, Won-Ho Hahn, Byoung-Soo Cho, Sung-Do Kim
Clin Exp Pediatr. 2010;53(2):215-221.   Published online February 15, 2010
Purpose : Interleukin-17 (IL-17) is produced by activated CD4+T cells and exhibits pleiotropic biological activity on various cell types. IL-17 was reported to be involved in the immunoregulatory response in IgA nephropathy (IgAN). Our aim was to investigate the association between single-nucleotide polymorphisms (SNPs) in IL-17 receptor A (IL-17RA) gene and childhood IgAN. Methods : We analyzed the SNPs in the...
Polymorphisms of the NR3C1 gene in Korean children with nephrotic syndrome
Hee Yeon Cho, Hyun Jin Choi, So Hee Lee, Hyun Kyung Lee, Hee Kyung Kang, Il Soo Ha, Yong Choi, Hae Il Cheong
Clin Exp Pediatr. 2009;52(11):1260-1266.   Published online November 15, 2009
Purpose : Idiopathic nephrotic syndrome (NS) can be clinically classified as steroid-sensitive and steroid-resistant. The detailed mechanism of glucocorticoid action in NS is currently unknown. Methods : In this study, we investigated 3 known single nucleotide polymorphisms (SNPs) (ER22/23EK, N363S, and BclI) of the glucocorticoid receptor gene (the NR3C1 gene) in 190 children with NS using polymerase chain reaction-restriction fragment...
Toll-like receptor 9 expression and interferon-α secretion upon CpG-ODN stimulation in allergic subjects
Man Yong Han, Hye Mi Jee, Hyeong Yoon Kim, Cho Ae Lee, Hyo-Jin Cho, Seong-Gyu Hwang, Kyu-Earn Kim
Clin Exp Pediatr. 2009;52(9):1015-1020.   Published online September 15, 2009

Purpose:The aim of this study is to explore the effect of the Toll-like receptor 9 (TLR9) expressed in plasmacytoid dendritic cells (pDCs) that respond to antigen to Th2 immune deviation in allergic patients. Methods:Subjects consisted of 19 allergic patients and 17 healthy volunteers. Skin prick tests and nasal provocation tests were performed for the two groups. Peripheral blood mononuclear cells (PBMCs)...
Effect of endothelin receptor blockade on monocrotaline-induced pulmonary hypertension in rats
Kyoung Ah Lim, Jung Yun Shim, Sang Ho Cho, Kwan Chang Kim, Jae Jin Han, Young Mi Hong
Clin Exp Pediatr. 2009;52(6):689-695.   Published online June 15, 2009
Purpose : To examine the effect of bosentan, a dual endothelin receptor (ER) antagonist, on the development of monocrotaline (MCT)-induced pulmonary hypertension in rats by especially focusing on the pulmonary vascular morphology changes. Methods : Sprague-Dawley rats were treated as follows: controls received a subcutaneous saline injection, MCT-treated rats received a subcutaneous MCT injection, and bosentan-treated rats received a MCT...
Association study of polymorphism in leukotriene C4 synthase and cysteinyl leukotriene receptor 1 genes with phenotype of asthma and clinical parameters in Korean children
Jung Yeon Shim, Byung-Joo Kim, Young Hwa Song, Mi-Jin Kang, So-Yeon Lee, Jinho Yu, Soo-Jong Hong
Clin Exp Pediatr. 2009;52(6):680-688.   Published online June 15, 2009
Purpose : Cysteinyl leukotrienes are important proinflammatory mediators in asthma. Recently, it was suggested that a promoter polymorphism in the genes encoding for leukotriene C4 synthase (LTC4S), a key enzyme in the leukotriene synthetic pathway, and cysteinyl leukotriene receptor 1 (CysLTR1) might be associated with aspirin-intolerant asthma. We investigated whether polymorphisms in LTC4S and CysLTR1 genes or their interactions were...
Toll-like receptor 2 expression on monocytes from patients with BCG vaccine-associated suppurative lymphadenitis
Hyun Joo Oh, Kyung-Sue Shin
Clin Exp Pediatr. 2009;52(6):667-673.   Published online June 15, 2009
Purpose : Toll-like receptor 2 (TLR2) is critical in the immune response to mycobacterial infections. The purpose of this study was to analyze TLR2 surface expressions and TLR2-mediated tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) production in patients with BCG vaccine-associated suppurative lymphadenitis. Methods : Peripheral monocytes were separated from 16 patients with BCG vaccine-associated suppurative lymphadenitis and 10 healthy...
Expression of nitric oxide synthase isoforms and N-methyl-D-aspartate receptor subunits according to transforming growth factor-β1 administration after hypoxic-ischemic brain injury in neonatal rats
Hae Young Go, Eok Su Seo, Woo Taek Kim
Clin Exp Pediatr. 2009;52(5):594-602.   Published online May 15, 2009
Purpose : Transforming growth factor (TGF)-β1 reportedly increases neuronal survival by inhibiting the induction of inducible nitric oxide synthase (NOS) in astrocytes and protecting neurons after excitotoxic injury. However, the neuroprotective mechanism of TGF-β1 on hypoxic-ischemic (HI) brain injury in neonatal rats is not clear. The aim of this study was to determine whether TGF-β1 has neuroprotective effects via a...
