PMID- 17243138
OWN - NLM
STAT- MEDLINE
DCOM- 20070822
LR  - 20180913
IS  - 1078-0998 (Print)
IS  - 1078-0998 (Linking)
VI  - 13
IP  - 6
DP  - 2007 Jun
TI  - Protein and energy metabolism response to the initial dose of infliximab in 
      children with Crohn's disease.
PG  - 737-44
AB  - BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha) may contribute to the 
      alterations in protein and energy metabolism present in children with Crohn's 
      disease (CD), who frequently suffer from growth disturbance. We hypothesized that 
      anti-TNF-alpha therapy would reduce protein losses, due to decreased proteolysis 
      and increased protein synthesis, and that anti-TNF-alpha therapy would decrease 
      resting energy expenditure. METHODS: Children with active CD underwent metabolic 
      assessment immediately before and 2 weeks following initial infliximab infusion. 
      Using the stable isotopes [d5] phenylalanine and [1-13C] leucine, 2 independent 
      measures of protein metabolism were determined during fasting and in response to 
      parenteral nutrition. Energy expenditure, determined by indirect calorimetry, was 
      measured in fasting and parenterally fed states. RESULTS: Fifteen children 
      completed the study. Following infliximab therapy, significant reductions in 
      proteolysis (P < 0.05) were noted in the fasting state (8%-11%) and during 
      parenteral nutrition infusion (10%-12%). Phenylalanine utilization for protein 
      synthesis decreased significantly (8%-13%) following infliximab (P < 0.05). 
      Protein balance was not significantly altered. No significant changes in energy 
      expenditure were observed following infliximab in fasting or parenterally fed 
      states. Supplementation with parenteral nutrition resulted in significantly 
      decreased proteolysis (8%-21%; P < 0.05), increased protein synthesis (37%-45%; P 
      < 0.01), and improved protein balance (P < 0.01) compared to the fasting state. 
      CONCLUSIONS: Following the initial infliximab infusion in children with CD, 
      proteolysis and protein synthesis were significantly reduced in the fasting and 
      parenterally fed states. Supplementation with parenteral nutrition resulted in 
      significant improvements in protein metabolism compared to the fasting state both 
      before and after infliximab therapy.
FAU - Steiner, Steven J
AU  - Steiner SJ
AD  - Division of Pediatric Gastroenterology/Hepatology/Nutrition, James Whitcomb Riley 
      Hospital for Children, Indiana University School of Medicine, Indianapolis, 
      Indiana 46202, USA. ssteiner@iupui.edu
FAU - Pfefferkorn, Marian D
AU  - Pfefferkorn MD
FAU - Fitzgerald, Joseph F
AU  - Fitzgerald JF
FAU - Denne, Scott C
AU  - Denne SC
LA  - eng
GR  - M01 RR000750/RR/NCRR NIH HHS/United States
GR  - R01 HD29153/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - England
TA  - Inflamm Bowel Dis
JT  - Inflammatory bowel diseases
JID - 9508162
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Carbon Isotopes)
RN  - 47E5O17Y3R (Phenylalanine)
RN  - B72HH48FLU (Infliximab)
RN  - GMW67QNF9C (Leucine)
SB  - IM
MH  - Adolescent
MH  - Anti-Inflammatory Agents/*administration & dosage
MH  - Antibodies, Monoclonal/*administration & dosage
MH  - Calorimetry, Indirect
MH  - Carbon Isotopes
MH  - Child
MH  - Crohn Disease/*blood/*drug therapy
MH  - Energy Metabolism/*drug effects
MH  - Fasting/blood
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Infliximab
MH  - Infusions, Intravenous
MH  - Leucine/*blood
MH  - Male
MH  - Phenylalanine/*blood
MH  - Prospective Studies
MH  - Treatment Outcome
EDAT- 2007/01/24 09:00
MHDA- 2007/08/23 09:00
CRDT- 2007/01/24 09:00
PHST- 2007/01/24 09:00 [pubmed]
PHST- 2007/08/23 09:00 [medline]
PHST- 2007/01/24 09:00 [entrez]
AID - 10.1002/ibd.20102 [doi]
PST - ppublish
SO  - Inflamm Bowel Dis. 2007 Jun;13(6):737-44. doi: 10.1002/ibd.20102.