Collagenous gastritis (CG) is a rare cause of refractory dyspepsia and anemia that frequently affects children and young adults and whose histological hallmark is chronic mucosal inflammation with a subepithelial collagen band. The etiology remains obscure, and no established treatments exist. We investigated the pathogenesis of CG by determining the expression profiles of genes related to immunity and inflammation in index biopsies.Gastric biopsies from 10 newly diagnosed patients with CG were evaluated using the NanoString nCounter assay. Gastric biopsies from 14 normal individuals served as controls. The gene expression ratios for CG versus controls were determined in pooled samples and confirmed in individual samples by quantitative reverse transcription polymerase chain reaction. The results were compared with previously reported expression data from a cohort of patients with collagenous colitis, a colonic disorder with similar morphology, including subepithelial collagen band.CG biopsies featured enhanced expression of key genes encoding both Th1 (IFNγ, TNF‐α, IL‐2, IL‐10, IL‐12A, IL‐12B, and IL‐18) and Th2 cytokines (IL‐3, IL‐4, IL‐5, IL‐6, and IL‐13). In contrast, biopsies from patients with CC exhibited upregulated Th1 cytokines only.We show in this first published gene expression profiling study that CG involves simultaneous upregulation of Th1 and Th2 cytokines. This finding is unique, contrasting with other types of chronic gastritis as well as with collagenous colitis, which shares the presence of a collagen band. Involvement of Th2 immunity in CG would support further investigation of potential dietary, environmental, or allergic factors to guide future therapeutic trials.
{"title":"Coexisting Th1 and Th2 cytokines in patients with collagenous gastritis and implications for its pathogenesis","authors":"Qingqing Liu, Yanping Wang, N. Harpaz","doi":"10.1002/jpn3.12109","DOIUrl":"https://doi.org/10.1002/jpn3.12109","url":null,"abstract":"Collagenous gastritis (CG) is a rare cause of refractory dyspepsia and anemia that frequently affects children and young adults and whose histological hallmark is chronic mucosal inflammation with a subepithelial collagen band. The etiology remains obscure, and no established treatments exist. We investigated the pathogenesis of CG by determining the expression profiles of genes related to immunity and inflammation in index biopsies.Gastric biopsies from 10 newly diagnosed patients with CG were evaluated using the NanoString nCounter assay. Gastric biopsies from 14 normal individuals served as controls. The gene expression ratios for CG versus controls were determined in pooled samples and confirmed in individual samples by quantitative reverse transcription polymerase chain reaction. The results were compared with previously reported expression data from a cohort of patients with collagenous colitis, a colonic disorder with similar morphology, including subepithelial collagen band.CG biopsies featured enhanced expression of key genes encoding both Th1 (IFNγ, TNF‐α, IL‐2, IL‐10, IL‐12A, IL‐12B, and IL‐18) and Th2 cytokines (IL‐3, IL‐4, IL‐5, IL‐6, and IL‐13). In contrast, biopsies from patients with CC exhibited upregulated Th1 cytokines only.We show in this first published gene expression profiling study that CG involves simultaneous upregulation of Th1 and Th2 cytokines. This finding is unique, contrasting with other types of chronic gastritis as well as with collagenous colitis, which shares the presence of a collagen band. Involvement of Th2 immunity in CG would support further investigation of potential dietary, environmental, or allergic factors to guide future therapeutic trials.","PeriodicalId":508144,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":"53 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139442020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Associate Editors' Corner: A quality improvement primer—The why and what, the how, and reasons to publish","authors":"Jeannie S. Huang","doi":"10.1002/jpn3.12110","DOIUrl":"https://doi.org/10.1002/jpn3.12110","url":null,"abstract":"","PeriodicalId":508144,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":"66 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jason A. Silverman, Ankur Chugh, J. Hollier, Nicole Martin, V. Raghu, Eduardo Rosas‐Blum, Miranda A. L. van Tilburg, Priya Venkataraman‐Rao, R. Venkatesh, Peter L. Lu
The advent of social media has changed numerous aspects of modern life, with users developing and maintaining personal and professional relationships, following and sharing breaking news and importantly, searching for and disseminating health information and medical research. In the present paper, we reviewed available literature to outline the potential uses, pitfalls and impacts of social media for providers, scientists and institutions involved in digestive health in the domains of patient care, research and professional development. We recommend that these groups become more active participants on social media platforms to combat misinformation, advocate for patients, and curate and disseminate valuable research and educational materials. We also recommend that societies such as NASPGHAN assist its members in accessing training on effective social media use and the creation and maintenance of public‐facing profiles and that academic institutions incorporate substantive social media contributions into academic promotion processes.
