Objectives: Mucopolysaccharidosis III, an autosomal recessive lysosomal storage disorder, is characterized by progressive mental retardation and behavioral problems. Meta-analysis of global mucopolysaccharidosis III epidemiology, which serves as a fundamental reference for public health decision-making, was not available prior to this study. To provide a systematic review and meta-analysis of birth prevalence of mucopolysaccharidosis III in multiple countries. Methods: MEDLINE and EMBASE databases were searched for original research articles on the epidemiology of mucopolysaccharidosis III from inception until 1st July, 2020. A checklist adapted from STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) was used to assess the quality of all studies involved. Meta-analysis, adopting a random effects logistic model, was performed to estimate pooled birth prevalence of mucopolysaccharidosis III and its subtypes. Results: Twenty-five studies screened out of 1,826 records were included for data extraction. The pooled global mucopolysaccharidosis III birth prevalence was 0.76 cases (95% CI: 0.57–0.96) per 100,000 live births. The pooled global birth prevalence of mucopolysaccharidosis III subtypes (A, B, and C) was 0.52 cases (95% CI: 0.33–0.72), 0.21 cases (95% CI: 0.12–0.30) and 0.01 cases (95% CI: 0.005–0.02) per 100,000 live births, respectively. Conclusions: Based on the global population size (7.8 billion) and the life span of patients, there would be 12–19 thousand mucopolysaccharidosis III patients worldwide. To our knowledge, this is the first comprehensive systematic review that presented quantitative data fundamental for evidence-based public health decision-making by evaluating global epidemiology of mucopolysaccharidosis III.

Neonatal medicine advancements have significantly improved preterm infants’ survival rates, yet optimizing their neurodevelopmental outcomes, is challenging. A central factor in these challenges is oxidative stress (OS), arising from an imbalance between free radicals (FRs) production and antioxidant defense mechanisms. In preterm infants, OS is particularly detrimental due to their underdeveloped antioxidant systems, high brain metabolic demands, immature blood-brain barrier (BBB), and increased vulnerability to inflammation and hypoxia. This review focuses on the multifaceted aspects of OS concerning preterm brain injury. It examines developmental, physiological, pathological, and environmental factors contributing to preterm infants’ susceptibility to OS. In addition, the review discusses various pathophysiological mechanisms of preterm brain injury and proposes comprehensive solutions, including the use of antioxidants, nutritional support with a focus on breast milk, tailored oxygen therapy, and the importance of reducing oxidative stressors in the neonatal intensive care unit (NICU) including effective pain management and environmental modifications. The review emphasizes the need for future research focused on developing integrated and individualized treatment approaches for brain injury in preterm infants. Specifically, a deeper understanding and effective management of OS is crucial for enhancing long-term prognoses in this vulnerable group.

Mucopolysaccharidoses are a group of lysosomal storage disorders that are caused by deficiency of enzymes involved in glycosaminoglycans degradation. Due to low prevalence and high childhood mortality, researches on mucopolysaccharidoses were mainly focused on the fatal manifestations. With the development of treatments, more and more mucopolysaccharidoses patients were treated by approved therapies, thereby getting prolonged life span and improved quality of life. Abnormal accumulation of glycosaminoglycans in the eye may block trabecular meshwork, thicken sclera and change mechanical behavior of lamina cribrosa, which, by increasing intraocular pressure and damaging optic nerve, could cause glaucoma. Glaucoma was the leading cause of irreversible blindness worldwide, but it was rarely reported in mucopolysaccharidoses patients. Although non-fatal, it seriously affected quality of life. Prevalence of glaucoma in mucopolysaccharidoses patients (ranged from 2.1 to 12.5%) indicated that glaucoma in patients with mucopolysaccharidoses was worthy of attention and further study, thereby improving the quality of life for MPSs patients.