Corticosteroids increase protein breakdown and loss in newly diagnosed pediatric Crohn disease

Area of Science:

• Pediatric Gastroenterology
• Metabolic Research
• Biochemistry

Background:

• Children with Crohn disease often experience impaired growth and altered body composition.
• Previous research indicated reduced protein breakdown with corticosteroid or anti-TNF-α therapy.

Purpose of the Study:

• To investigate whole-body protein metabolism in children with newly diagnosed Crohn disease undergoing corticosteroid therapy.

Main Methods:

• Utilized stable isotopes ([d5] phenylalanine, [1-(13)C] leucine, [(15)N(2)] urea) to assess protein kinetics in a fasting state.
• Metabolic assessments were conducted on children with suspected Crohn disease and controls, with follow-up assessments after 2 weeks of corticosteroid treatment for Crohn disease patients.

Main Results:

• No significant differences in protein breakdown or loss were observed between newly diagnosed Crohn disease patients and controls at baseline.
• Following 2 weeks of corticosteroid therapy, Crohn disease patients showed significant increases in phenylalanine (32%) and leucine (26%) appearance rates, indicating elevated protein breakdown.
• A substantial increase in urea appearance rate (273%) was noted, signifying increased protein loss.

Conclusions:

• Corticosteroid therapy in children with newly diagnosed Crohn disease leads to a significant increase in whole-body protein breakdown and loss.
• These metabolic changes induced by corticosteroids may significantly impact body composition in pediatric Crohn disease patients.