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Nauwelaerts SJD, Van Goethem N, Ureña BT, De Cremer K, Bernard A, Saenen ND, Nawrot TS, Roosens NHC, De Keersmaecker SCJ. Urinary CC16, a potential indicator of lung integrity and inflammation, increases in children after short-term exposure to PM 2.5/PM 10 and is driven by the CC16 38GG genotype. ENVIRONMENTAL RESEARCH 2022; 212:113272. [PMID: 35439460 DOI: 10.1016/j.envres.2022.113272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Abstract
Particular matter (PM) exposure is a big hazard for public health, especially for children. Serum CC16 is a well-known biomarker of respiratory health. Urinary CC16 (U-CC16) can be a noninvasive alternative, albeit requiring adequate adjustment for renal handling. Moreover, the SNP CC16 G38A influences CC16 levels. This study aimed to monitor the effect of short-term PM exposure on CC16 levels, measured noninvasively in schoolchildren, using an integrative approach. We used a selection of urine and buccal DNA samples from 86 children stored in an existing biobank. Using a multiple reaction monitoring method, we measured U-CC16, as well as RBP4 (retinol binding protein 4) and β2M (beta-2-microglobulin), required for adjustment. Buccal DNA samples were used for CC16 G38A genotyping. Linear mixed-effects models were used to find relevant associations between U-CC16 and previously obtained data from recent daily PM ≤ 2.5 or 10 μm exposure (PM2.5, PM10) modeled at the child's residence. Our study showed that exposure to low PM at the child's residence (median levels 18.9 μg/m³ (PM2.5) and 23.6 μg/m³ (PM10)) one day before sampling had an effect on the covariates-adjusted U-CC16 levels. This effect was dependent on the CC16 G38A genotype, due to its strong interaction with the association between PM levels and covariates-adjusted U-CC16 (P = 0.024 (PM2.5); P = 0.061 (PM10)). Only children carrying the 38GG genotype showed an increase of covariates-adjusted U-CC16, measured 24h after exposure, with increasing PM2.5 and PM10 (β = 0.332; 95% CI: 0.110 to 0.554 and β = 0.372; 95% CI: 0.101 to 0.643, respectively). To the best of our knowledge, this is the first study using an integrative approach to investigate short-term PM exposure of children, using urine to detect early signs of pulmonary damage, and taking into account important determinants such as the genetic background and adequate adjustment of the measured biomarker in urine.
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Affiliation(s)
- Sarah J D Nauwelaerts
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium; Centre for Toxicology and Applied Pharmacology, University Catholique de Louvain, Woluwe, Brussels, Belgium
| | - Nina Van Goethem
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium; Department of Epidemiology and Biostatistics, Institut de Recherche Expérimentale et Clinique, Faculty of Public Health, Université catholique de Louvain, Belgium
| | - Berta Tenas Ureña
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium
| | - Koen De Cremer
- Platform Chromatography and Mass Spectrometry, Sciensano, Brussels, Belgium
| | - Alfred Bernard
- Centre for Toxicology and Applied Pharmacology, University Catholique de Louvain, Woluwe, Brussels, Belgium
| | - Nelly D Saenen
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium; Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Nancy H C Roosens
- Transversal Activities in Applied Genomics, Sciensano, Brussels, Belgium
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Dockx Y, Bijnens EM, Luyten L, Peusens M, Provost E, Rasking L, Sleurs H, Hogervorst J, Plusquin M, Casas L, Nawrot TS. Early life exposure to residential green space impacts cognitive functioning in children aged 4 to 6 years. ENVIRONMENT INTERNATIONAL 2022; 161:107094. [PMID: 35074632 PMCID: PMC8885429 DOI: 10.1016/j.envint.2022.107094] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/13/2021] [Accepted: 01/11/2022] [Indexed: 05/27/2023]
Abstract
INTRODUCTION During early childhood, neuronal networks are highly susceptible to environmental factors. Previous research suggests that green space exposure is beneficial for cognitive functioning. Here, we investigate the associations between residential green space exposure and behavioral problems and cognitive development in children aged four to six years. METHOD We included children participating in the ENVIRONAGE birth cohort. Residential green spaces were calculated based on high-resolution land cover data within several buffers (50-1,000 m) around the residence. The children's behavior was assessed with the Strengths and Difficulties Questionnaire (SDQ) among 411 children. In addition, to evaluate cognitive function, 456 children completed four tasks of the Cambridge Neuropsychological Test Automated Battery (CANTAB). We used multivariate logistic and linear regression models while accounting for potential confounders and covariables. RESULTS An interquartile (IQR) increase of residential green space within 50 m was associated with a 38% (95% CI: 56;14) lower odds of a child having hyperactivity problems. Additionally, we found a beneficial influence of residential green space in close proximity (50-100 m) on the attention and psychomotor speed, represented by the Motor Screening Task. For example, we found a decrease of 0.45 (95% CI: -0.82;-0.09) pixel units from target center with an IQR increase of residential green space in a 50 m buffer. In addition, we observed an improved visual recognition/working memory, represented by the Delayed Matching to Sample Task within all included buffers (50-1000 m). For example, we observed a decrease of 4.91% (95 %CI: -7.46;-2.36) probability of an error occurring if the previous trial was correct and a 2.02% (95 %CI: 0.08; 3.97) increase of correct trials with an IQR increase of green space within a 100 m buffer. CONCLUSION This study provides additional indications for a beneficial influence of green space exposure on the development of behavioral problems and cognitive function as young as four years of age.
