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Infliximab reverses growth hormone resistance associated with inflammatory bowel disease
Author(s) -
Gentilucci U. Vespasiani,
Caviglia R.,
Picardi A.,
Carotti S.,
Ribolsi M.,
Galati G.,
Petitti T.,
Afeltra A.,
Cicala M.
Publication year - 2005
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2005.02449.x
Subject(s) - medicine , endocrinology , growth factor , insulin resistance , infliximab , inflammatory bowel disease , ulcerative colitis , insulin like growth factor , insulin , tumor necrosis factor alpha , disease , receptor
Summary Background : 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 insulin‐like growth factor‐binding protein‐3 concentrations, which were significantly lower in inflammatory bowel disease patients before treatment compared with controls ( P < 0.01), significantly increased during the induction phase (+58% and +29%, respectively, after the second infusion, P < 0.01), and dropped to baseline levels during maintenance therapy. Both insulin‐like growth factor‐1 and insulin‐like growth factor‐binding protein‐3 showed significant negative correlations with C‐reactive protein ( ρ = −0.37, P = 0.002; ρ = −0.35, P = 0.01, respectively). Growth hormone and acid labile subunit levels were not statistically different between controls and inflammatory bowel disease patients either at baseline or during treatment. Conclusions : Infliximab induction treatment reverses growth hormone resistance observed in active inflammatory bowel disease through the suppression of systemic inflammation. The restored growth hormone/insulin‐like growth factor‐1 axis is impaired again following the prolonged interval between maintenance infusions, possibly because of the subclinical reactivation of the inflammatory process.