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Promoting growth in chronic inflammatory disease: lessons from studies of the growth plate

S F Ahmed1, L Sävendahl

  • 1Bone and Endocrine Research Group, Division of Developmental Medicine, University of Glasgow, Royal Hospital for Sick Children, Glasgow, UK.

Hormone Research
|November 27, 2009
PubMed

Insights

Growth disorders in children with chronic inflammation are linked to growth hormone-insulin-like growth factor I (IGF-I) axis disruption. While IGF-I therapy helps, managing inflammation and glucocorticoids remains key for growth.

Area of Science:

  • Pediatric endocrinology
  • Inflammatory diseases
  • Growth disorders

Background:

  • Children with chronic inflammatory diseases often experience growth disorders.
  • Growth is regulated by the growth hormone-insulin-like growth factor I (IGF-I) axis.
  • Glucocorticoids (GCs) and proinflammatory cytokines impact this axis and growth plate function.

Purpose of the Study:

  • To understand how GCs and cytokines affect the growth plate.
  • To explore the rationale for growth-promoting therapies in children with inflammation and growth retardation.

Main Methods:

  • Review of recent advances in understanding GC and cytokine effects on the growth plate.
  • Analysis of the impact on the growth hormone-IGF-I axis.
  • Evaluation of potential therapeutic interventions.

Main Results:

  • Both GCs and proinflammatory cytokines negatively impact growth plate chondrogenesis.
  • Increased local IGF-I exposure can partially ameliorate these adverse effects.
  • IGF-I intervention does not fully normalize growth plate function.

Conclusions:

  • Effective control of the inflammatory disease process is crucial for improving growth.
  • Judicious use of GCs remains a cornerstone of management.
  • While IGF-I shows promise, it does not completely resolve growth plate abnormalities.
Abstract

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