Immune function in children with intestinal atresia

Hanh Vo, MD, is an assistant professor in the division of Pediatric Gastroenterology, Hepatology and Nutrition. She is the senior author of an article published in March in the Journal of Pediatric Surgery.1 Hanh VoCo-authors include Ruben Quiros-Tejeira, MD (division chief) and first author Sittichoke Prachuapthunyachart, MD, who worked on the project while completing a fellowship in the division and is now practicing medicine in Thailand. They collaborated with faculty from UNMC’s division of Transplantation Surgery. Dr. Vo kindly took time to respond to the following questions about the study.

Q: What is intestinal atresia, and what are the key differences between the two forms that you investigated in this study?

A: Intestinal atresia is a congenital malformation of the intestine that results in a narrowing or obstruction of the lumen before birth. In this study, we investigated two forms of intestinal atresia based on the intestinal narrowing part: (1) Isolated intestinal atresia if the patient had either jejunal or ileal atresia, and (2) Multiple intestinal atresia if the patient had more than one area of atresia.

Q: What main questions did your team aim to answer in this study?

A: Previous studies have demonstrated an association between multiple intestinal atresia and immunodeficiency, and that children with multiple intestinal atresia and immunodeficiency often have infectious complications early in life. If undergoing intestinal transplantation, these patients often have a worse post-transplant outcome with a significant risk for graft-versus-host disease.

The primary question we aimed to answer in this retrospective study was whether there are any differences in immune function between children with isolated intestinal atresia and those with multiple intestinal atresia. The secondary question was how such differences might be associated with infectious complications and impact patient outcomes.

Q: After analyzing clinical records from these patients, which conclusions did you find most impactful?

A: Our findings have shown that children with isolated intestinal atresia referred for evaluation of intestinal failure could also have immunodeficiency and associated infectious complications requiring hospitalization.

Q: What’s the next step in research that could help gastroenterologists further improve care for children with intestinal atresia?

A: We suggest performing immunologic evaluation not only in children with multiple intestinal atresia, but also in those with isolated intestinal atresia who are referred to an intestinal rehabilitation program for evaluation of intestinal failure. Early immunodeficiency screening may help initiate appropriate intervention and improve patient outcomes.

  1. Prachuapthunyachart S, Merani S, Cloonan M, Langnas AN, Quiros-Tejeira RE, Vo HD. Immune function and infectious complications in children with jejunoileal atresia. Journal of Pediatric Surgery. 2021 Mar;56(3):454-458.