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Article ; Online: Current and emerging pharmacotherapy for respiratory syncytial virus (RSV) infection in infants.

Principi, Nicola / Autore, Giovanni / Perrone, Serafina / Esposito, Susanna

2023 Volume 24, Issue 6, Page(s) 747–762

Abstract: Introduction: Respiratory syncytial virus (RSV) is a common respiratory virus with a huge impact on patients, the healthcare system, and society worldwide. Very few effective chances of prevention and treatment of RSV infection are available.: Areas ... ...

Abstract	Introduction: Respiratory syncytial virus (RSV) is a common respiratory virus with a huge impact on patients, the healthcare system, and society worldwide. Very few effective chances of prevention and treatment of RSV infection are available. Areas covered: In this paper, knowledge on RSV characteristics and current stage of development of new pharmacological measures against this virus are discussed. Expert opinion: In recent years, the structure of RSV was explored in depth and several pharmacologic measures potentially effective for prevention and treatment of RSV infection and disease were identified. These new measures have the aim to overcome the limitations of palivizumab and ribavirin. Strategies to protect infants through immunization of pregnant women and/or the use of more effective monoclonal antibodies were developed. At the same time, it was defined which vaccines could be administered to unprimed infants to avoid the risk of enhanced respiratory disease and which vaccines could be effective in older patients and in subjects with reduced immune system efficiency. Finally, a great number of new antiviral drugs targeting the RSV proteins that allow RSV entering host cells or regulate virus replication were produced. Although further studies are needed, some preparations seem effective and safe, making the future of RSV infection prevention and treatment less gloomy.
MeSH term(s)	Infant ; Humans ; Female ; Pregnancy ; Aged ; Respiratory Syncytial Virus Infections/drug therapy ; Respiratory Syncytial Virus Infections/prevention & control ; Palivizumab/therapeutic use ; Antiviral Agents/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Respiratory Syncytial Virus, Human
Chemical Substances	Palivizumab (DQ448MW7KS) ; Antiviral Agents ; Antibodies, Monoclonal
Language	English
Publishing date	2023-04-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2001535-5
ISSN	1744-7666 ; 1465-6566
ISSN (online)	1744-7666
ISSN	1465-6566
DOI	10.1080/14656566.2023.2197590
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Zs.A 5130: Show issues

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Article ; Online: Brain-Oriented Strategies for Neuroprotection of Asphyxiated Newborns in the First Hours of Life.

Cannavò, Laura / Perrone, Serafina / Gitto, Eloisa

Pediatric neurology

2023 Volume 143, Page(s) 44–49

Abstract: Perinatal asphyxia represents the first cause of severe neurological disabilities and the second cause of neonatal death in term-born babies. Currently, no treatment can prevent immediate cell death from necrosis, but some therapeutic interventions, such ...

Abstract	Perinatal asphyxia represents the first cause of severe neurological disabilities and the second cause of neonatal death in term-born babies. Currently, no treatment can prevent immediate cell death from necrosis, but some therapeutic interventions, such as therapeutic hypothermia (TH), can reduce delayed cell death from apoptosis. TH significantly improves the combined outcome of mortality or major neurodevelopmental disability, but the number of patients to be treated is 7 to get 1 child with no adverse neurological outcome. The aim of this educational review is to analyze the other care strategies to be implemented to improve the neurological outcome of children with hypoxic ischemic encephalopathy (HIE). Hypocapnia, hypoglycemia, pain control, and functional brain monitoring are recognized as appropriate approaches to improve outcome in critically ill infants with HIE. Pharmacologic neuroprotective adjuncts are currently under investigation. New drugs such as allopurinol and melatonin seem to provide positive effects although more randomized controlled trials are required to establish the effective therapeutic scheme. In the meantime, sustaining the respiratory, metabolic, and cardiovascular system during TH can be a valuable aid in managing and treating the patient with HIE in an optimal way.
MeSH term(s)	Infant ; Child ; Infant, Newborn ; Humans ; Neuroprotection ; Hypoxia-Ischemia, Brain/therapy ; Infant, Newborn, Diseases/therapy ; Asphyxia Neonatorum/complications ; Asphyxia Neonatorum/therapy ; Stroke/etiology ; Hypothermia, Induced/adverse effects ; Brain
Language	English
Publishing date	2023-03-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	639164-3
ISSN	1873-5150 ; 0887-8994
ISSN (online)	1873-5150
ISSN	0887-8994
DOI	10.1016/j.pediatrneurol.2023.02.015
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Zs.A 2260: Show issues

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Article: An Overview of Antibiotic Therapy for Early- and Late-Onset Neonatal Sepsis: Current Strategies and Future Prospects.

