scholarly journals Improvements in Bone Density and Structure during Anti-TNF-α Therapy in Pediatric Crohn's Disease

2015 ◽  
Vol 100 (7) ◽  
pp. 2630-2639 ◽  
Author(s):  
Lindsay M. Griffin ◽  
Meena Thayu ◽  
Robert N. Baldassano ◽  
Mark D. DeBoer ◽  
Babette S. Zemel ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Bone Density ◽  
Crohn's Disease ◽  
Bone Formation ◽  
Cortical Area ◽  
Mineral Density ◽  
Muscle Area ◽  
Cortical Structure ◽  
Tnf Α ◽  
Z Scores

Context: Pediatric Crohn's Disease (CD) is associated with deficits in trabecular bone mineral density (BMD) and cortical structure, potentially related to TNF-α effects to decrease bone formation and promote bone resorption. Objective: This study aimed to examine changes in bone density and structure in children and adolescents with CD following initiation of anti-TNF-α therapy. Design and Participants: Participants (n = 74; age 5–21 years) with CD completed a 12-month prospective cohort study. Main Outcome Measures: Tibia peripheral quantitative computed tomography scans were obtained at initiation of anti-TNF-α therapy and 12 months later. Musculoskeletal outcomes were expressed as sex-and race-specific z scores relative to age, based on >650 reference participants. Results: At baseline, CD participants had lower height, trabecular BMD, cortical area (due to smaller periosteal and larger endocortical circumferences), and muscle area z scores, compared with reference participants (all P < .01). Pediatric CD activity index decreased during the 10-week induction (P < .001), in association with subsequent gains in height, trabecular BMD, cortical area (due to recovery of endocortical bone), and muscle area z scores over 12 months (height P < .05; others P < .001). Bone-specific alkaline phosphatase levels, a biomarker of bone formation, increased a median of 75% (P < .001) during induction with associated 12-month improvements in trabecular BMD and cortical area z scores (both P < .001). Younger age was associated with greater increases in trabecular BMD z scores (P < .001) and greater linear growth with greater recovery of cortical area (P < .001). Conclusions: Anti-TNF-α therapy was associated with improvements in trabecular BMD and cortical structure. Improvements were greater in younger and growing participants, suggesting a window of opportunity for treatment of bone deficits.

Erythrocyte sedimentation rate as an osteoporosis risk factor in patients with active Crohn’s disease

2009 ◽  
Vol 18 (03) ◽  
pp. 209-216 ◽  
Author(s):  
J. Cortis ◽  
Ch. Claus ◽  
M. Funke ◽  
W. Nolte ◽  
M. Hü fner ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bone Formation ◽  
Erythrocyte Sedimentation Rate ◽  
Bone Mineral ◽  
Sedimentation Rate ◽  
Inflammatory Process ◽  
Mineral Density ◽  
Erythrocyte Sedimentation

SummaryCrohn’s disease (CD) is associated with reduced bone mineral density and increased fracture risk. To assess the effects of the inflammatory process itself on bone parameters, we investigated patients with active CD and in remission without glucocorticoid treatment four weeks prior to analysis. Patients with active CD were compared to age-and sex-matched healthy volunteers and osteoporosis patients. Bone mineral density, bone formation and resorption markers were assessed, in addition to simple inflammatory markers and cytokines. Out of seven patients with active disease, three had osteopenia and one osteoporosis (WHO definition). The erythrocyte sedimentation rate (ESR) was associated with BMD at the femoral neck (R2 = 0.853, p < 0.01) and the spine (R2 = 0.772, p < 0.05). ESR seems to influence bone formation, as shown by lower bone alkaline phosphatase with high ESR (R2 = 0.725, R = – 0.852, p < 0.05). The clinical disease activity score was not useful in determining patients’ risk of acquiring bone disease. In conclusion, in patients with Crohn’s disease, the degree of the inflammatory process as assessed by ESR indicates bone loss and might be of value in identifying patients at risk of developing osteoporosis.

scholarly journals Prevalent hypovitaminosis D in Crohn´s disease correlates highly with mediators of osteoimmunology

2014 ◽  
Vol 37 (3) ◽  
Author(s):  
Nikša Turk ◽  
Zdenka Turk
Keyword(s):  
Bone Mineral Density ◽  
Ulcerative Colitis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bone Mineral ◽  
Bone Disease ◽  
Odds Ratio ◽  
Mineral Density ◽  
Tnf Α ◽  
Significant Difference

