[Influence of enteral nutrition therapy on serum angiogenic growth factors concentrations in children].
BACKGROUND
Effectiveness of enteral nutrition therapy is not only connected with improvement of the nutritional status of the patient, but also with its strong anti-inflammatory activity. Angiogenic growth factors play an important role in the early stage of inflammation. Vascular endothelial growth factor (VEGF) and transforming growth factor beta 1 (TGF-beta 1) stimulate the angiogenesis and healing processes. The objective of our study was to assess the influence of the enteral nutrition therapy on the vascular endothelial growth factor (VEGF) and transforming growth factor beta 1 (TGF-beta 1) concentrations in serum in children with different diseases of gastro-intestinal tract, in which enteral nutrition therapy is effective method of treatment.


METHODS
Sixty two children (29 boys, 33 girls, mean age: 12.5 yrs, range: 6-18 yrs) and 25 healthy controls were included into the study. The Crohn's disease group (CD) consisted of 25 patients, ulcerative colitis group (UC)-18 patients, acute pancreatitis (AP) group-12 patients and severe malnutrition (N) group-7 patients. Serum VEGF and TGF-beta 1 concentrations were assessed at baseline, before starting and after 2 and 4 weeks of enteral nutrition therapy using ELISA immunoassays (R and D Systems, USA).


RESULTS
Before starting enteral nutrition, we found increased VEGF concentration in CD group (Me = 600 pg/ml) compared to UC group (266.9 pg/ml), AP group (552.6 pg/ml), N group (238.5 pg/ml) and controls (172 pg/ml) (p < 0.05). We found decrease of VEGF concentrations during enteral nutrition in CD, UC and N group and increase in AP at the beginning, followed by decrease to the initial values. Assessing TGF-beta 1, we found its concentration increased before starting enteral nutrition in UC group (37.5 ng/ml) compared to CD group (29.7 ng/ ml) and controls (24.8 ng/ml) (p < 0.05). During enteral nutrition we observed decrease of TGF-beta 1 concentration in UC group and increase in CD group (32,7 ng/ml) and AP group (26,6 ng/ml) (p < 0.05) The best improvement of nutritional status was observed in CD patients compared to N and AP patients.


CONCLUSIONS
Differentiation of serum VEGF and TGF-beta 1 concentrations, what was observed in various gastro-intestinal diseases, reflects different mechanisms of enteral nutrition therapy acting on the inflammatory process. The most efficient therapeutic effect was seen in CD, where stimulation of TGF-beta 1 production was observed.
Klinika Pediatrii, Gastroenterolog Polsko-Amerykański Instytut Pediatrii WL UJ 31-663 Kraków, ul. Wielicka 265. awedrycho@cm-uj.krakow.pl
Andrzej
A
Wedrychowicz
Kinga
K
Kowalska-Duplaga
Stanisław
S
Pieczarkowski
Przemysław
P
Tomasik
Mikołaj
M
Spodaryk
Krzysztof
K
Fyderek
D000293:Adolescent; D002648:Child; D004750:Enteral Nutrition; D005260:Female; D005767:Gastrointestinal Diseases / Q000097:blood* / Q000628:therapy*; D006801:Humans; D008297:Male; D009752:Nutritional Status; D053773:Transforming Growth Factor beta1 / Q000097:blood*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
D053773:Transforming Growth Factor beta1; D042461:Vascular Endothelial Growth Factor A