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Objective: In individuals with asthma, obesity induces the production of leptin and is associated with disease severity. Our objective was to evaluate the levels of serum leptin and their effect on Th1/Th2 balance in obese and non-obese children with asthma, as well as to investigate the association between serum leptin levels and clinical outcomes. Methods: We evaluated 50 atopic children with physician-diagnosed moderate-to-severe persistent asthma and 20 controls. The children with asthma were divided into two groups, by body mass index percentile: obese (n = 25) and non-obese (n = 25). From all subjects, we collected peripheral blood samples in order to determine the levels of leptin, IFN-γ, and IL-4. Asthma severity was assessed by an asthma symptom score, and the results were correlated with the parameters studied. Results: Serum leptin levels were significantly higher in the obese asthma group than in the non-obese asthma group, as well as being significantly higher in the children with asthma than in the controls, whereas IFN-γ levels were significantly higher and IL-4 levels were significantly lower in the obese asthma group than in the non-obese asthma group. In addition, the obese asthma group showed higher asthma symptom scores and significantly lower FEV 1 (% of predicted) than did the non-obese asthma group. There was a significant positive correlation between leptin and IFN-γ levels only in the obese asthma group. Conclusions: Although leptin is involved in the pathogenesis of asthma in obese and non-obese children, its effect is more pronounced in the former. In the presence of high leptin levels, only obese children with asthma exhibited Th1 polarization, with higher IFN-γ levels and greater asthma severity.Keywords: Leptin; Asthma; Interferon-gamma; Interleukin-4. ResumoObjetivo: A obesidade induz a produção de leptina em asmáticos e está associada à gravidade da doença. Nosso objetivo foi avaliar os níveis de leptina sérica e seu efeito no equilíbrio Th1/Th2 em crianças asmáticas obesas e não obesas e investigar a associação desses níveis com desfechos clínicos. Métodos: O estudo envolveu 50 crianças atópicas com diagnóstico médico de asma persistente moderada a grave e 20 controles. Os asmáticos foram agrupados como obesos (n = 25) e não obesos (n = 25) de acordo com o percentil do índice de massa corpórea. Amostras de sangue periférico foram coletadas de todos os sujeitos, e os níveis de leptina, IFN-γ e IL-4 foram determinados. A gravidade da asma foi avaliada por um escore de sintomas de asma, e os resultados foram correlacionados com os parâmetros estudados. Resultados: Os níveis séricos de leptina foram significativamente maiores nos asmáticos obesos do que nos asmáticos não obesos, assim como nos asmáticos comparados aos controles, enquanto os níveis de IFN-γ foram significativamente maiores e os de IL-4 foram significativamente menores nos asmáticos obesos do que nos asmáticos não obesos. Os asmáticos obesos tiveram maiores escores de sintomas de asma e VEF 1 (% do previsto) si...

Background: Children with chronic kidney disease (CKD), particularly those who require hemodialysis (HD), are at high risk of hepatitis B virus (HBV) infection. The HBV vaccine non-/hypo-response rate among HD children remains high, and it is critical to investigate the influencing factors and their linkages. The aim of this study was to identify the pattern of HB vaccination response in HD children and to analyze the interference of various clinical and biomedical factors with the immunological response to HB vaccination. Methods: This cross-sectional study included 74 children on maintenance hemodialysis, aged between 3 and 18 years. These children were subjected to complete clinical examination and laboratory investigations. Results: Out of a total of 74 children with HD, 25 (33.8%) were positive for the HCV antibody. Regarding the immunological response to hepatitis B vaccine, 70% were non-/hypo-responders (≤100 IU/mL) and only 30% mounted a high-level response (more than 100 IU/mL). There was a significant relation between non-/hypo-response and sex, dialysis duration, and HCV infection. Being on dialysis for more than 5 years and being HCV Ab-positive were independent variables for non-/hypo-response to HB vaccine. Conclusions: Children with CKD on regular HD have poor seroconversion rates in response to the HBV vaccine, which were influenced by dialysis duration and HCV infection.

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