Boscarino, Giovanni / Romano, Rossana / Iotti, Carlotta / Tegoni, Francesca / Perrone, Serafina / Esposito, Susanna

Antibiotics (Basel, Switzerland)

2024 Volume 13, Issue 3

Abstract: Neonatal sepsis is a clinical syndrome mainly associated with a bacterial infection leading to severe clinical manifestations that could be associated with fatal sequalae. According to the time of onset, neonatal sepsis is categorized as early- (EOS) or ... ...

Abstract	Neonatal sepsis is a clinical syndrome mainly associated with a bacterial infection leading to severe clinical manifestations that could be associated with fatal sequalae. According to the time of onset, neonatal sepsis is categorized as early- (EOS) or late-onset sepsis (LOS). Despite blood culture being the gold standard for diagnosis, it has several limitations, and early diagnosis is not immediate. Consequently, most infants who start empirical antimicrobial therapy do not have an underlying infection. Despite stewardship programs partially reduced this negative trend, in neonatology, antibiotic overuse still persists, and it is associated with several relevant problems, the first of which is the increase in antimicrobial resistance (AMR). Starting with these considerations, we performed a narrative review to summarize the main findings and the future prospects regarding antibiotics use to treat neonatal sepsis. Because of the impact on morbidity and mortality that EOS and LOS entail, it is essential to start an effective and prompt treatment as soon as possible. The use of targeted antibiotics is peremptory as soon as the pathogen in the culture is detected. Although prompt therapy is essential, it should be better assessed whether, when and how to treat neonates with antibiotics, even those at higher risk. Considering that we are certainly in the worrying era defined as the "post-antibiotic era", it is still essential and urgent to define novel strategies for the development of antibacterial compounds with new targets or mechanisms of action. A future strategy could also be to perform well-designed studies to develop innovative algorithms for improving the etiological diagnosis of infection, allowing for more personalized use of the antibiotics to treat EOS and LOS.
Language	English
Publishing date	2024-03-10
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics13030250
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Article ; Online: Molecular mechanisms of oxidative stress-related neonatal jaundice.

Perrone, Serafina / Lembo, Chiara / Giordano, Maurizio / Petrolini, Chiara / Cannavò, Laura / Gitto, Eloisa

Journal of biochemical and molecular toxicology

2023 Volume 37, Issue 6, Page(s) e23349

Abstract: Oxidative stress is a pathological condition characterized by an overload of oxidant products, named free radicals, which are not well counteracted by antioxidant systems. Free radicals induce oxidative damage to many body organs and systems. In neonatal ...

Abstract	Oxidative stress is a pathological condition characterized by an overload of oxidant products, named free radicals, which are not well counteracted by antioxidant systems. Free radicals induce oxidative damage to many body organs and systems. In neonatal red blood cells, free-radical mediated-oxidative stress leads to eryptosis, a suicidal death process of erythrocytes consequent to alteration of cell integrity. Neonatal red blood cells are targets and at the same time generators of free radicals through the Fenton and Haber-Weiss reactions. Enhanced eryptosis in case of oxidative stress damage may cause anemia if the increased loss of erythrocytes is not enough compensated by enhanced new erythrocytes synthesis. The oxidative disruption of the red cells may cause unconjugated idiopathic hyperbilirubinemia in neonates. High levels of bilirubin are recognized to be dangerous for the central nervous system in newborns, however, many studies have highlighted the antioxidant function of bilirubin. Recently, it has been suggested that physiologic concentration of bilirubin correlates with higher antioxidant status while high pathological bilirubin levels are associated with pro-oxidants effects. The aim of this educational review is to provide an updated understanding of the molecular mechanisms underlying erythrocyte oxidant injury and its reversal in neonatal idiopathic hyperbilirubinemia.
MeSH term(s)	Infant, Newborn ; Humans ; Jaundice, Neonatal/pathology ; Antioxidants/pharmacology ; Oxidative Stress/physiology ; Hyperbilirubinemia/pathology ; Bilirubin ; Erythrocytes ; Free Radicals/pharmacology ; Oxidants/pharmacology
Chemical Substances	Antioxidants ; Bilirubin (RFM9X3LJ49) ; Free Radicals ; Oxidants
Language	English
Publishing date	2023-04-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1410020-4
ISSN	1099-0461 ; 1095-6670
ISSN (online)	1099-0461
ISSN	1095-6670
DOI	10.1002/jbt.23349
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Zs.A 2201: Show issues

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Article: Oxidative Stress in Preterm Newborns.

Lembo, Chiara / Buonocore, Giuseppe / Perrone, Serafina

Antioxidants (Basel, Switzerland)

2021 Volume 10, Issue 11

Abstract: Preterm babies are highly susceptible to oxidative stress (OS) due to an imbalance between the oxidant and antioxidant systems. The generation of free radicals (FR) induces oxidative damage to multiple body organs and systems. OS is the main factor ... ...