Purpose: In the context of osteoimmunology in Crohn's disease, an association was hypothesized among vitamin D and members of the TNF-α family, known as the RANK (receptor-activator of nuclear factor- κB)-RANK ligand-osteoprotegerin pathway. Methods:This was a cross-sectional study of 95 patients with Crohn’s disease (80 with long-standing disease and 15 newly diagnosed, never treated) and two control groups (healthy volunteers, n=30; and ulcerative colitis patients, n=30). Spine and hip bone mineral density was measured by dual-energy x-ray absorptiometry. Serum 25-hydroxyvitamin-D3, TNF-α, IL-6, sRANKL, osteoprotegerin levels and biochemical markers of bone turnover were analyzed. Results: The precursor metabolite, 25(OH)D3, was measured in 95 young adult CD patients (47 men, 48 women; median age 30 years). A suboptimal 25(OH)D3 level was observed in 90% of CD patients, of whom 40% had a serious deficiency. There was no significant difference in 25(OH)D3 levels between CD patients and those with ulcerative colitis. Analysis revealed an association between 25(OH)D3 deficiency and the increased biogenesis of osteoclastically-active sRANKL (p=0.014) and the proinflammatory cytokines TNF-α (p=0.015) and IL-6 (p=0.029) . CD patients with low bone mineral density had a mean 25(OH)D3 (35±18 nmol/l) in the range of serious deficiency to insufficiency, whereas mean 25(OH)D3 was higher (49±28 nmol/l) in patients with healthy bone status, although levels were still inadequate (p=0.004). The logistic model reported low levels of 25(OH)D3 to be a significant predictor of bone disease [odds ratio=2.66(6.8), p < 0.009]. In the multivariable analysis, adjusted for several confounding factors, 25(OH)D3, sRANKL, IL-6 and TNF-α were independently associated with a likelihood of bone disease [odds ratio (range): 1.02(2.75); 1.09(3.71); 1.27(6.95) respectively, p=0.001]. Conclusion: The presented findings suggest that a 25(OH)D3 deficiency accompanying an inflammatory state in CD is a high risk condition for metabolic bone disease.

THE EVALUATION OF SERUM SEROTONIN LEVEL AMONG PATIENTS WITH CROHN’S DISEASE AND ITS IMPACT ON QUALITY OF LIFE

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S55-S55
Author(s):  
Marcin Sochal ◽  
Piotr Bialasiewicz ◽  
Agata Gabryelska ◽  
Renata Talar-Wojnarowska ◽  
Jakub Fichna ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Sleep Quality ◽  
Sleep Fragmentation ◽  
Clinical Severity ◽  
Serotonin Level ◽  
Intestinal Physiology ◽  
Tnf Α

Abstract Background and aims Serotonin affects intestinal physiology, mood, as well as circadian rhythm. Moreover, serotonin has proinflammatory function. Therefore, the aim of this study was to investigate the role of serotonin in clinical severity of Crohn’s Disease (CD) and its effect on pain and sleep quality. Methods Fifty-nine CD patients (34 in exacerbation and 25 in remission according to the Harvey-Bradshaw Index-HBI) and 25 health control individuals(HC) were recruited. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI) and subjective severity of pain by the Visual Analog Scale (VAS). Seventeen patients were treated with anti-TNF-α induction therapy for 14 weeks. Results Serotonin level was higher in CD (145.12ng/mL, IQR:98.14–179.25) compared to HC (87.52ng/mL, IQR:70.04–129.39; p=0.002) and in exacerbation of CD (157.66ng/mL, IQR:111.94–197.64) compared to remission (122.33ng/mL, IQR:83.28–163.67; p=0.029). Serotonin level with cut-off point of 92.45 ng/mL is useful for distinguishing participants with CD from HC (sensitivity: 78%, specificity: 60%, positive predictive value: 82%). Positive correlation between serotonin and HBI (r=0.279, p=0.032) and severity of diarrhoea (r=0.260, p=0.047) were found. Serotonin does not correlate with PSQI (r=0.152, p=0.168), but correlates with presence of sleep fragmentation for example by getting up to use the bathroom (joined 5b-5j PSQI questions; r=0.270, p=0.039). Correlations between serotonin and VAS were also obtained (r=0.220, p=0.045). Moreover, serotonin level significantly decreased after anti-TNF-α therapy (192.35ng/mL, IQR:150.36–225.56 vs. 121.11ng/mL, IQR:91.28–188.87; p=0.006). The study was funded by National Science Centre, Poland (#2018/31/N/NZ5/03715). Conclusions Serotonin level correlates with the severity of CD and decreases after anti-TNF-α therapy. It is associated with sleep fragmentation, which may be caused by diarrhea.

Intravenous pamidronate increases bone density in patients with Crohn's disease

2003 ◽  
Vol 124 (4) ◽  
pp. A198
Author(s):  
Jerry McGrath ◽  
Richmond G. Sy ◽  
Harold G. Preiksaitis ◽  
Lisanne G. Laurier
Keyword(s):  
Crohn’S Disease ◽  
Bone Density ◽  
Crohn's Disease ◽  
Intravenous Pamidronate

Patient outcomes after anti TNF-α drugs for Crohn’s disease

2010 ◽  
Vol 10 (2) ◽  
pp. 163-175 ◽  
Author(s):  
Nazila Assasi ◽  
Gord Blackhouse ◽  
Feng Xie ◽  
John K Marshall ◽  
E Jan Irvine ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Patient Outcomes ◽  
Tnf Α

Bone mineral density in relation to efficacy and side effects of budesonide and prednisolone in Crohn’s disease

2005 ◽  
Vol 3 (2) ◽  
pp. 113-121 ◽  
Author(s):  
Erik J. Schoon ◽  
Simona Bollani ◽  
Peter R. Mills ◽  
Eran Israeli ◽  
Dieter Felsenberg ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Crohn’S Disease ◽  
Side Effects ◽  
Crohn's Disease ◽  
Bone Mineral ◽  
Mineral Density

Meta-analysis: polymorphisms in TNF-α gene promoter and Crohn’s disease

2010 ◽  
Vol 32 (2) ◽  
pp. 159-170 ◽  
Author(s):  
Z. Han ◽  
C. Li ◽  
S. Han ◽  
Y. Han ◽  
J. Qiu ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Meta Analysis ◽  
Gene Promoter ◽  
Tnf Α
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