Infliximab reverses growth hormone resistance associated with inflammatory bowel disease.
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.


OBJECTIVE
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 (rho = -0.37, P = 0.002; rho = -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.
Vespasiani Gentilucci
U
U
Internal Medicine and Hepatology Laboratory, Centre of Interdisciplinary Research (CIR), University Campus Bio-Medico [corrected] Rome, Italy.
Caviglia
R
R
Picardi
A
A
Carotti
S
S
Ribolsi
M
M
Galati
G
G
Petitti
T
T
Afeltra
A
A
Cicala
M
M
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000097:blood / Q000188:drug therapy*; D003424:Crohn Disease / Q000097:blood / Q000188:drug therapy*; D004351:Drug Resistance; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D000069285:Infliximab; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged
D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D000069285:Infliximab