Magnetic resonance imaging (MRI) is an important non-invasive examination in the early diagnosis of juvenile dermatomyositis (JDM). We aimed to evaluate the feasibility of radiomics to establish a quantitative analysis of MRI images. Radiomics and machine learning were used to retrospectively analyze MRI T2 fat suppression sequences and relevant clinical data. The model associated with radiomics features was established using a cohort of patients who underwent thigh MRI at the children’s hospital from June 2014 to September 2021. In total, 75 patients with JDM and 75 control children were included in the training cohort (n = 102) and validation cohort (n = 48). The independent factors including lower muscle strength (OR, 0.75; 95% CI, 0.59–0.90), higher creatine kinase (CK) level (OR, 1.65; 95% CI, 1.20–2.38), and higher radiomics score (OR, 2.30; 95% CI, 1.63–3.62) were associated with a clinical diagnosis of JDM. The combined model achieved good discrimination performance compared the radiomics score model under linear discriminant analyses in the training cohort (AUC, 0.949; 95% CI, 0.912–0.986 vs. AUC, 0.912; 95% CI, 0.858–0.967; p = 0.02) and in the validation cohort (AUC, 0.945; 95% CI, 0.878–1 vs. AUC, 0.905; 95% CI, 0.812–0.998; p = 0.03). The combined model showed the diagnostic value was not weaker than the biopsy (AUC, 0.950; 95% CI, 0.919–0.981, n = 150 vs. AUC, 0.952; 95% CI, 0.889–1, n = 72; p = 0.95) and electromyogram (EMG) (AUC, 0.950; 95% CI, 0.919–0.981 vs. AUC, 0.900; 95% CI, 0.852–0.948; p = 0.10) among all the patients. The combination of radiomics features extracted from the MRI and non-invasive clinical characteristics obtained a pronounced discriminative performance to assist in discriminating JDM.

At present, there are no effective, non-invasive, and objective indicators to evaluate the efficacy of pediatric house dust mite (HDM)-specific allergen immunotherapy (AIT). A prospective, observational study was performed in children with Dermatophagoides pteronyssinus (Der p) asthma and/or allergic rhinitis (AR). Forty-four patients received subcutaneous Der p-AIT for 2 years, and eleven patients received only symptomatic treatment. The patients needed to finish their questionnaires at each visit. Serum and salivary Der p-specific IgE, IgG4, and IgE-blocking factors (IgE-BFs) were measured at 0, 4, 12, and 24 months during AIT. A correlation between them was also evaluated. Subcutaneous Der p-specific AIT improved the clinical symptoms of children with asthma and/or AR. The Der p-specific IgE-BF significantly increased at 4, 12, and 24 months after AIT treatment. Serum and salivary Der p-specific IgG4 significantly increased with the time of the AIT treatment, and significant correlations between them at different time points were observed (p < 0.05). Furthermore, there were significant correlations (R = 0.31–0.62) between the serum Der p-specific IgE-BF and Der p-specific IgG4 at the baseline, 4, 12, and 24 months after the AIT (p < 0.01). The salivary Der p-specific IgG4 levels also demonstrated a certain correlation with the Der p-specific IgE-BF. Der p-specific AIT is an effective treatment for children with asthma and/or AR. Its effect was associated with increased serum and salivary-specific IgG4 levels, as well as an increased IgE-BF. Non-invasive salivary-specific IgG4 may be useful for monitoring the efficacy of AIT in children.

Background: Childhood asthma is a common inflammatory airway disease, and its occurrence is influenced by environmental factors. Artificial light at night (ALAN) can disrupt circadian rhythms, but its relationship with childhood asthma remains unclear. To evaluate the association between ALAN and childhood asthma, and to investigate the role of the circadian clock gene in this relationship. Method: The study combined multiple approaches: an epidemiological analysis of asthma prevalence and urban ALAN levels in China; a pediatric asthma clinical study assessing nighttime light exposure, circadian disruption, and lung function; Mendelian randomization to test for a causal link between circadian disruption and asthma, and multi-omics plus experimental models to evaluate the function of TIMELESS , a circadian clock gene. Results: ALAN exposure in Chinese cities has increased and was identified by AutoGluon modeling as a significant environmental risk factor for childhood asthma. In a pediatric asthma cohort, excessive nighttime light exposure was strongly associated with circadian rhythm disruption ( R = 0.756, p < 0.001). Mendelian randomization analysis supported a causal relationship between circadian rhythm disruption and asthma ( p = 0.040). Multi-omics analysis identified TIMELESS as a key circadian regulator that is highly expressed in the airway epithelium of asthmatic children. In an asthma mouse model, TIMELESS expression was upregulated in airway epithelium, and TIMELESS knockdown in airway epithelial cells significantly reduced their proliferation. Conclusions: Circadian disruption associated with nighttime light exposure may contribute to airway epithelial proliferation and remodeling via TIMELESS , potentially exacerbating childhood asthma.