30 April 2025

JPGN Journal Club: May 2025

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Hello! The JPGN Journal Club, led by Dr. Jake Mann, is back — in your speakers, your earbuds, or maybe even over the airport tannoy… well, probably not the last one. Anyway, it's good to be back in touch.

Please visit https://www.espghan.org/knowledge-center to explore current offerings, and don't forget ESPGHAN’s annual meeting, taking place May 14–17 in Helsinki.

This session’s discussion papers:

1.From Journal of Pediatric Gastroenterology and Nutrition (JPGN):Ritchie et al. (Aberdeen, UK, and Christchurch, NZ) –"Role of Noncontrast-Enhanced Abdominal Ultrasound in the Diagnostic Assessment of Pediatric Inflammatory Bowel Disease"

  • A retrospective review of 47 children in New Zealand with inflammatory bowel disease (IBD).

  • Examined the contributions of endoscopy, biopsy, magnetic resonance enterography (MRE), and noncontrast sonography (NCS) in diagnosing small-bowel involvement.

  • Findings:

    • 14 children had no small-bowel disease.

    • Of the 33 with small-bowel involvement:

      • 19 had findings on NCS.

        • In 7 cases, NCS detected disease that endoscopy, biopsy, and MRE missed.

        • In 12 cases, NCS confirmed disease found by other modalities and found additional sites of involvement.

      • In 14 cases, NCS failed to detect small-bowel disease that other methods identified.

  • Conclusion:NCS alone missed about two-fifths of cases but expanded diagnosis in about one-fifth.

2. From Nature:Rosenberger et al. (Czechia, Denmark, Germany) –"Deep Visual Proteomics Maps Proteotoxicity in a Genetic Liver Disease"

  • Focused on alpha-1-antitrypsin storage disorder (A1ASD), where mutations in SERPINA1 cause alpha-1-antitrypsin (A1A) to accumulate in liver cells.

  • Mechanisms of injury ("proteotoxicity") were unclear.

  • The study used staining, microdissection, and mass spectrometry to analyze individual hepatocytes.

  • Key findings:

    • Upregulation of the unfolded protein response.

    • Downregulation of hepatocellular synthesis and secretion processes.

    • Strong activation of peroxisomes in samples from individuals with less fibrosis; this activation declined in cases with more fibrosis.

  • Implication:The authors speculate that peroxisome activators might help modulate disease progression.

  • Limitations:The study focused on adult samples (ages 40–80), leaving unanswered how A1ASD leads to cholestasis in some infants but not others.

References
  • Ritchie K, et al. Role of Noncontrast-Enhanced Abdominal Ultrasound in the Diagnostic Assessment of Pediatric Inflammatory Bowel Disease. JPGN, 2025 Apr 9.PMID: 40201985 | DOI: 10.1002/jpn3.70044

  • Rosenberger FA, et al. Deep Visual Proteomics Maps Proteotoxicity in a Genetic Liver Disease. Nature, 2025 Apr 16.PMID: 40240610 | DOI: 10.1038/s41586-025-08885-4