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Pathophysiology and management of abnormal growth in children with chronic inflammatory bowel disease
S F Ahmed1, C Farquharson, P McGrogan
1Royal Hospital for Sick Children, University of Glasgow, Glasgow, UK. faisal.ahmed@glasgow.ac.uk
Insights
Chronic inflammation in children with diseases like inflammatory bowel disease can cause growth retardation by affecting the growth hormone/IGF-1 axis. Understanding this axis is key to developing better growth therapies.
Area of Science:
- Pediatric Endocrinology
- Pediatric Gastroenterology
- Chronic Inflammation Research
Background:
- Children with chronic diseases often experience inflammation and growth retardation.
- Growth is regulated by the growth hormone/IGF-1 axis, influenced by factors like sex steroids.
- This axis is increasingly recognized as affected in pediatric chronic inflammation.
Purpose of the Study:
- To review the pathophysiology of growth retardation in pediatric inflammatory bowel disease.
- To explore how chronic inflammation impacts the GH/IGF-1 axis.
- To identify potential therapeutic interventions for improving growth in affected children.
Main Methods:
- Literature review focusing on growth hormone/IGF-1 axis in chronic inflammation.
- Analysis of multifactorial causes of growth retardation, including nutrition and medications (e.g., glucocorticoids).
- Concentration on inflammatory bowel disease as a primary example.
Main Results:
- Chronic inflammation and associated factors (nutrition, medications) contribute to growth retardation.
- The GH/IGF-1 axis is demonstrably affected in children with chronic inflammatory conditions.
- Optimal disease management alone may not resolve growth issues in all children.
Conclusions:
- Understanding the GH/IGF-1 axis in chronic inflammation is crucial for targeted growth therapies.
- Interventions aimed at modulating the GH/IGF-1 axis may improve growth outcomes.
- Further research is needed to optimize therapeutic strategies for growth failure in pediatric chronic diseases.
Abstract:
Many children with a variety of chronic diseases suffer from a variable component of chronic inflammation and often have co-existing growth retardation. The aetiology of this growth retardation may be multifactorial and in a condition such as inflammatory bowel disease it includes the effects of the disease on nutrition as well as the effect of drugs such as glucocorticoids. Growth is primarily regulated through the endocrine and paracrine component of the GH/IGF-1 axis which may be modulated by other factors such as sex steroids. There is increasing evidence that this axis may be affected in children with chronic inflammation. An improved understanding of the GH/IGF-1 axis and how it is affected in chronic inflammation will lead to an improved rationale for developing therapeutic regimens that can improve growth in those children whose growth does not improve despite optimal management of the disease. This review will illustrate these aspects by concentrating primarily on the pathophysiology of growth retardation in inflammatory bowel disease and possible interventions for improving growth.
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