Naslov
Inflammation is the main determinant of bone loss in naive patients with Crohn disease

Autori
Turk, Nikša ; Čuković-Čavka, Silvija ; Koršić, Mirko ; Turk, Zdenka ; Vucelić, Boris

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstracts / Gastroenterology (New York, N.Y. 1943) Issue 4 Supplement 1 / - , 2008, A512-A512

Skup
AGA Institute and Digestive Disease Week 2008

Mjesto i datum
San Diego (CA), Sjedinjene Američke Države, 17.05.2008. - 22.05.2008

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Crohn's disease; Metabolic bone disease; Proinflammatory cytokines; Receptor activator of nuclear factor κ B-ligand; Osteoprotegerin

Sažetak
Background/Aim The high incidence of bone disease and increasing evidence for Crohn disease affecting bone in corticosteroid users and non-users suggest that bone metabolism is affected by inflammatory process. As the biogenesis of receptor activator of nuclear factor &#954; B-ligand (RANKL) and its decoy receptor osteoprotegerin (OPG) may be a consequence of intestinal inflammation and because this signal pathway is shared between the immune and bone system, we hypothesized that the action of sRANKL, OPG and other inflammatory cytokines is not limited to the induction of local inflammation but might be directly or indirectly involved in the activation of bone metabolism. This study aimed to determine comparative serum levels of proinflammatory cytokines, markers of bone formation and resorption, and regulatory molecules of osteoclast biogenesis, in na&iuml ; ; ve and long-standing patients with Crohn disease. Patients and Methods The study included 95 patients, 15 of them newly diagnosed and untreated. Serum sRANKL, OPG, TNF-&#945; , IL-1&#946; , IL-6, osteocalcin and C-telopeptide I were measured by immunoassay. The spine and total hip bone mineral density (BMD) was measured by DXA. Results Decreased BMD at diagnosis was found in 53% and low bone mass in 72% of the study population. The newly diagnosed, untreated patients showed correlation between TNF-&#945; and sRANKL (r=0.6 ; p=0.027), and this positive relationship characterized the study population as a whole (r=0.5 ; p=0.002). Multiple regression identified TNF-&#945; as the best predictor of sRANKL (p<0.001). Patients with increased parameter of bone resorption were characterized by elevation of TNF-&#945; , IL-6, CRP and OPG in systemic circulation. Analysis of the OPG and sRANKL relationship according to subgroups showed absence of correlation in patients with healthy skeleton, and an inverse relationship in those with pathologic BMD (r=-0.36 ; p=0.003). In newly diagnosed patients with BMD t-score&#8804; -1.0, the correlation between sRANKL and OPG was highly inverse (r=-0.8 ; p=0.02). Conclusion Bone disease that accompanies Crohn disease at diagnosis in previously untreated patients suggests that bone metabolism is affected by the underlying inflammatory process per se, as probably confirmed by our finding that the central proinflammatory cytokine TNF-&#945; was strongly associated with the osteoclastogenic mediator RANKL.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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