{"title":"Using social media for patient care, research, and professional development: A North American society of pediatric gastroenterology, hepatology, and nutrition position paper","authors":"Jason A. Silverman, Ankur Chugh, J. Hollier, Nicole Martin, V. Raghu, Eduardo Rosas‐Blum, Miranda A. L. van Tilburg, Priya Venkataraman‐Rao, R. Venkatesh, Peter L. Lu","doi":"10.1002/jpn3.12051","DOIUrl":"https://doi.org/10.1002/jpn3.12051","url":null,"abstract":"The advent of social media has changed numerous aspects of modern life, with users developing and maintaining personal and professional relationships, following and sharing breaking news and importantly, searching for and disseminating health information and medical research. In the present paper, we reviewed available literature to outline the potential uses, pitfalls and impacts of social media for providers, scientists and institutions involved in digestive health in the domains of patient care, research and professional development. We recommend that these groups become more active participants on social media platforms to combat misinformation, advocate for patients, and curate and disseminate valuable research and educational materials. We also recommend that societies such as NASPGHAN assist its members in accessing training on effective social media use and the creation and maintenance of public‐facing profiles and that academic institutions incorporate substantive social media contributions into academic promotion processes.","PeriodicalId":508144,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":"65 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139449092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anne Lecoutour, Claire Dupont, D. Caldari, C. Dumant, Audrey Vanrenterghem, Mathias Ruiz, Rémi Duclaux‐Loras, Stéphanie Berthet, Georges Dimitrov, Delphine Lacroix, Pauline Duvant, Céline Roman, Anne Claire Wagner, Aurélie Bourmaud, Jérôme Viala, F. Ruemmele, B. Pigneur
Infliximab (IFX) and adalimumab (ADA) are recommended for induction and maintenance of remission in pediatric Crohn's disease (CD). ADA is now often used in first line due to its efficacy and tolerability, but a loss of response (LOR) can occur over time. The aim was to assess the efficacy of IFX as second line therapy after LOR or intolerance to ADA in pediatric CD patients at 1 year.We conducted a retrospective and multicenter study in France among the “GETAID pédiatrique” centers between April 2019 and April 2022. CD patients under 18 years old and treated with IFX after ADA failure or intolerance were included. We collected anthropometric, clinical, and biological data at baseline (start of IFX), at 6 and 12 months. Clinical remission was defined by a Weighted Pediatric CD Activity Index (wPCDAI) score less than 12.5 points.Of the 32 patients included in our study, 27 (84.4%) were still on IFX at 12 months of the switch. Among them, 13 had discontinued ADA because of a LOR, 12 for insufficient response and 2 due to primary nonresponse. At M12, 22 patients were in corticosteroid free clinical remission (68.7%). Under IFX, the wPCDAI decreased over time (47.5 ± 24.1, 16.6 ± 21.2 and 9.7 ± 19.0 at M0, M6 and M12 respectively). The only factor associated with clinical remission at 12 months was absence of perianal disease at the end of the IFX induction.IFX is effective in maintaining remission at 1 year in pediatric CD patients experiencing a LOR or intolerance with ADA, and IFX could be an interesting therapeutic choice instead of other biologics in this situation.
