Responsiveness of IGF‐I and IGFBP‐3 to therapeutic intervention in children and adolescents with Crohn's disease

Beattie, R Mark; Camacho‐Hübner, Cecilia; Wacharasindhu, Suttipong; Cotterill, Andrew; Walker-Smith, J A; Savage, Martin O.

doi:10.1046/j.1365-2265.1998.00562.x

Cited by 93 publications

(81 citation statements)

References 33 publications

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“…Based on previous studies in adults with inactive Crohn disease, it was hypothesized that adolescents with inactive Crohn disease would be anabolic, decreasing proteolysis and increasing protein synthesis in response to enteral feeding (8). This hypothesis is supported by reports that Crohn disease remission is associated with improvement of growth and of hormonal and metabolic processes promoting accrual of lean body mass (11)(12)(13). However, previous studies have shown that in adolescents with inactive Crohn disease energy expenditure is increased as compared with healthy adolescents (14), and deficits in lean body mass persist during remission (15).…”

supporting

confidence: 54%

“…One participant had a history of treatment with prednisone (10 mg) during the month the study was performed. Crohn disease severity was assessed by using the previously validated Pediatric Crohn's Disease Activity Index (PCDAI), with PCDAI scores categorized as follows: quiescent disease (0 -10), mild disease activity (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), moderate to severe disease activity (Ͼ30) (16). The mean PCDAI was 8 Ϯ 9 [standard deviation (SD)] and range was 0 -25, indicating quiescent to mild disease activity in all subjects at the time of evaluation.…”

Section: Methodsmentioning

confidence: 99%

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Acute Effects of Enteral Nutrition on Protein Turnover in Adolescents with Crohn Disease

et al. 2007

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Adults with inactive Crohn disease have been shown to have normal rates of protein turnover when compared with healthy adults. It is not known whether this is true for adolescents with inactive Crohn disease, when rate of protein synthesis must be greater than that of breakdown for normal development. The objective of this study was to determine whether enteral nutrition acutely suppresses proteolysis and increases protein synthesis in adolescents with inactive Crohn disease. Six adolescents (five males/one female; mean age, 15.8 Ϯ 1.9 y; range, 13.2-17.6 y; mean bone age, 14.6 Ϯ 1.8 y; range, 12.5-17 y) participated. Leucine (Leu) and phenylalanine (Phe) kinetics were measured using stable isotopes under fasted and fed conditions during a single study visit. In response to enteral nutrition, the endogenous rates of appearance (R a ) of Leu and Phe (reflecting proteolysis) decreased significantly by 40%. The percentages of splanchnic uptake of Leu and Phe were 35 Ϯ 10% and 13 Ϯ 12%, respectively. Under fed conditions, utilization of Phe for protein synthesis increased significantly. We conclude that in clinically stable adolescents with Crohn disease, enteral nutrition promotes anabolism by suppressing proteolysis and increasing protein synthesis. Rates of suppression of proteolysis were similar to those reported previously in normal children. (Pediatr Res 61: 356-360, 2007)

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supporting

confidence: 54%

Section: Methodsmentioning

confidence: 99%

Acute Effects of Enteral Nutrition on Protein Turnover in Adolescents with Crohn Disease

et al. 2007

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“…16 Studies in IBD patients have clearly demonstrated that the reduction in systemic inflammation following various therapeutic strategies is associated with an increase in plasma IGF-1 and IGFBP-3 levels. 17,18 Furthermore, the anti-inflammatory properties of steroids overcome even their adverse effect on the GH/IGF-1 axis at hypothalamic, pituitary and target organ levels. 18 However, notwithstanding the widespread use of anti-TNF-a treatment in IBD patients, no data are available concerning its effect on the GH/IGF-1 axis.…”

mentioning

confidence: 99%

Infliximab reverses growth hormone resistance associated with inflammatory bowel disease

Gentilucci¹,

Caviglia

Picardi³

et al. 2005

Aliment Pharmacol Ther

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SUMMARYBackground: Increasing evidence shows that inflammation plays a major role in the aetiology of catabolism and wasting observed in inflammatory bowel disease via growth hormone resistance. Aim: To evaluate the effect of infliximab treatment on the growth hormone/insulin-like growth factor-1 axis. Methods: Fourteen adults with active Crohn's disease or ulcerative colitis underwent three infliximab infusions at a dose of 5 mg/kg for induction of remission, plus two maintenance infusions 8 weeks apart. Blood samples were collected for the analysis of serum growth hormone, insulin-like growth factor-1, insulin-like growth factor-binding protein-3 and acid labile subunit. Results: Serum insulin-like growth factor-1 and insulinlike growth factor-binding protein-3 concentrations, which were significantly lower in inflammatory bowel disease patients before treatment compared with con-

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“…Aproximadamente 20% dos pacientes ficaram com altura final mais de 8 cm abaixo do alvo familiar, sendo mais comprometidos aqueles que já apresentavam baixa estatura no diagnóstico da doença e aqueles com comprometimento de jejuno (41). A suplementação nutricional adequada e a ressecção cirúrgi-ca da porção intestinal acometida levam à melhora do crescimento, porém alguns pacientes não conseguem recuperar totalmente o crescimento (42). Alguns estudos têm demonstrado os efeitos do tratamento com GH nestes pacientes.…”

Section: Doença De Crohnunclassified

Tratamento com hormônio de crescimento em crianças com doenças crônicas

Barreto

Bigolin

Ramos

et al. 2008

Arq Bras Endocrinol Metab

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Crianças com doenças crônicas freqüentemente apresentam crescimento inadequado e baixa estatura. A falência do crescimento é multifatorial. Nas doenças inflamatórias, como na artrite juvenil idiopática e nas doenças inflamatórias intestinais, o crescimento é comprometido também pelo processo inflamatório. Muitas vezes, o tratamento da doença de base compromete o crescimento, especialmente quando é necessário glicocorticóides. Em algumas situações é possível comprovar a deficiência associada de hormônio de crescimento (GH, do inglês growth hormone). Em outras, os exames sugerem certo grau de insensibilidade ao GH. O tratamento destes pacientes com GH tem se mostrado útil e seguro com melhora do crescimento e da qualidade de vida. Nesta revisão, são apresentados resultados do tratamento com GH em pacientes com baixa estatura decorrente de doenças crônicas, algumas indicações já bem definidas e outras ainda em investigação.

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Responsiveness of IGF‐I and IGFBP‐3 to therapeutic intervention in children and adolescents with Crohn's disease

Abstract: The IGF system, as shown by serum IGF-I and IGFBP-3, is responsive to therapeutic intervention in active Crohn's disease. It is likely that a combination of decreased inflammatory activity and improved nutrition contributes to these changes.

Cited by 93 publications

References 33 publications

Acute Effects of Enteral Nutrition on Protein Turnover in Adolescents with Crohn Disease

Acute Effects of Enteral Nutrition on Protein Turnover in Adolescents with Crohn Disease

Infliximab reverses growth hormone resistance associated with inflammatory bowel disease

Tratamento com hormônio de crescimento em crianças com doenças crônicas

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