title: The role of insulin-like growth factor 1, receptor activator for nuclear factor κB ligand - osteoprotegerin system, interleukin 6 and 1β in post-transplantation bone metabolic disease in childhood.
abstract: BACKGROUND
  Bone disorders observed commonly after haematopoietic stem cells transplantation (HSCT) can be caused by several factors,but their detailed pathomechanism is still not well known, especially in childhood.The aim of this study was to evaluate: IGF-I, RANKL-OPG system, IL-6, and IL1β levels and their association with bone mineral density(BMD) in children and adolescents after HSCT.
  
  
  METHODS
  Thirty five patients after allogeneic (N = 21) and autologous (N = 14) HSCT, mean age 8.48 ± 5.18 years, wereincluded in the study. Blood samples were taken before HSCT, on the transplantation day, three and six months after HSCT, then eachyear after HSCT for 2-8 years. RANKL, OPG, and IL-1β, IGF-1, and IL-6 were measured by immunochemistry. Total BMD was evaluatedsix months after HSCT using dual energy X-ray absorptiometry, then annually.
  
  
  RESULTS
  All Z-core values for BMD were negative in all patients. It was significantly higher in patients after auto HSCT than after allo HSCT.Serum levels of IGF-1 and IL-6 significantly changed after HSCT. IGF-I levels started to increase in the second year after transplantation.IL-6 increased up to 12 months after transplantation. Dynamic although not significant changes of OPG and RANKL levels were observedafter HSCT. RANKL and IGF-1 values correlated with BMD. IL-6 correlated positively with IL-1β but both did not correlate with BMD.
  
  
  CONCLUSIONS
  Our data indicates that factors influencing bone remodelling change dynamically in the post-transplantation period.It suggests that serum RANKL and IGF-1 levels could be markers of bone metabolism after HSCT in paediatric patients.
authors.affiliation: Department of Paediatric and Adolescent Endocrinology, Chair of Paediatrics, Polish-American Paediatric Institute, Medical College, Jagiellonian University in Krakow, Poland 2. anna.wedrychowicz@uj.edu.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Wędrychowicz
authors.forename: Krystyna
authors.initials: K
authors.lastname: Sztefko
authors.forename: Marcin
authors.initials: M
authors.lastname: Majka
authors.forename: Mariusz Z
authors.initials: MZ
authors.lastname: Ratajczak
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001851:Bone Diseases, Metabolic / Q000378:metabolism* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007120:Immunochemistry; D007223:Infant; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D053583:Interleukin-1beta / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D053245:RANK Ligand / Q000097:blood*; D053246:Receptor Activator of Nuclear Factor-kappa B / Q000097:blood*
chemical_list: D015415:Biomarkers; D053583:Interleukin-1beta; D015850:Interleukin-6; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; D007334:Insulin-Like Growth Factor I