Abstract	Preterm babies are highly susceptible to oxidative stress (OS) due to an imbalance between the oxidant and antioxidant systems. The generation of free radicals (FR) induces oxidative damage to multiple body organs and systems. OS is the main factor responsible for the development of typical premature infant diseases, such as bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia, kidney damage, eryptosis, and also respiratory distress syndrome and patent ductus arteriosus. Many biomarkers have been detected to early identify newborns at risk of developing a free radical-mediated disease and to investigate new antioxidant strategies. This review reports the current knowledge on OS in the preterm newborns and the newest findings concerning the use of OS biomarkers as diagnostic tools, as well as in implementing antioxidant therapeutic strategies for the prevention and treatment of these diseases and their sequelae.
Language	English
Publishing date	2021-10-23
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2704216-9
ISSN	2076-3921
ISSN	2076-3921
DOI	10.3390/antiox10111672
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Article: Update on Viral Infections Involving the Central Nervous System in Pediatric Patients.

Autore, Giovanni / Bernardi, Luca / Perrone, Serafina / Esposito, Susanna

Children (Basel, Switzerland)

2021 Volume 8, Issue 9

Abstract: Infections of the central nervous system (CNS) are mainly caused by viruses, and these infections can be life-threatening in pediatric patients. Although the prognosis of CNS infections is often favorable, mortality and long-term sequelae can occur. The ... ...

Abstract	Infections of the central nervous system (CNS) are mainly caused by viruses, and these infections can be life-threatening in pediatric patients. Although the prognosis of CNS infections is often favorable, mortality and long-term sequelae can occur. The aims of this narrative review were to describe the specific microbiological and clinical features of the most frequent pathogens and to provide an update on the diagnostic approaches and treatment strategies for viral CNS infections in children. A literature analysis showed that the most common pathogens worldwide are enteroviruses, arboviruses, parechoviruses, and herpesviruses, with variable prevalence rates in different countries. Lumbar puncture (LP) should be performed as soon as possible when CNS infection is suspected, and cerebrospinal fluid (CSF) samples should always be sent for polymerase chain reaction (PCR) analysis. Due to the lack of specific therapies, the management of viral CNS infections is mainly based on supportive care, and empiric treatment against herpes simplex virus (HSV) infection should be started as soon as possible. Some researchers have questioned the role of acyclovir as an empiric antiviral in older children due to the low incidence of HSV infection in this population and observed that HSV encephalitis may be clinically recognizable beyond neonatal age. However, the real benefit-risk ratio of selective approaches is unclear, and further studies are needed to define appropriate indications for empiric acyclovir. Research is needed to find specific therapies for emerging pathogens. Moreover, the appropriate timing of monitoring neurological development, performing neuroimaging evaluations and investigating the effectiveness of rehabilitation during follow-up should be evaluated with long-term studies.
Language	English
Publishing date	2021-09-06
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children8090782
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Management of Congenital Diaphragmatic Hernia (CDH): Role of Molecular Genetics.

Cannata, Giulia / Caporilli, Chiara / Grassi, Federica / Perrone, Serafina / Esposito, Susanna

International journal of molecular sciences

2021 Volume 22, Issue 12

Abstract: Congenital diaphragmatic hernia (CDH) is a relatively common major life-threatening birth defect that results in significant mortality and morbidity depending primarily on lung hypoplasia, persistent pulmonary hypertension, and cardiac dysfunction. ... ...

Abstract	Congenital diaphragmatic hernia (CDH) is a relatively common major life-threatening birth defect that results in significant mortality and morbidity depending primarily on lung hypoplasia, persistent pulmonary hypertension, and cardiac dysfunction. Despite its clinical relevance, CDH multifactorial etiology is still not completely understood. We reviewed current knowledge on normal diaphragm development and summarized genetic mutations and related pathways as well as cellular mechanisms involved in CDH. Our literature analysis showed that the discovery of harmful
MeSH term(s)	Diaphragm/embryology ; Diaphragm/pathology ; Genetic Predisposition to Disease ; Hernias, Diaphragmatic, Congenital/classification ; Hernias, Diaphragmatic, Congenital/diagnosis ; Hernias, Diaphragmatic, Congenital/genetics ; Hernias, Diaphragmatic, Congenital/pathology ; High-Throughput Nucleotide Sequencing ; Humans ; Prognosis
Language	English
Publishing date	2021-06-14
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms22126353
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Article ; Online: Oxidative stress biomarkers in the perinatal period: Diagnostic and prognostic value.

Perrone, Serafina / Laschi, Elisa / Buonocore, Giuseppe

Seminars in fetal & neonatal medicine

2020 Volume 25, Issue 2, Page(s) 101087

Abstract: Perinatal oxidative stress (OS) is involved in the physiopathology of many pregnancy-related disorders and is largely responsible for cellular, tissue and organ damage that occur in the perinatal period especially in preterm infants, leading to the so- ... ...