Correlaton between soluble transferrin receptor concentration and inflammatory markers
So Young Kim, Meong Hi Son, Jung suk Yeom, Ji sook Park, Eun Sil Park, Ji-Hyun Seo, Jae-Young Lim, Chan-Hoo Park, Hyang-Ok Woo, Hee-Shang Youn
Clin Exp Pediatr. 2009;52(4):435-440.   Published online April 15, 2009
Purpose : The concentration of soluble transferrin receptor (sTfR) is estimated as an iron parameter to evaluate erythropoiesis and iron status. The aim of our study is to evaluate the correlation between sTfR concentration and inflammatory parameters and to distinguish iron deficiency anemia from anemia of inflammation. Methods : One hundred and forty-four infants younger than two years of age who...
Case Report
Identification of a de novo mutation (H435Y) in the THRB gene in a Korean patient with resistance to thyroid hormone
Jin Young Shin, Chang-Seok Ki, Jin Kyung Kim
Clin Exp Pediatr. 2007;50(6):576-579.   Published online June 15, 2007
The syndrome of resistance to thyroid hormone (RTH) is characterized by reduced tissue sensitivity to thyroid hormone (TH). In the majority of subjects, RTH is caused by mutations in the thyroid hormone receptor beta (TRβ) gene, located on the chromosome locus 3p24.3. RTH is inherited in an autosomal dominant manner. The clinical presentation of RTH is variable, but common features...
Original Article
Association of Leukotriene C4 Synthase Gene Polymorphism with Clinical Response to Montelukast in Childhood Asthma
Kyung-Sue Shin, Youn Woo Kim
Clin Exp Pediatr. 2005;48(7):766-771.   Published online July 15, 2005
목 적 : 류코트리엔 수용체 길항제는 천식의 병리 반응에 관여하는 cysteiny leukotriene의 생성과 작용을 억제하여 급성기 천식 증상의 치료와 천식 증상의 조절 요법에 사용할 수 있다. 본 연구에서는 소아 천식환자에서 cysteinyl leukotriene 생성에 관여하는 LTC4S 유전자 다형태와 류코트리엔 수용체 길항제인 montelukast의 임상적 효과를 조사하여 약물유전학적 연관성 유무를 알고자 하였다. 방 법 : 환자군은 경증 지속성 천식과 중등증 지속성 천식환자 161명을 대상으로...
Case Report
Hyperthyroidism Caused by a Mutation in the Thyrotropin Receptor Gene in Two Brothers
Jae Hyun Kim, Sung Soo Lee, Jung Sub Lim, Choong Ho Shin, Sei Won Yang
Clin Exp Pediatr. 2005;48(3):337-341.   Published online March 15, 2005
Thyrotropin receptor(TSHR) mutations must be considered when congenital hyperthyroidism has persisted, but there has been no evidence for autoimmunity. TSHR mutations leading to constitutive activation of the thyroid gland were identified as the molecular cause of autosomal dominant nonautoimmune hyperthyroidism and sporadic congenital hyperthyroidism. We report two cases of hyperthyroidism caused by germline TSHR mutation who presented with exessive sweating...
Original Article
Expression of Toll-like Receptor-2 on the Peripheral Blood Monocytes in Kawasaki Disease Patients
Dae Hwan Hwang, Jung Woo Han, Kyung Min Choi, Kyung Mi Shin, Dong Soo Kim
Clin Exp Pediatr. 2005;48(3):315-320.   Published online March 15, 2005
Objective : Toll like receptor(TLR) is known to be involved in innate immunity. Many microbial antigens stimulate TLR, and as a result of intracellular signal transduction, they activate nuclear factor-kB which produces diverse inflammtory cytokines. Until now, many research topics in Kawasaki disease focused on cytokine increasement. In this study, we aim to reveal TLR increasement which might be associated...
Medical Lecture Course
Helper T Cell Polarizing Through Dendritic Cells
Manyong Han
Clin Exp Pediatr. 2005;48(1):6-12.   Published online January 15, 2005
In the last few years, a spectrum of dendritic cells(DCs), including toll like receptors(TLRs), might play a critical role in regulating allergy and asthma. DC plays a central role in initiating immune responses, linking innate and adaptive responses to pathogen. Human peripheral blood has three non- overlapping dendritic subset that expressed various 11 TLRs. These dendritic subsets and TLR contribute...
Original Article
Febrile Seizure-induced Neuroexcitability in Immature Rat Hipocampus
Bong Keun Choi, Kyu Geun Hwang, Hae Rahn Bae
Clin Exp Pediatr. 2004;47(9):992-1001.   Published online September 15, 2004
Purpose : To determine whether febrile seizure enhances neuroexcitability by altering synaptic transmission and whether febrile seizure-induced hyperexcitability leads to long-lasting neuronal death. Methods : We investigated the expression of synaptic and postsynaptic proteins and the apoptosis of neuronal cells in rat pup hippocampus after hyperthermic seizure using immunoblotting and confocal microscopy. Results : Hyperthermic seizure enhanced the long-term expressions of...
Medical Lecture Course
Recurrent Early-Life Seizures and Changes in GABAA Receptors Expression in Hippocampus
Doo Kwun Kim
Clin Exp Pediatr. 2004;47(6):596-603.   Published online June 15, 2004
The immature brain differs from the adult brain in its susceptibility to seizures, seizure characteristics, and responses to antiepileptic drugs. Gamma(γ)-aminobutyric acid(GABA) is the predominant inhibitory neurotransmitter in the adult brain. GABA exerts its main action through GABAA receptors, which are coupled to a ligand-gated chloride channel. The receptor protein is a pentameric structure composed of multiple subunits of different...
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