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Affiliation(s)
- Yinthe Dockx
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Esmée M Bijnens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; Department of Human Structure and Repair, Ghent University Hospital, Ghent, Belgium
| | - Leen Luyten
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Martien Peusens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Eline Provost
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; Health Unit, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Leen Rasking
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Hanne Sleurs
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Janneke Hogervorst
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium
| | - Lidia Casas
- Social Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Belgium; Insitute for Environment and Sustainable Development (IMDO), University of Antwerp, Belgium; Center for Environment and Health, Department of Public Health, Leuven University (KU Leuven)
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; Center for Environment and Health, Department of Public Health, Leuven University (KU Leuven).
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Plaza-Florido A, Pérez-Prieto I, Molina-Garcia P, Radom-Aizik S, Ortega FB, Altmäe S. Transcriptional and Epigenetic Response to Sedentary Behavior and Physical Activity in Children and Adolescents: A Systematic Review. Front Pediatr 2022; 10:917152. [PMID: 35813370 PMCID: PMC9263076 DOI: 10.3389/fped.2022.917152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The links of sedentary behavior and physical activity with health outcomes in children and adolescents is well known. However, the molecular mechanisms involved are poorly understood. We aimed to synthesize the current knowledge of the association of sedentary behavior and physical activity (acute and chronic effects) with gene expression and epigenetic modifications in children and adolescents. METHODS PubMed, Web of Science, and Scopus databases were systematically searched until April 2022. A total of 15 articles were eligible for this review. The risk of bias assessment was performed using the Joanna Briggs Institute Critical Appraisal Tool for Systematic Reviews and/or a modified version of the Downs and Black checklist. RESULTS Thirteen studies used candidate gene approach, while only 2 studies performed high-throughput analyses. The candidate genes significantly linked to sedentary behavior or physical activity were: FOXP3, HSD11B2, IL-10, TNF-α, ADRB2, VEGF, HSP70, SOX, and GPX. Non-coding Ribonucleic acids (RNAs) regulated by sedentary behavior or physical activity were: miRNA-222, miRNA-146a, miRNA-16, miRNA-126, miR-320a, and long non-coding RNA MALAT1. These molecules are involved in inflammation, immune function, angiogenic process, and cardiovascular disease. Transcriptomics analyses detected thousands of genes that were altered following an acute bout of physical activity and are linked to gene pathways related to immune function, apoptosis, and metabolic diseases. CONCLUSION The evidence found to date is rather limited. Multidisciplinary studies are essential to characterize the molecular mechanisms in response to sedentary behavior and physical activity in the pediatric population. Larger cohorts and randomized controlled trials, in combination with multi-omics analyses, may provide the necessary data to bring the field forward. SYSTEMATIC REVIEW REGISTRATION [www.ClinicalTrials.gov], identifier [CRD42021235431].
