Значение пробиотиков в педиатрической практике

Crohn’s disease (CD) in children with juvenile idiopathic arthritis (JIA) is frequently diagnosed late due to overlapping symptoms and non-specific biomarkers. We hypothesized that longitudinal cytokine profiling could identify a pre-symptomatic signature predictive of CD conversion in pediatric JIA patients. Ninety pediatric participants (JIA, CD, psoriatic arthritis, healthy controls) underwent serum cytokine profiling (IL-1α, IL-1β, IL-36α, IL-37, IL-6, IL-18, IL-27, IL-31) at baseline and 12 months. Statistical analysis used Mann–Whitney U tests for two-group comparisons, the Kruskal–Wallis test with Dunn’s post hoc for multi-group comparisons, Fisher’s Exact Test for categorical outcomes, and exploratory principal component analysis (PCA). Baseline screening identified a subgroup of JIA patients (N = 4) with significantly elevated IL-1α, IL-1β, and IL-36α. At 12 months, all four patients in this subgroup received a secondary CD diagnosis (4/4 converters vs. 0/21 non-converters; Fisher’s Exact Test: p < 0.0001). The longitudinal analysis at conversion revealed a broader pro-inflammatory shift, with marked increases in IL-18 and IL-31, alongside elevated IL-37, suggesting a compensatory regulatory response. PCA confirmed that converters clustered distinctly from both stable JIA and established CD. A baseline IL-1 family signature may represent a preliminary predictive signature for CD onset in pediatric JIA. Although constrained by the small converter subgroup (N = 4), these data support cytokine profiling for earlier diagnosis in high-risk populations.

Background. Inflammatory bowel disease (IBD) and allergic diseases (ADs) share some pathogenetic mechanisms. The intersection of IBD and ADs is increasingly discussed within the scientific community. However, pediatric data on the relationship between IBD and allergy remain limited, particularly in the Russian literature, warranting this study. Aim. To determine the prevalence and characteristics of allergic disorders in children diagnosed with IBD, and to compare these findings with a control group of children with juvenile idiopathic arthritis (JIA). Materials and methods. The main group comprised 54 children diagnosed with IBD, with a mean age of 13.2±3.8 years, including 32 patients (59.3%) diagnosed with Crohn's disease and 22 patients (40.7%) diagnosed with ulcerative colitis. The comparison group included 34 patients with JIA, with a mean age of 11.9±4.3 years. All participants were observed at the Clinic of Children's Diseases of the Sechenov Center for Motherhood and Childhood. Diagnoses were confirmed in accordance with the current clinical guidelines issued by the Ministry of Health of Russia. The study evaluated the family history of ADs, the frequency of adverse perinatal events, feeding practices, and the frequency and types of allergic manifestations (including asthma, atopic dermatitis, allergic rhinitis, and food and drug allergies) in each group with a comparative analysis of the collected data. Statistical analyses were performed using Stata software, employing the Shapiro–Wilk test, Student's t-test, Mann–Whitney test, Pearson's χ² test, Fisher's exact test, and logistic regression to calculate odds ratios and 95% confidence intervals. Differences were considered statistically significant at p 0.05. Results. Among the children diagnosed with IBD, 59.3% reported allergic disorders, with 25.9% exhibiting two or more allergies. The most prevalent allergies included atopic dermatitis (18.5%) and food allergies (27.8%), with drug allergies observed in 14.8% of children in this group. Perinatal complications were noted in 44.4% of these patients. 47.4% of patients had been breastfed for over six months, and a family history of ADs was documented in 25.9% of the children. In contrast, allergic manifestations were reported in 38.2% of the JIA group; the most common manifestations included atopic dermatitis (20.6%) and food or drug allergies (11.8% each), with asthma and allergic rhinitis being less common (2.9% each). A complicated early medical history was recorded in 50.0% of JIA patients, with 29.4% having been breastfed for more than six months, and 14.7% showing a family history of ADs. Conclusion. The prevalence of ADs in children diagnosed with IBD is significantly higher than in the general population. Although the prevalence of allergies in children with JIA is also higher compared to the overall population data, the difference is not statistically significant. It remains lower than that observed in children with IBD (Fisher's exact test p=0.079). However, the probability of developing allergies in IBD patients was approximately 2.9 times greater than that of JIA patients, with the most pronounced trend in food allergy. The findings of this study suggest a probable association between IBD and the prevalence of allergic disorders.