JPGN July 2025: Neonatal Gut Interventions and Stem Cell Therapy for Monogenic IBD

You’ll never guess who’s across the table from me today – well, across the miles, since we’re encountering one another via ZOOM, but either way, you’ll never guess. It’s JPGN Journal Club again with... wait for it... have you marked your score sheet, folded it in quarters, and dropped it into the sealed box? No? Too late now – because it’s Dr Jake Mann! How many of you guessed right?Jake’s Picks This Week:1. From J Pediatr Gastroenterol NutrStock et al. from Kassel, Germany – yes, the city of Documenta, Brothers Grimm, and once the capital of the Kingdom of Westphalia under Jérôme Bonaparte (who, by the way, emancipated the Jews and brought in the metric system – good job, Jerry!). This study comes from the Children’s Hospital there: “Hydrostatic low-volume enemas in infants with birth weight ≤ 1000 g or gestational age ≤ 28 weeks: A controlled interventional study.” What’s it all about? In short, they tested whether standardizing enemas in extremely premature infants could help improve outcomes like reducing NEC, intestinal perforation, or meconium plug syndrome. The answer: Yes, standardization helped – but didn’t change the need for parenteral feeding.The bigger question lingers though – does clearing meconium early really help overall? Probably not, say the authors. The gut’s still immature, no matter what you do. Or in Starfleet speak: Primum non nocere. 2. From Clin Gastroenterol HepatolBaccarella et al., at The Children’s Hospital of Philadelphia (CHOP – and side note, I grew up 50 km away, so Philly was once my Bright Lights, Big City). “Outcomes of allogeneic hematopoietic stem cell transplant in monogenic inflammatory bowel disease.” What they found will lift your spirits: In 25 kids (23 of whom had very early-onset IBD), stem cell transplants worked beautifully. No deaths. 23 are in remission and med-free up to 10 years later. Some bumps – infections, GVHD, veno-occlusive disease – but all manageable.Interesting detail: patients with certain genetic mutations (affecting both leukocytes and epithelial cells) didn’t respond as well as those with mutations limited to immune cells. 🎉 What good news! Brava la dottoressa Baccarella, bravi tutti i dottori di Filadelfia!LiteratureBaccarella A et al. Outcomes of allogeneic hematopoietic stem cell transplant in monogenic inflammatory bowel disease. Clin Gastroenterol Hepatol. 2025 May 14:S1542-3565(25)00404-5.Doi: 10.1016/j.cgh.2025.03.018PMID: 40378986Stock T et al. Hydrostatic low-volume enemas in infants with birth weight ≤ 1000 g or gestational age ≤ 28 weeks: A controlled interventional study. J Pediatr Gastroenterol Nutr. 2025 May 8.Doi: 10.1002/jpn3.70055PMID: 40344423

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