{"title":"Efficacy of infliximab after loss of response of/intolerance to adalimumab in pediatric Crohn's disease: A retrospective multicenter cohort study of the “GETAID pédiatrique”","authors":"Anne Lecoutour, Claire Dupont, D. Caldari, C. Dumant, Audrey Vanrenterghem, Mathias Ruiz, Rémi Duclaux‐Loras, Stéphanie Berthet, Georges Dimitrov, Delphine Lacroix, Pauline Duvant, Céline Roman, Anne Claire Wagner, Aurélie Bourmaud, Jérôme Viala, F. Ruemmele, B. Pigneur","doi":"10.1002/jpn3.12044","DOIUrl":"https://doi.org/10.1002/jpn3.12044","url":null,"abstract":"Infliximab (IFX) and adalimumab (ADA) are recommended for induction and maintenance of remission in pediatric Crohn's disease (CD). ADA is now often used in first line due to its efficacy and tolerability, but a loss of response (LOR) can occur over time. The aim was to assess the efficacy of IFX as second line therapy after LOR or intolerance to ADA in pediatric CD patients at 1 year.We conducted a retrospective and multicenter study in France among the “GETAID pédiatrique” centers between April 2019 and April 2022. CD patients under 18 years old and treated with IFX after ADA failure or intolerance were included. We collected anthropometric, clinical, and biological data at baseline (start of IFX), at 6 and 12 months. Clinical remission was defined by a Weighted Pediatric CD Activity Index (wPCDAI) score less than 12.5 points.Of the 32 patients included in our study, 27 (84.4%) were still on IFX at 12 months of the switch. Among them, 13 had discontinued ADA because of a LOR, 12 for insufficient response and 2 due to primary nonresponse. At M12, 22 patients were in corticosteroid free clinical remission (68.7%). Under IFX, the wPCDAI decreased over time (47.5 ± 24.1, 16.6 ± 21.2 and 9.7 ± 19.0 at M0, M6 and M12 respectively). The only factor associated with clinical remission at 12 months was absence of perianal disease at the end of the IFX induction.IFX is effective in maintaining remission at 1 year in pediatric CD patients experiencing a LOR or intolerance with ADA, and IFX could be an interesting therapeutic choice instead of other biologics in this situation.","PeriodicalId":508144,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":"29 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139448699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Raghu, Xingyu Zhang, James E Squires, Elizabeth Eisenberg, Amy G. Feldman, Jennifer Halma, Anna L. Peters, R. Gonzalez-Peralta, Vicky L. Ng, Simon Horslen, S. Lobritto, John C. Bucuvalas, G. Mazariegos, E. Perito
The Starzl Network for Excellence in Pediatric Transplantation identified optimizing immunosuppression (IS) as a priority practice improvement area for patients, families, and providers. We aimed to evaluate associations between clinical characteristics, early IS, and outcomes.We analyzed pediatric liver transplant (LT) data from 2013 to 2018 in the United Network for Organ Sharing (UNOS) and the Society of Pediatric Liver Transplantation (SPLIT) registries.We included 2542 LT recipients in UNOS and 1590 in SPLIT. IS choice varied between centers with steroid induction and mycophenolate mofetil (MMF) use each ranging from 0% to 100% across centers. Clinical characteristics associated with early IS choice were inconsistent between the two data sets. T‐cell depleting antibody use was associated with improved 1‐year graft (hazard ratio [HR] 0.50, 95% confidence interval [CI] 0.34−0.76) and patient (HR 0.40, 95% CI 0.20−0.79) survival in UNOS but decreased 1‐year patient survival (HR 4.12, 95% CI 1.31−12.93) and increased acute rejection (HR 1.58, 95% CI 1.07−2.34) in SPLIT. Non‐T‐cell depleting antibody use was not associated with differential risk of survival nor rejection. MMF use was associated with improved 1‐year graft survival (HR 0.73, 95% CI 0.54−0.99) in UNOS only.Variation exists in center choice of early IS regimen. UNOS and SPLIT data provide conflicting associations between IS and outcomes in multivariable analysis. These results highlight the need for future multicenter collaborative work to identify evidence‐based IS best practices.
