De Pascalis B, Bianchi A, Satta M A, Lupascu A, Mentella M C, Leo D, Fiore F, Fedeli P, Pontecorvi A, Pola P, Melina D, Gasbarrini A, De Marinis L, Armuzzi A
Department of Internal Medicine, Catholic University, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2006 Jan-Feb;10(1):13-6.
Crohn's disease and ulcerative colitis are inflammatory diseases of the gastrointestinal tract characterized by chronic relapsing inflammation and catabolism. Growth hormone/insulin-like growth factor-I axis is important in inflammatory bowel disease, because of the effects on epithelial cell kinetics, collagen deposition and immunomodulation. The potential of growth hormone as a therapeutic option in inflammatory bowel disease has been proven in various clinical settings. Acquired growth hormone resistance in inflammatory bowel disease seems to be mediated by a combination of undernutrition and active inflammation. In particular, proinflammatory cytokines, such as TNF-a and interleukin-6, have been implicated as potential mediators of growth hormone resistance. The introduction of anti-TNF-alpha monoclonal antibodies has proven very efficacious in patients with inflammatory bowel disease. By reducing cytokines levels in inflammatory cells of intestinal mucosa, infliximab could interfere with cytokine-induced growth hormone resistance. Recent in vivo data have shown that acquired growth hormone resistance in patients with inflammatory bowel disease may be reversed after the administration of anti-TNF-alpha therapy.
克罗恩病和溃疡性结肠炎是胃肠道的炎症性疾病，其特征为慢性复发性炎症和分解代谢。生长激素/胰岛素样生长因子-I轴在炎症性肠病中很重要，因为它对上皮细胞动力学、胶原蛋白沉积和免疫调节有影响。生长激素作为炎症性肠病治疗选择的潜力已在各种临床环境中得到证实。炎症性肠病中获得性生长激素抵抗似乎是由营养不良和活动性炎症共同介导的。特别是，促炎细胞因子，如肿瘤坏死因子-α和白细胞介素-6，被认为是生长激素抵抗的潜在介质。抗TNF-α单克隆抗体的引入已被证明对炎症性肠病患者非常有效。通过降低肠黏膜炎症细胞中的细胞因子水平，英夫利昔单抗可能会干扰细胞因子诱导的生长激素抵抗。最近的体内数据表明，炎症性肠病患者的获得性生长激素抵抗在接受抗TNF-α治疗后可能会逆转。
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