Daniel Mihai Teleanu

Treating neurological disorders in children is particularly challenging due to the dynamic maturation of the developing brain, age-dependent pharmacokinetics, and evolving structural and functional properties of the blood–brain barrier (BBB). This review explores the latest advances in drug-delivery systems tailored for pediatric neurology, emphasizing strategies to address physiological and developmental determinants of treatment response across infancy, childhood, and adolescence. The paper begins by outlining the distinct challenges of drug delivery in children, focusing on BBB maturation, transporter expression, metabolic capacity, and neurodevelopmental vulnerability. Emerging delivery systems, such as liposomes, polymeric nanoparticles, dendrimers, micelles, gold nanoparticles, and gene- and RNA-based vectors, are further reviewed in relation to major pediatric neurological conditions. These platforms demonstrate promise in enhancing drug bioavailability, targeting specific brain regions, and minimizing systemic toxicity. This paper also covers important safety, regulatory, and ethical considerations in pediatric populations, with a focus on the need for age-appropriate design and thorough clinical validation. Concluding with emerging trends and future directions, this work serves as a comprehensive resource for advancing pediatric neurological therapeutics through state-of-the-art drug delivery technologies.

Spinal surgery involves highly complex procedures where the risk of severe complications, including postoperative infections, may compromise both surgical success and patient survival. In this study, functional coatings for spinal screws were developed to promote bone integration and simultaneously prevent infection. The coating design employed a multilayer architecture based on poly(ε-caprolactone) (PCL) as the main structural layer, covered with chitosan (CS), a biocompatible polymer that enhances surface interaction with both the metallic substrate and the active agents. To stimulate bone regeneration, calcium β-hydroxy-β-methylbutyrate (HMB) was incorporated, while antimicrobial efficacy was achieved by embedding PLGA-based polymeric microspheres encapsulating gentamicin sulfate, a broad-spectrum antibiotic. The obtained results confirmed the successful integration of all components, as evidenced by FTIR and Raman spectroscopy, along with homogeneous surface morphologies observed via SEM analysis. Biological assays demonstrated significant antimicrobial activity against Staphylococcus aureus and Escherichia coli. The developed coatings therefore exhibit strong potential as bioactive, dual-functional protective layers for spinal screws, providing both osteoconductive and antimicrobial properties.

Nanotechnology is rapidly transforming the perspective on pediatric neurology, enabling diagnostic, therapeutic, and monitoring strategies tailored to the unique features of neurological illnesses in children. This review acknowledges the problems caused by delays in diagnosis, the limitations of conventional procedures, and the need for new, focused approaches, highlighting recent advances in nanoscale materials and smart nanocarriers. Specifically, this paper summarizes advances in nanomaterials that can overcome physiological barriers, such as the developing blood–brain barrier (BBB) and age-dependent pharmacokinetics. We discuss innovations in stimuli-responsive delivery systems, theranostic platforms, and multimodal nanohybrids designed for precise targeting and real-time treatment monitoring. Special emphasis is placed on pediatric-specific considerations, including developmental differences in immune and metabolic responses, the necessity for age-adjusted dosing, and the potential long-term safety implications of nanoparticle exposure. Transformative applications are explored in various pediatric neurological conditions, including brain tumors, epilepsy, neurodevelopmental disorders, and rare degenerative diseases, emphasizing both achievements and challenges in translation. This paper evaluates various regulatory, ethical, and societal factors, alongside the integration of converging technologies such as AI-driven nanoparticle optimization, brain organoids, and digital twins to accelerate personalized therapy development. Conclusively, this paper emphasizes the importance of interdisciplinary collaboration, pediatric-focused clinical trial designs, and sustained investment to fully realize the potential of nanotechnology in improving neurological outcomes for children.

The development of implantable neural interfaces is essential for enabling bidirectional communication between the nervous system and prosthetic devices, yet their evaluation still relies primarily on in vivo models which are costly, variable, and ethically constrained. Here, we report a bio-inspired artificial nerve simulator engineered as a reproducible ex vivo platform for pre-implantation testing of plug-type electrodes. The simulator is fabricated from a conductive hydrogel composite based on reduced graphene oxide (rGO), polyaniline (PANI), agarose, sucrose, and sodium chloride, with embedded conductive channels that replicate the fascicular organization and conductivity of peripheral nerves. The resulting construct exhibits impedance values of ~2.4–2.9 kΩ between electrode needles at 1 kHz, closely matching in vivo measurements (~2 kΩ) obtained in Sus scrofa domesticus nerve tissue. Its structural and electrical fidelity enables systematic evaluation of electrode–nerve contact properties, signal transmission, and insertion behavior under controlled conditions, while reducing reliance on animal experiments. This bio-inspired simulator offers a scalable and physiologically relevant testbed that bridges materials engineering and translational neuroprosthetics, accelerating the development of next-generation implantable neural interfaces.

Spinal injuries have a major impact on patients’ quality of life due to the implacable consequences they bring, such as reduced mobility and loss of flexibility, in most cases requiring surgery to restore spinal stability and functionality. In this respect, spinal fixation devices represent an important strategy to stabilize the spine after severe injuries or degenerative conditions, providing structural support and preserving spinal function. However, at the moment, the materials used to manufacture spinal implants present numerous disadvantages (e.g., Young’s modulus larger than cortical bone, which can produce bone resorption and implant enlargement) that can lead to implant failure. In this context, nanotechnology can offer promising solutions, bringing improved properties (e.g., biocompatibility, osseointegration, and increased mechanical performance) that increase the potential for obtaining devices customized to patients’ needs. Thus, the present work aims to present an overview of the types of nanocoating surface modification, the impact of rough and porous implant surfaces, and the integration of bioactive nanoparticles that reduce the risk of infection and implant rejection. In addition, incorporating 3D printing technology and the use of biodegradable materials into the discussion provides a valuable perspective for future studies in this field. Although the emerging results are encouraging, further studies to assess the long-term safety of implant coatings are needed.

