JAMA Pediatrics
October 2015, Vol 169, No. 10
http://archpedi.jamanetwork.com/issue.aspx

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American Pediatric Society
Global Collaboration to Develop New and Existing Drugs for Neonates
Jonathan M. Davis, MD; Mark A. Turner, MB, PhD, MRCPCH
This Viewpoint discusses the specific areas that should be considered by global investigators when collaborating on the development of drugs for neonatal patients.
Neonates do not have access to medicines that have been adequately tested for dosing, safety, and efficacy.1 Physicians must use their best judgment to make up for these knowledge gaps, leading to incorrect, and possibly harmful, doses of unnecessary and expensive medications. Some experts even believe that it is difficult or unethical for research to be conducted in neonates.2 Neither of these beliefs are justified, and it is inappropriate to expose neonates to potential risk without conclusive evidence that the drugs they are receiving are safe and efficacious. Neonates must participate in all stages of drug development in trials that use contemporary methods, because the health care industry has an ethical duty to meet the needs of this population.3

Review
Influenza A Virus Infection, Innate Immunity, and Childhood
Bria M. Coates, MD; Kelly L. Staricha; Kristin M. Wiese, MD; Karen M. Ridge, PhD
Abstract
Infection with influenza A virus is responsible for considerable morbidity and mortality in children worldwide. While it is apparent that adequate activation of the innate immune system is essential for pathogen clearance and host survival, an excessive inflammatory response to infection is detrimental to the young host. A review of the literature indicates that innate immune responses change throughout childhood. Whether these changes are genetically programmed or triggered by environmental cues is unknown. The objectives of this review are to summarize the role of innate immunity in influenza A virus infection in the young child and to highlight possible differences between children and adults that may make children more susceptible to severe influenza A infection. A better understanding of age-related differences in innate immune signaling will be essential to improve care for this high-risk population.