Abstract	Perinatal oxidative stress (OS) is involved in the physiopathology of many pregnancy-related disorders and is largely responsible for cellular, tissue and organ damage that occur in the perinatal period especially in preterm infants, leading to the so-called "free-radicals related diseases of the newborn". Reliable biomarkers of lipid, protein, DNA oxidation and antioxidant power in the perinatal period have been demonstrated to show specificity for the disease, to have prognostic power or to correlate with disease activity. Yet potential clinical applications of oxidative stress biomarkers in neonatology are still under study. Overcoming the technical and economic difficulties that preclude the use of OS biomarkers in the clinical practice is a challenge that needs to be overcome to identify high-risk subjects and to predict their short- and long-term outcome. Cord blood, urine and saliva represent valid and ethically acceptable biological samples for investigations in the perinatal period.
MeSH term(s)	Biomarkers/analysis ; Biomarkers/blood ; Biomarkers/metabolism ; Female ; Fetal Blood/metabolism ; Humans ; Infant, Newborn ; Infant, Premature/metabolism ; Oxidative Stress/physiology ; Perinatology/methods ; Predictive Value of Tests ; Pregnancy ; Prognosis ; Reproducibility of Results ; Saliva/metabolism
Chemical Substances	Biomarkers
Language	English
Publishing date	2020-01-23
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2174416-6
ISSN	1878-0946 ; 1744-165X
ISSN (online)	1878-0946
ISSN	1744-165X
DOI	10.1016/j.siny.2020.101087
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Zs.A 4798: Show issues

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Article ; Online: The challenge to define the optimal prophylactic regimen for vitamin K deficiency bleeding in infants.

Lembo, Chiara / Buonocore, Giuseppe / Perrone, Serafina

Acta paediatrica (Oslo, Norway : 1992)

2020 Volume 110, Issue 4, Page(s) 1113–1118

Abstract: Infants are at risk of vitamin K deficiency that may lead to vitamin K deficiency bleeding (VKDB). Although many vitamin K prophylactic regimens have been developed throughout the years, still cases of late form VKBD may occur. The introduction of ... ...

Abstract	Infants are at risk of vitamin K deficiency that may lead to vitamin K deficiency bleeding (VKDB). Although many vitamin K prophylactic regimens have been developed throughout the years, still cases of late form VKBD may occur. The introduction of combined prophylactic strategy with prolonged oral prophylaxes after the intramuscular dose at birth has showed a decrease of the late severe VKDB incidence. Nevertheless, there is still lack of consensus about the administration scheme after the first dose at birth. CONCLUSION: Late form VKBD is not eradicated, and the best prophylactic regimen in term and preterm infants is still an open debate.
MeSH term(s)	Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Vitamin K ; Vitamin K Deficiency Bleeding/prevention & control
Chemical Substances	Vitamin K (12001-79-5)
Language	English
Publishing date	2020-10-06
Publishing country	Norway
Document type	Journal Article ; Review
ZDB-ID	203487-6
ISSN	1651-2227 ; 0365-1436 ; 0803-5253
ISSN (online)	1651-2227
ISSN	0365-1436 ; 0803-5253
DOI	10.1111/apa.15566
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Um IV Zs.95: Show issues

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Article: Oxidative Stress in Preterm Newborns

Lembo, Chiara / Buonocore, Giuseppe / Perrone, Serafina

Antioxidants. 2021 Oct. 23, v. 10, no. 11

2021

Abstract	Preterm babies are highly susceptible to oxidative stress (OS) due to an imbalance between the oxidant and antioxidant systems. The generation of free radicals (FR) induces oxidative damage to multiple body organs and systems. OS is the main factor responsible for the development of typical premature infant diseases, such as bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia, kidney damage, eryptosis, and also respiratory distress syndrome and patent ductus arteriosus. Many biomarkers have been detected to early identify newborns at risk of developing a free radical-mediated disease and to investigate new antioxidant strategies. This review reports the current knowledge on OS in the preterm newborns and the newest findings concerning the use of OS biomarkers as diagnostic tools, as well as in implementing antioxidant therapeutic strategies for the prevention and treatment of these diseases and their sequelae.
Keywords	antioxidants ; biomarkers ; bronchopulmonary dysplasia ; complications (disease) ; distress ; enterocolitis ; hemorrhage ; kidneys ; oxidants ; oxidative stress ; patent ductus arteriosus ; premature birth ; retinal diseases ; risk ; therapeutics
Language	English
Dates of publication	2021-1023
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2704216-9
ISSN	2076-3921
ISSN	2076-3921
DOI	10.3390/antiox10111672
Database	NAL-Catalogue (AGRICOLA)

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