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Affiliation(s)
- Abel Plaza-Florido
- Department of Physical and Sports Education, Faculty of Sport Sciences, PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Inmaculada Pérez-Prieto
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
| | - Pablo Molina-Garcia
- Department of Physical and Sports Education, Faculty of Sport Sciences, PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria (ibs.Granada), Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Granada, Spain
| | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center, UC Irvine School of Medicine, Irvine, CA, United States
| | - Francisco B Ortega
- Department of Physical and Sports Education, Faculty of Sport Sciences, PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Signe Altmäe
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain.,Division of Obstetrics and Gynecology, CLINTEC, Karolinska Institutet, Stockholm, Sweden.,Competence Centre on Health Technologies, Tartu, Estonia
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Alfano R, Robinson O, Handakas E, Nawrot TS, Vineis P, Plusquin M. Perspectives and challenges of epigenetic determinants of childhood obesity: A systematic review. Obes Rev 2022; 23 Suppl 1:e13389. [PMID: 34816569 DOI: 10.1111/obr.13389] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 12/20/2022]
Abstract
The tremendous increase in childhood obesity prevalence over the last few decades cannot merely be explained by genetics and evolutionary changes in the genome, implying that gene-environment interactions, such as epigenetic modifications, likely play a major role. This systematic review aims to summarize the evidence of the association between epigenetics and childhood obesity. A literature search was performed via PubMed and Scopus engines using a combination of terms related to epigenetics and pediatric obesity. Articles studying the association between epigenetic mechanisms (including DNA methylation and hydroxymethylation, non-coding RNAs, and chromatin and histones modification) and obesity and/or overweight (or any related anthropometric parameters) in children (0-18 years) were included. The risk of bias was assessed with a modified Newcastle-Ottawa scale for non-randomized studies. One hundred twenty-one studies explored epigenetic changes related to childhood obesity. DNA methylation was the most widely investigated mechanism (N = 101 studies), followed by non-coding RNAs (N = 19 studies) with evidence suggestive of an association with childhood obesity for DNA methylation of specific genes and microRNAs (miRNAs). One study, focusing on histones modification, was identified. Heterogeneity of findings may have hindered more insights into the epigenetic changes related to childhood obesity. Gaps and challenges that future research should face are herein described.
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Affiliation(s)
- Rossella Alfano
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK.,Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Oliver Robinson
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
| | - Evangelos Handakas
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK.,Medical Research Council-Health Protection Agency Centre for Environment and Health, Imperial College London, London, UK.,Unit of Molecular and Genetic Epidemiology, Human Genetic Foundation (HuGeF), Turin, Italy
| | - Michelle Plusquin
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
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Chang YJ, Tuz-Zahra F, Godbole S, Avitia Y, Bellettiere J, Rock CL, Jankowska MM, Allison MA, Dunstan DW, Rana B, Natarajan L, Sears DD. Endothelial-derived cardiovascular disease-related microRNAs elevated with prolonged sitting pattern among postmenopausal women. Sci Rep 2021; 11:11766. [PMID: 34083573 PMCID: PMC8175392 DOI: 10.1038/s41598-021-90154-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/06/2021] [Indexed: 02/03/2023] Open
Abstract
Time spent sitting is positively correlated with endothelial dysfunction and cardiovascular disease risk. The underlying molecular mechanisms are unknown. MicroRNAs contained in extracellular vesicles (EVs) reflect cell/tissue status and mediate intercellular communication. We explored the association between sitting patterns and microRNAs isolated from endothelial cell (EC)-derived EVs. Using extant actigraphy based sitting behavior data on a cohort of 518 postmenopausal overweight/obese women, we grouped the woman as Interrupted Sitters (IS; N = 18) or Super Sitters (SS; N = 53) if they were in the shortest or longest sitting pattern quartile, respectively. The cargo microRNA in EC-EVs from the IS and SS women were compared. MicroRNA data were weighted by age, physical functioning, MVPA, device wear days, device wear time, waist circumference, and body mass index. Screening of CVD-related microRNAs demonstrated that miR-199a-5p, let-7d-5p, miR-140-5p, miR-142-3p, miR-133b level were significantly elevated in SS compared to IS groups. Group differences in let-7d-5p, miR-133b, and miR-142-3p were validated in expanded groups. Pathway enrichment analyses show that mucin-type O-glycan biosynthesis and cardiomyocyte adrenergic signaling (P < 0.001) are downstream of the three validated microRNAs. This proof-of-concept study supports the possibility that CVD-related microRNAs in EC-EVs may be molecular transducers of sitting pattern-associated CVD risk in overweight postmenopausal women.
