Inflammatory Diseases and Growth: Effects on the GH-IGF Axis and on Growth Plate

Area of Science:

• Pediatric Endocrinology
• Immunology
• Developmental Biology

Background:

• Chronic inflammatory diseases in childhood, such as cystic fibrosis (CF), inflammatory bowel diseases (IBDs), juvenile idiopathic arthritis (JIA), and intrauterine growth restriction (IUGR), are associated with significant physiological changes.
• These conditions can manifest alterations in the placenta and cord blood, suggesting an early impact on fetal development and subsequent growth.

Purpose of the Study:

• To review the common chronic inflammatory diseases in childhood.
• To describe the associated changes in the placenta and cord blood.
• To elucidate the mechanisms linking inflammation to growth failure, including hormonal and epigenetic factors.

Main Methods:

• Literature review of studies on childhood chronic inflammatory diseases.
• Analysis of reported changes in placental and cord blood parameters.
• Examination of the roles of growth hormone (GH), insulin-like growth factor (IGF) system, nuclear factor-κB (NF-κB), pro-inflammatory cytokines, growth plate, and microRNAs (miRNAs).

Main Results:

• Chronic inflammation in childhood is linked to alterations in GH secretion, GH resistance, and the IGF system.
• Increased nuclear factor-κB (NF-κB) and pro-inflammatory cytokines are implicated in these growth-related changes.
• Changes in the growth plate and a potential role for microRNAs (miRNAs) in epigenetic modifications associated with chronic inflammation were observed.

Conclusions:

• Multiple mechanisms contribute to growth failure in children with chronic inflammatory diseases.
• The interplay between inflammation, hormonal regulation, and epigenetic factors is crucial.
• Further research is warranted to fully understand and address growth impairment in these pediatric conditions.