Mediastinal esophageal duplication cysts are rare congenital foregut malformations that may cause respiratory symptoms due to airway compression. Excision is recommended once a diagnosis is made to prevent infection, bleeding, or rupture. We report two boys with recurrent wheeze/stridor or chronic cough; contrast-enhanced chest computed tomography showed paraesophageal cysts (20-30 mm) in the right posterior mediastinum. Both underwent thoracoscopic resection using a three-port approach with low-pressure CO₂ insufflation. Operative time was ~120 min with minimal blood loss (~10 mL). One infant had a small esophageal mucosal injury that was repaired intraoperatively; oral feeding resumed after a negative contrast study on postoperative day 5. The other patient resumed oral intake on postoperative day 1. They were discharged within 7 days and remained recurrence-free at 12 months. Thoracoscopic excision is feasible, safe, and cosmetically favorable in children. We highlight critical technical considerations in preventing, managing esophageal mucosal injury, and optimizing postoperative feeding.

Dupilumab is a fully human IgG4 monoclonal antibody that targets the interleukin-4 receptor alpha subunit, thereby inhibiting interleukin-4 and interleukin-13 signalling, two central drivers of type-2 (T2) inflammation. It is currently approved by both the Food and Drug Administration and the European Medicines Agency for multiple indications, including moderate-to-severe atopic dermatitis (from 6 months of age), add-on maintenance therapy for moderate-to-severe asthma with T2 inflammation (≥ 6 years), eosinophilic esophagitis (≥ 1 year and ≥ 15 kg), chronic rhinosinusitis with nasal polyps (≥ 12 years in the United States and ≥ 18 years in Europe), and chronic spontaneous urticaria (≥ 12 years in the United States and ≥ 2 years in Europe) who remains symptomatic despite antihistamine therapy. Additional adult indications include prurigo nodularis, bullous pemphigoid, and chronic obstructive pulmonary disease with an eosinophilic phenotype. Beyond these established indications, increasing evidence suggests a broader therapeutic potential for dupilumab in paediatric diseases characterized by T2 immune dysregulation. This narrative review synthesizes the emerging literature on off-label and investigational paediatric uses of dupilumab, focusing on inflammatory skin diseases, inborn errors of immunity with severe atopic phenotypes, transplant-associated immune dysregulation, selected respiratory conditions and food allergy. Although current evidence largely derives from case reports, small case series, and observational studies, reported outcomes consistently indicate significant improvements in disease severity, and quality of life, with a favourable safety profile. These findings highlight the expanding role of IL-4/IL-13 blockade in paediatrics and underscore the need for prospective studies to better define efficacy, long-term safety, and optimal patient selection in emerging indications.

Esophageal cancer remains a leading cause of global cancer mortality with limited therapeutic efficacy. This study aims to characterize pyroptosis-related immune mechanisms in esophageal cancer and develop a clinical prediction model to improve prognostic evaluation.

Lactate, a key byproduct of tumor metabolic reprogramming, accumulates in the tumor microenvironment (TME) and profoundly shapes T cell-mediated anti-tumor immunity. As research into TME metabolism advances, lactate has emerged as a critical regulator with broad effects on immune function. In many cancers-including gastric cancer, hepatocellular carcinoma, lung cancer, melanoma, and pancreatic cancer-lactate suppresses or remodels anti-tumor immunity by acting on CD8⁺ T cells, regulatory T cells (Tregs), dendritic cells (DCs), and immune checkpoint molecules. The underlying mechanisms are becoming increasingly well-defined. However, major knowledge gaps remain, especially regarding how lactate-associated enzymes (e.g., LDHA), lactate transporters (e.g., MCT4), and signaling pathways impact T cell function. This review summarizes how lactate regulates anti-tumor immune responses and explores emerging immunotherapies targeting lactate metabolism, with a focus on metabolic enzymes and transporters. We cover preclinical and clinical progress on LDHA inhibitors and lactate transporter inhibitors. By comprehensively analyzing lactate's function in the TME, we aim to build a theoretical framework for precision tumor immunotherapy and propose future directions centered on modulating the immune microenvironment through lactate-targeted strategies.

Mediastinitis remains a life-threatening infection that requires rapid, imaging-guided diagnosis and decisive source control. This article analyzes and compiles the current, evidence-based management across major etiologies of mediastinitis descending cervicothoracic infections, esophageal leak/perforation, and poststernotomy infection, emphasizing antimicrobial treatment, timely drainage and debridement, chest wall stabilization and vascularized coverage when indicated, and the judicious use of negative-pressure wound therapy as a bridge to final closure. Practical, evidence based pathways are outlined to determine access and reconstruction, alongside key points on nutrition, antifungal strategy, and short-interval reassessment to optimize outcomes.

Dysregulation of type 2 (T2) immunity, which normally protects the host against large parasites, toxins, and venoms, leads to aberrant inflammatory responses underlying several allergic diseases. Recent advances have highlighted the important role of innate immune responses in the initiation and persistence of these disorders, identifying innate immune cells as key drivers as well as potential biomarkers and therapeutic targets. In this review, we summarize recent findings on the molecular mechanisms through which innate immune cells interact with adaptive immunity to promote the development and chronification of T2-mediated diseases, including allergic rhinitis, chronic rhinosinusitis with nasal polyps, asthma, food allergy, eosinophilic esophagitis, and atopic dermatitis. We also discuss the emerging role of trained immunity and maladaptive trained immunity in either protecting against or promoting allergic disease development. A better understanding of innate immune pathways and their interplay with adaptive immunity might be crucial for the identification of novel biomarkers and therapeutic targets, fostering precision medicine approaches aimed at improving patients' quality of life while reducing the considerable socioeconomic burden of allergic diseases.

Esophageal reconstruction is one of the most challenging procedures in gastrointestinal surgery. While conventional therapeutic approaches, such as gastric pull-up and intestinal interposition, can restore continuity, they often fail to replicate native physiology. This limitation frequently leads to long-term complications, including dysphagia, stricture, and reflux, which can significantly affect the patients' quality of life. Tissue engineering approaches offer promising alternatives aimed at developing esophageal constructs that restore both structure and function, addressing the shortcomings of current treatment methods. 
This review highlights recent progress in esophageal tissue engineering (ETE), focusing on the requirements for ideal ETE scaffolds and examining available biomaterials, including natural, synthetic, and hybrid. We discuss advances in fabrication techniques and various cell-based approaches, such as primary cells, stem cells, and organoids. Furthermore, we also review the steps necessary to transition ETE constructs from the laboratory to clinical settings (ongoing human trials), including preclinical studies conducted on rodent, rabbit, canine, and porcine models with the expected functional outcomes and regeneration capabilities.
Early translational efforts in ETE are addressed, along with the regulatory and ethical considerations regarding Good Manufacturing Practice (GMP) compliance, traceability, and long-term surveillance. While significant advancements in ETE have been made in preclinical models, the review also discusses the challenges of moving to clinical studies. Potential strategies to address these challenges, such as 4-Dimensional printing, smart materials, Artificial Intelligence (AI)-driven scaffold optimization, and organoid-based models, are introduced to help bridge the gap from preclinical research to successful clinical trials. 
In summary, ETE is transitioning from an experimental advancement to a translational reality by integrating significant achievements in biomaterials, fabrication technologies, and cell biology while following health regulatory standards. These efforts aim to provide regenerative solutions that overcome the limitations of current therapeutic approaches in clinical settings, ultimately facilitating healing and improving the patients' quality of life.