As an imbalance in the intestinal microbiota can lead to the development of several diseases (e.g., type 1 diabetes, cancer, among others), the use of prebiotics, probiotics, and postbiotics to alter the gut microbiome has attracted recent interest. Postbiotics include any substance released by or produced through the metabolic activity of the microorganism, which exerts a beneficial effect on the host, directly or indirectly. As postbiotics do not contain live microorganisms, the risks associated with their intake are minimized. Here, we provided a critical review of postbiotics described in the literature, including their mechanisms of action, clinical characteristics, and potential therapeutic applications. We detailed the pleiotropic effects of postbiotics, including their immunomodulatory, anti-inflammatory, antioxidant, and anti-cancer properties. Although the use of postbiotics is an attractive strategy for altering the microbiome, further study into its efficacy and safety is warranted.

Pollen–food allergy syndrome is an IgE-mediated allergic condition resulting from cross-reactivity between pollen allergens and homologous proteins present in plant-derived foods. PFAS typically presents with rapid-onset itching, burning, swelling, and erythema of the oral cavity and pharynx, with symptoms usually limited to the oropharyngeal region, although systemic reactions, including respiratory or gastrointestinal symptoms and, rarely, anaphylaxis, may occur. PFAS is strongly associated with the atopic phenotype and frequently coexists with allergic rhinitis, atopic dermatitis, and asthma. Available studies show marked variability in prevalence, from a few percent in general pediatric populations to 50–80% among atopic children, especially those with allergic rhinitis, with regional differences likely reflecting pollen sensitization patterns and dietary habits. The aim of this review was to summarize current knowledge regarding the epidemiology, clinical characteristics, molecular determinants, and food-related aspects of PFAS in children across different regions of the world. PFAS is a common but still insufficiently studied condition in children. Standardized diagnostic criteria and large population-based studies incorporating molecular diagnostic approaches are needed to better define the true burden, risk factors, and clinical spectrum of PFAS in childhood.

Background: Spinal muscular atrophy type 1 (SMA1) is a severe neuromuscular disorder characterized by progressive muscle weakness and atrophy, including the muscles of the oral cavity and esophagus. Eosinophilic esophagitis (EoE), a chronic, allergic disease, presents with eosinophilic infiltration of the esophagus, leading to esophageal dysmotility. Feeding difficulties may occur in both conditions. So far, the coexistence of EoE and SMA1 has not been described; we present the first such case. Case presentation: The patient was a girl with SMA1 diagnosed shortly after birth, treated with nusinersen and onasemnogene abeparvovec, and fed a standard industrial diet through a gastrostomy. In her second year of life, she developed increasing symptoms: distress during feeding, regurgitation, vomiting, and weight loss. She was treated with proton pump inhibitors without clinical improvement. Gastroscopy was performed, revealing superficial epithelial damage with bleeding in the proximal esophagus. Histopathology showed chronic inflammation with up to 150 eosinophils per high-power field, microabscesses, spongiosis, and basal layer hypertrophy. The girl was diagnosed with EoE. Her diet was switched from a standard industrial formula to an amino acid-based formula, which led to marked clinical improvement, the resolution of symptoms, and appropriate weight gain. Conclusions: This case report highlights the challenges of diagnosing EoE in SMA1 patients and emphasizes the need for multidisciplinary approaches and further investigation of allergic manifestations in SMA1 patients.