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Affiliation(s)
- Ya-Ju Chang
- Department of Family Medicine, UC San Diego, La Jolla, CA, USA
| | - Fatima Tuz-Zahra
- Herbert Wertheim School of Public Health, UC San Diego, La Jolla, CA, USA
| | - Suneeta Godbole
- Department of Family Medicine, UC San Diego, La Jolla, CA, USA
| | - Yesenia Avitia
- Department of Family Medicine, UC San Diego, La Jolla, CA, USA
| | - John Bellettiere
- Herbert Wertheim School of Public Health, UC San Diego, La Jolla, CA, USA.,Center for Behavioral Epidemiology and Community Health, San Diego State University, San Diego, CA, USA
| | - Cheryl L Rock
- Department of Family Medicine, UC San Diego, La Jolla, CA, USA.,Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | | | | | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Brinda Rana
- Moores Cancer Center, UC San Diego, La Jolla, CA, USA.,Department of Psychiatry, UC San Diego, La Jolla, CA, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health, UC San Diego, La Jolla, CA, USA.,Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Dorothy D Sears
- Department of Family Medicine, UC San Diego, La Jolla, CA, USA. .,Moores Cancer Center, UC San Diego, La Jolla, CA, USA. .,Department of Medicine, UC San Diego, La Jolla, CA, USA. .,College of Health Solutions, Arizona State University, 550 N 3rd Street, Phoenix, AZ, 85004, USA.
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Troisi J, Belmonte F, Bisogno A, Pierri L, Colucci A, Scala G, Cavallo P, Mandato C, Di Nuzzi A, Di Michele L, Delli Bovi AP, Guercio Nuzio S, Vajro P. Metabolomic Salivary Signature of Pediatric Obesity Related Liver Disease and Metabolic Syndrome. Nutrients 2019; 11:nu11020274. [PMID: 30691143 PMCID: PMC6412994 DOI: 10.3390/nu11020274] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 01/16/2019] [Accepted: 01/21/2019] [Indexed: 12/11/2022] Open
Abstract
Pediatric obesity-related metabolic syndrome (MetS) and nonalcoholic fatty liver disease (NAFLD) are increasingly frequent conditions with a still-elusive diagnosis and low-efficacy treatment and monitoring options. In this study, we investigated the salivary metabolomic signature, which has been uncharacterized to date. In this pilot-nested case-control study over a transversal design, 41 subjects (23 obese patients and 18 normal weight (NW) healthy controls), characterized based on medical history, clinical, anthropometric, and laboratory data, were recruited. Liver involvement, defined according to ultrasonographic liver brightness, allowed for the allocation of the patients into four groups: obese with hepatic steatosis ([St+], n = 15) and without hepatic steatosis ([St–], n = 8), and with (n = 10) and without (n = 13) MetS. A partial least squares discriminant analysis (PLS-DA) model was devised to classify the patients’ classes based on their salivary metabolomic signature. Pediatric obesity and its related liver disease and metabolic syndrome appear to have distinct salivary metabolomic signatures. The difference is notable in metabolites involved in energy, amino and organic acid metabolism, as well as in intestinal bacteria metabolism, possibly reflecting diet, fatty acid synthase pathways, and the strict interaction between microbiota and intestinal mucins. This information expands the current understanding of NAFLD pathogenesis, potentially translating into better targeted monitoring and/or treatment strategies in the future.
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Affiliation(s)
- Jacopo Troisi
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
- Theoreo srl, Via degli Ulivi 3, 84090 Montecorvino Pugliano (SA), Italy.
- European Biomedical Research Institute of Salerno (EBRIS), Via S. de Renzi, 3, 84125 Salerno, Italy.
- Hosmotic srl, Via R. Bosco 178, 80069 Vico Equense (NA), Italy.
| | - Federica Belmonte
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Antonella Bisogno
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Luca Pierri
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Angelo Colucci
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
- Theoreo srl, Via degli Ulivi 3, 84090 Montecorvino Pugliano (SA), Italy.
| | - Giovanni Scala
- Hosmotic srl, Via R. Bosco 178, 80069 Vico Equense (NA), Italy.
| | - Pierpaolo Cavallo
- Department of Physics, University of Salerno, 84084 Fisciano (Salerno), Italy.
| | - Claudia Mandato
- Department of Pediatrics, Children's Hospital Santobono-Pausilipon, 80129 Naples, Italy.
| | - Antonella Di Nuzzi
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Laura Di Michele
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Anna Pia Delli Bovi
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Salvatore Guercio Nuzio
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Pietro Vajro
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
- European Laboratory of Food Induced Intestinal Disease (ELFID), University of Naples Federico II, 80100 Naples, Italy.
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