Starzl 儿科移植卓越网络将优化免疫抑制（IS）确定为患者、家属和医疗服务提供者的优先实践改进领域。我们分析了器官共享联合网络（UNOS）和小儿肝移植协会（SPLIT）登记处2013年至2018年的小儿肝移植（LT）数据。各中心对IS的选择各不相同，类固醇诱导和霉酚酸酯（MMF）的使用率从0%到100%不等。与早期 IS 选择相关的临床特征在两个数据集之间并不一致。在UNOS中，使用T细胞清除抗体与移植物（危险比[HR] 0.50，95%置信区间[CI] 0.34-0.76）和患者（HR 0.40，95%置信区间[CI] 0.20-0.79）1年生存率的提高有关，但在SPLIT中，使用T细胞清除抗体与患者1年生存率的降低（HR 4.12，95%置信区间[CI] 1.31-12.93）和急性排斥反应的增加（HR 1.58，95%置信区间[CI] 1.07-2.34）有关。使用非 T 细胞清除抗体与不同的生存风险或排斥反应无关。仅在 UNOS 中，MMF 的使用与 1 年移植物存活率的提高有关（HR 0.73，95% CI 0.54-0.99）。在多变量分析中，UNOS 和 SPLIT 数据提供了 IS 与结果之间相互矛盾的关联。这些结果凸显了未来开展多中心合作以确定循证 IS 最佳实践的必要性。
{"title":"Impact of early immunosuppression on pediatric liver transplant outcomes within 1 year","authors":"V. Raghu, Xingyu Zhang, James E Squires, Elizabeth Eisenberg, Amy G. Feldman, Jennifer Halma, Anna L. Peters, R. Gonzalez-Peralta, Vicky L. Ng, Simon Horslen, S. Lobritto, John C. Bucuvalas, G. Mazariegos, E. Perito","doi":"10.1002/jpn3.12112","DOIUrl":"https://doi.org/10.1002/jpn3.12112","url":null,"abstract":"The Starzl Network for Excellence in Pediatric Transplantation identified optimizing immunosuppression (IS) as a priority practice improvement area for patients, families, and providers. We aimed to evaluate associations between clinical characteristics, early IS, and outcomes.We analyzed pediatric liver transplant (LT) data from 2013 to 2018 in the United Network for Organ Sharing (UNOS) and the Society of Pediatric Liver Transplantation (SPLIT) registries.We included 2542 LT recipients in UNOS and 1590 in SPLIT. IS choice varied between centers with steroid induction and mycophenolate mofetil (MMF) use each ranging from 0% to 100% across centers. Clinical characteristics associated with early IS choice were inconsistent between the two data sets. T‐cell depleting antibody use was associated with improved 1‐year graft (hazard ratio [HR] 0.50, 95% confidence interval [CI] 0.34−0.76) and patient (HR 0.40, 95% CI 0.20−0.79) survival in UNOS but decreased 1‐year patient survival (HR 4.12, 95% CI 1.31−12.93) and increased acute rejection (HR 1.58, 95% CI 1.07−2.34) in SPLIT. Non‐T‐cell depleting antibody use was not associated with differential risk of survival nor rejection. MMF use was associated with improved 1‐year graft survival (HR 0.73, 95% CI 0.54−0.99) in UNOS only.Variation exists in center choice of early IS regimen. UNOS and SPLIT data provide conflicting associations between IS and outcomes in multivariable analysis. These results highlight the need for future multicenter collaborative work to identify evidence‐based IS best practices.","PeriodicalId":508144,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":"24 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139452350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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