Infliximab effect on serum IGF-1 and IGFBP-3 in active inflammatory bowel disease
Katsanos1, A. Tsatsoulis2, V. Cholevas3, Anna Challa3, E.V. Tsianos1, K.H.
AIM: There are few studies that have investigated the
changes of the insulin-like growth factor (IGF) system in
inflammatory bowel disease (IBD) and the majority of these
studies have examined the alterations of the GH-IGF axis
in growth-retarded IBD children. Moreover, the impact of
the chimeric monoclonal anti-TNFá antibody (Infliximab)
in the IGF system in patients with Crohns disease (CD) or
ulcerative colitis (UC) has not yet been investigated.
PATIENTS-METHOD: Five IBD patients (3 with Crohns
and 2 with ulcerative colitis) and five age and sex matched
controls were included in this study. In all patients and
controls a baseline serum sample for IFG-1, IGFBP-3 and
IL-6 was obtained one week before Infliximab treatment
initiation. During the first four times of Infliximab administration
morning fasting serum samples were obtained
from each patient. At the same time, fasting morning control
samples were also obtained.
RESULTS: Short-term effect of infliximab administration
(baseline-1st dose comparison) resulted in a statistically
significant increase in serum IGFBP-3 levels (p=0.39) while
no statistically significant change was noticed in IL-6 and
IGF-1 levels. After four doses of Infliximab (long term effect,
baseline-4th dose comparison) a statistically significant
increase in serum IGF-1 and IGFBP-3 levels was noticed
(p=0.02 in both parameters) while IL-6 was decreased to a
statistically significant exlent (p=0.01).
DISCUSSION: This study demonstrated that Infliximab
can influence the IGF system in IBD patients. This increase
of serum IGF-1 and IGFBP-3 with concomitant decrease in
IL-6, may represent a probable mechanism through which
this drug acts in these patients, in whom there is a evidence
of an impaired GH/IGF axis.
Key words: inflammatory bowel disease, ulcerative colitis,
Crohns disease, infliximab, IGF system, interleukin