Hyperadiponectinemia During Infliximab Induction Therapy in Pediatric Crohn's Disease

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Abstract

Objectives:

The inflammatory process in Crohn's disease (CD) involves the visceral fat, characterized by adipocyte hyperplasia and altered adipose tissue and serum concentrations of TNF, leptin, adiponectin and resistin. We investigated the effect of anti-TNF therapy with infliximab (IFX) on serum adipokine levels in pediatric CD.

Methods:

Serum concentrations of resistin (ng/ml), leptin (ng/ml), and total adiponectin (μg/ml) were assessed by ELISA in 18 pediatric CD patients (mean age 15.0 ± 1.5 years) before 1st, 2nd and 4th IFX infusion (week 0, 2 and 14) and compared with baseline values from sex- and BMI-matched healthy controls (HC, mean age 13.4 ± 1.6 years).

Results:

At baseline CD patients (mean age 15.0 ± 1.5 years, 10/18 males) compared to HC (13.4 ± 1.6 years, 7/15 males) had higher resistin levels (median 14.7 ng/ml, range 5.1–50.5 vs. 7.3 ng/ml, 0.5–14.5) (p = 0.0002). At week 2 and 14 resistin decreased to 6.9 ng/ml (2.9–16.8) (p < 0.0001) and 9.2 ng/ml (4.1–20.6) (p = 0.0011), respectively. Leptin and adiponectin were comparable between patients and HC at baseline. Leptin increased in females from 9.5 ng/ml (4.0–30.1) to 16.0 ng/ml (7.9–35.2) (p = 0.0156) and 17.2 ng/ml (10.8- 26.8) (p = 0.1953) at week 0, 2 and 14 respectively; with a trend in males from 2.0 (0.6–12.9) to 2.8 (1.7–8.6) (p = 0.0840) and 3.3 (1.3–4.6) (p = 0.1309). Adiponectin peaked initially from 7.8 μg/ml (4.6–11.9) at week 0 to 9.2 μg/ml (4.1–20.7) (p = 0.0005) at week 2 and thereafter fell to 6.5 μg/ml (3.0–12.7) (p = 0.0182) at week 14.

Conclusions:

TNF blockade is associated with changes in circulating adipokines. The marked early increase of the potent anti-inflammatory adiponectin may contribute to the rapid response to IFX in CD.

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