The effect of acute and chronic stress on growth

Lars Sävendahl1

  • 1Department of Women's and Children's Health, Karolinska Institutet, Stockholm SE-17176, Sweden. lars.savendahl@ki.se

Science Signaling
|October 25, 2012
PubMed

Insights

Stress impairs bone growth in children by affecting the growth plate via inflammation and cortisol. Treatments like immunomodulatory therapy and growth hormone (GH) show promise but require further study for optimal outcomes.

Area of Science:

  • Pediatric endocrinology
  • Inflammation and bone biology
  • Growth disorders

Background:

  • Stress in children can lead to impaired bone growth, with the growth plate being a key target.
  • Mechanisms include elevated proinflammatory cytokines, cortisol, and disrupted growth hormone (GH)-insulin-like growth factor-1 (IGF-1) axis.
  • Glucocorticoids and cytokines negatively impact chondrogenesis, with local IGF-1 offering partial amelioration.

Purpose of the Study:

  • To investigate the impact of stress on bone growth in children.
  • To evaluate the effectiveness of current and potential therapeutic strategies for stress-related growth impairment.
  • To explore novel treatments for children unresponsive to conventional therapies.

Main Methods:

  • Review of mechanisms by which stress affects the growth plate, including hormonal and inflammatory pathways.
  • Analysis of the role of glucocorticoids, proinflammatory cytokines, and the GH-IGF-1 axis in chondrogenesis.
  • Examination of therapeutic interventions such as glucocorticoid use, immunomodulatory agents (anti-TNFα), and GH therapy in conditions like juvenile idiopathic arthritis (JIA).

Main Results:

  • Glucocorticoids and proinflammatory cytokines impair chondrogenesis, but local IGF-1 can partially improve these effects.
  • Disease control and judicious glucocorticoid use are crucial for managing stress-impaired growth in chronic inflammation.
  • Anti-TNFα therapy partially restores linear growth in some JIA patients; GH intervention may benefit some non-responders.

Conclusions:

  • While current therapies like immunomodulatory agents and GH show potential, they do not completely normalize growth in all cases.
  • Further research is needed to understand if GH can rescue growth in patients unresponsive to anticytokine therapy.
  • Exploring new treatment strategies is essential for improving bone growth in children with stress-related growth impairment who do not respond to conventional treatments.

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