Document Detail

Mechanisms of growth impairment in pediatric Crohn's disease.
MedLine Citation:
PMID:  19713986     Owner:  NLM     Status:  MEDLINE    
Crohn's disease manifests during childhood or adolescence in up to 25% of patients. The potential for linear growth impairment as a complication of chronic intestinal inflammation is unique to pediatric patient populations. Insulin-like growth factor I (IGF-I), produced by the liver in response to growth hormone (GH) stimulation, is the key mediator of GH effects at the growth plate of bones. An association between impaired growth in children with Crohn's disease and low IGF-I levels is well recognized. Early studies emphasized the role of malnutrition in suppression of IGF-I production. However, a simple nutritional hypothesis fails to explain all the observations related to growth in children with Crohn's disease. The direct, growth-inhibitory effects of proinflammatory cytokines are increasingly recognized and explored. The potential role of noncytokine factors, such as lipopolysaccharides, and their potential to negatively influence the growth axis have recently been investigated with intriguing results. There is now reason for optimism that the modern anticytokine therapeutic agents available for treating children and adolescents with Crohn's disease will reduce the prevalence of this otherwise common complication. As our understanding of the mechanisms that underlie growth impairment advance, so too should the opportunity for developing further novel and targeted therapies.
Thomas D Walters; Anne M Griffiths
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Nature reviews. Gastroenterology & hepatology     Volume:  6     ISSN:  1759-5053     ISO Abbreviation:  Nat Rev Gastroenterol Hepatol     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-28     Completed Date:  2009-11-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101500079     Medline TA:  Nat Rev Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  513-23     Citation Subset:  IM    
Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
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MeSH Terms
Child, Preschool
Crohn Disease / complications*,  metabolism
Cytokines / metabolism
Growth Disorders / etiology*,  metabolism
Growth Hormone / metabolism
Insulin-Like Growth Factor I / metabolism*
Nutritional Status / physiology
Reg. No./Substance:
0/Cytokines; 67763-96-6/Insulin-Like Growth Factor I; 9002-72-6/Growth Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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