ALIAmides and pediatric health: a structured narrative review

Introduction: Although most children require medications only for occasional acute conditions, a significant proportion lives with chronic diseases that necessitate long-term, often multiple treatments, which negatively impact their health and quality of life, and may lead to adverse outcomes. Challenges related to prescribing and formulation further complicate pediatric treatment, underscoring the need for safe and effective innovative strategies. Autacoid Local Injury Antagonism amides (ALIAmides), particularly palmitoylethanolamide (PEA) and Adelmidrol, represent promising therapeutic options. This structured narrative review aims to collect and discuss all available literature on PEA and Adelmidrol use in pediatric patients. Methods: A search of PubMed, Scopus, and the Cochrane Library identified 17 studies involving a total of 2,530 patients, of whom 1,772 received PEA (oral or topical), and 54 received Adelmidrol. Following a transdiagnostic approach, results were organized by symptom domains rather than by specific diagnoses, to capture potential benefits across multiple conditions and facilitate comparison with previous studies. Data extraction included study design, population characteristics, intervention type and formulation, outcomes assessed, and main findings. Results: Beneficial effects on behavioral, cognitive, motor, and visceral functions, along with improvements in respiratory and dermatological disorders emerged from studies administering oral PEA, mostly in micron-sized formulations. Topical application of both PEA and Adelmidrol also demonstrated benefits on respiratory and skin conditions. Conclusion: Overall, the findings of this review suggest that PEA and Adelmidrol may represent promising, well-tolerated adjunctive strategies for managing pediatric symptoms across various clinical conditions, particularly those that are chronic or require polypharmacy.