Growth hormone in inflammatory bowel disease.
Crohn's disease and ulcerative colitis are inflammatory diseases of the gastrointestinal tract characterized by chronic relapsing inflammation and catabolism. Growth hormone/insulin-like growth factor-I axis is important in inflammatory bowel disease, because of the effects on epithelial cell kinetics, collagen deposition and immunomodulation. The potential of growth hormone as a therapeutic option in inflammatory bowel disease has been proven in various clinical settings. Acquired growth hormone resistance in inflammatory bowel disease seems to be mediated by a combination of undernutrition and active inflammation. In particular, proinflammatory cytokines, such as TNF-a and interleukin-6, have been implicated as potential mediators of growth hormone resistance. The introduction of anti-TNF-alpha monoclonal antibodies has proven very efficacious in patients with inflammatory bowel disease. By reducing cytokines levels in inflammatory cells of intestinal mucosa, infliximab could interfere with cytokine-induced growth hormone resistance. Recent in vivo data have shown that acquired growth hormone resistance in patients with inflammatory bowel disease may be reversed after the administration of anti-TNF-alpha therapy.
De Pascalis
B
B
Department of Internal Medicine, Catholic University, Rome, Italy.
Bianchi
A
A
Satta
M A
MA
Lupascu
A
A
Mentella
M C
MC
Leo
D
D
Fiore
F
F
Fedeli
P
P
Pontecorvi
A
A
Pola
P
P
Melina
D
D
Gasbarrini
A
A
De Marinis
L
L
Armuzzi
A
A
D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D004351:Drug Resistance; D013006:Growth Hormone / Q000378:metabolism / Q000627:therapeutic use*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000378:metabolism; D000069285:Infliximab; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D000069285:Infliximab