The intestine is an important segment of the gastrointestinal tract, which is involved in complex processes that maintain the body’s normal homeostasis. It hosts a vast, diverse, and dynamic microbial community called the gut microbiota, which develops from birth. It has been observed that the gut microbiota is involved in essential physiological processes, including the development of the central nervous system via the gut microbiota–brain axis. An alteration of the gut microbiota can lead to serious health problems, including defective neurodevelopment. Thus, this paper aims to highlight the most recent advances in studies that focus on the link between the gut microbiota and the evolution of neurodevelopmental diseases in children. Currently, studies show that the use of drugs that stimulate and restore the gut microbiota (e.g., probiotics and prebiotics) have the potential to alleviate some of the symptoms associated with conditions such as Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, Tic Disorder, Tourette Syndrome, epilepsy, and Down Syndrome. In addition, due to the challenges associated with drug administration in children, as well as the widespread shortage of medications intended for pediatric use, researchers are working on the development of new delivery systems. Liposome-based systems or solid lipid nanoparticles have been safely used for drug delivery in various pediatric conditions, which may also indicate their potential for use in the administration of microbiota-modulating therapies.

Implant-associated infections represent challenging complications following orthopedic surgeries, with spinal fixation procedures being particularly linked with increased risks. Thus, urgent research is required to develop enhanced solutions to avoid bacterial colonization, associated implant failure, and severe issues. Our study is based on the laser coating of surfaces with a composite mixture of PLA/Fe₃O₄@CEF that can fight against infectious agents and preserve their activity for a prolonged time. In the present study, we synthesized Fe₃O₄@Ceftriaxone (CEF) nanoparticles by co-precipitation and blended them into polylactic acid (PLA)-based coatings that were thoroughly evaluated from physicochemical and biological points of view. The novelty of this work is the dual functionality of these coatings, combining localized, sustained antibiotic delivery with enhanced biocompatibility for spinal screw applications. The coatings exhibited substantial anti-biofilm effects, reducing Staphylococcus aureus colonization from 1.8 × 10⁸ to 1.6 × 10⁵ CFU/mL and Pseudomonas aeruginosa from 1.2 × 10¹¹ to 1.9 × 10⁶ CFU/mL after 24 h. Furthermore, in vitro assays with murine preosteoblasts and human osteoblasts demonstrated excellent biocompatibility, maintaining >95% cell viability and showing no significant cytotoxicity or inflammatory response. These results highlight the potential of PLA/Fe₃O₄@CEF composite coatings in preventing implant-associated infections and promoting osseointegration, offering a multifunctional strategy for improving spinal fixation screw longevity and patient outcomes.

There is great interest in the development of prosthetic limbs capable of complex activities that are wirelessly connected to the patient’s neural system. Although some progress has been achieved in this area, one of the main problems encountered is the selective acquisition of nerve impulses and the closing of the automation loop through the selective stimulation of the sensitive branches of the patient. Large-scale research and development have achieved so-called “cuff electrodes”; however, they present a big disadvantage: they are not selective. In this article, we present the progress made in the development of an implantable system of plug neural microelectrodes that relate to the biological nerve tissue and can be used for the selective acquisition of neuronal signals and for the stimulation of specific nerve fascicles. The developed plug electrodes are also advantageous due to their small thickness, as they do not trigger nerve inflammation. In addition, the results of the conducted tests on a sous scrofa subject are presented.

Spinal disorders cover a broad spectrum of pathologies and are among the most prevalent medical conditions. The management of these health issues was noted to be increasingly based on surgical interventions. Spinal fixation devices are often employed to improve surgery outcomes, increasing spinal stability, restoring structural integrity, and ensuring functionality. However, most of the currently used fixation tools are fabricated from materials with very different mechanical properties to native bone that are prone to pull-out effects or fail over time, requiring revision procedures. Solutions to these problems presently exploited in practice include the optimal selection of screw shape and size, modification of insertion trajectory, and utilization of bone cement to reinforce fixation constructs. Nevertheless, none of these methods are without risks and limitations. An alternative option to increasing biomechanical resistance to the pull-out effect is to tackle bone regenerative capacity and focus on screw osteointegration properties. Osteointegration was reportedly enhanced through various optimization strategies, including use of novel materials, surface modification techniques (e.g., application of coatings and topological optimization), and utilization of composites that allow synergistic effects between constituents. In this context, this paper takes a comprehensive path, starting with a brief presentation of spinal fixation devices, moving further to observations on how the pull-out strength can be enhanced with existing methods, and further focusing on techniques for implant osteointegration improvement.

Multiple sclerosis (MS) represents a chronic immune-mediated neurodegenerative disease of the central nervous system that generally debuts around the age of 20–30 years. Still, in recent years, MS has been increasingly recognized among the pediatric population, being characterized by several peculiar features compared to adult-onset disease. Unfortunately, the etiology and disease mechanisms are poorly understood, rendering the already limited MS treatment options with uncertain efficacy and safety in pediatric patients. Thus, this review aims to shed some light on the progress in MS therapeutic strategies specifically addressed to children and adolescents. In this regard, the present paper briefly discusses the etiology, risk factors, comorbidities, and diagnosis possibilities for pediatric-onset MS (POMS), further moving to a detailed presentation of current treatment strategies, recent clinical trials, and emerging alternatives. Particularly, promising care solutions are indicated, including new treatment formulations, stem cell therapies, and cognitive training methods.