Impact of pediatric inflammatory bowel disease on linear growth: Data from a national cohort study in Saudi Arabia

Mouzan, MohammadI El

doi:10.4103/1319-3767.191147

Cited by 7 publications

(14 citation statements)

References 5 publications

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“…Although most patients have delayed growth charts, published studies indicate that pediatric patients catch up and reach appropriate adult height levels [39]. Delay in treatment can result in stunted growth development secondary to chronic inflammation and malnutrition among other factors [40]. However, diagnosis of EO-IBD can be difficult.…”

Section: Clinical Presentation and Diagnosis Of Pediatric Ibdmentioning

confidence: 99%

Pediatric Inflammatory Bowel Disease: A Review of Immune Homeostasis and Genetics with an Emphasis on the IL-10 Pathway

Lin¹

2019

BJSTR

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Inflammatory bowel disease (IBD) is an auto-immune condition characterized by chronic gastrointestinal inflammation. The incidence of pediatric IBD, particularly the early onset disease subtypes, has been increasing internationally. In contrast to later-onset IBD, recent literature indicates that early-onset (between 3 -5 years) and very early-onset (between 0 -2 years) patients present with a more severe and aggressive disease. A comprehensive review of the literature indicates that the gut microbiome, which is heavily influenced in the early life, is reduced in IBD patients and hence plays a role in regulating gastrointestinal homeostasis. While many genes have been confirmed to be associated with IBD, only a portion of those genes have been shown to cause pediatric IBD.The IL-10/STAT3 pathway is a well-studied gene pathway as is, involved in maintaining immune homeostasis in both acute and chronic inflammation. Accumulating evidence indicates that IL-10/STAT3 pathway is a key player in pediatric IBD. New mutations identified within the IL-10 pathway have been shown to disrupt immune homeostasis and cause gastrointestinal inflammation. Furthermore, significant epistatic interactions have been demonstrated between different single-nucleotide polymorphisms of IL-10 genes suggesting that understanding gene interactions within the IL-10//STAT3 pathway may be key to understanding more about IBD pathogenesis. Heme oxygenase 1 (HO-1) is speculated to be regulated by the IL-10/STAT3 pathway and hence involved in pediatric IBD formation. This review aims to provide an overview of pediatric IBD and discuss the role of the gut microbiome, IL-10/STAT3 pathway, and HO-1 gene in modulating immune homeostasis in IBD pathogenesis.

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Section: Clinical Presentation and Diagnosis Of Pediatric Ibdmentioning

confidence: 99%

Pediatric Inflammatory Bowel Disease: A Review of Immune Homeostasis and Genetics with an Emphasis on the IL-10 Pathway

Lin¹

2019

BJSTR

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“…Inflammatory bowel disease (IBD) is a chronic, relapsing disease [1][2]. IBD is divided into three diseases: Crohn's disease (CD), ulcerative colitis (UC), and indeterminate colitis [1][2][3][4]. It may present at any age, including infancy [1,5].…”

Section: Introductionmentioning

confidence: 99%

“…Most patients with IBD presented around the age of pubertal growth spurt [6]. Linear growth impairment (LGI) is one of the complications of childhood IBD, and it is considered a significant aspect of the disease [3][4][7][8][9][10]. LGI has different synonyms.…”

Section: Introductionmentioning

confidence: 99%

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Linear Growth Impairment in Patients With Pediatric Inflammatory Bowel Disease

Isa¹,

Mohamed²,

Alahmed³

et al. 2022

Cureus

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IntroductionLinear growth impairment (LGI) is one of the complications of pediatric inflammatory bowel disease (IBD). This study aimed to assess the linear growth of patients with pediatric IBD and to detect the frequency and the possible risk factors of LGI. MethodsA retrospective cross-sectional review of medical records of patients with pediatric IBD was conducted in the pediatrics department, Salmaniya Medical Complex, Bahrain, from 1984 to 2019. Demographic and anthropometric data were gathered. World Health Organization (WHO) standards and references were used to define LGI. According to WHO, stunting and severe stunting were defined as length/height for age of <-2 standard deviations and <-3 standard deviations from age and sex-specific reference means, respectively. To determine the possible risk factors for LGI, stunted patients were compared with normal height patients in regard to demographic data, clinical presentations, and treatment used. ResultsOut of 130 patients with pediatric IBD, 88 (67.7%) had anthropometric data available. Fifty-five (62.5%) were males. Forty-seven (53.4%) had Crohn's disease and 41 (46.6%) had ulcerative colitis. The mean age at presentation was 10.7±3.8 years. The median age at the time of growth measurement was 14.2 (interquartile range=12.1-24.4) years. Fifteen (17%) patients were stunted, and seven (46.7%) of those stunted patients were severely stunted. Weight at presentation was lower in stunted patients (21.6±5.9 kilograms) compared to normal height patients (31±13.4 kilogram) (p=0.048). Sex, delivery type, birth weight, height at presentation, age at presentation, age at growth measurements, IBD type, disease duration, presence of extraintestinal manifestations, and prednisolone and biologic therapy use were not significant factors of stunting. ConclusionPatients with pediatric IBD have a high prevalence of LGI compared to the general population. Low weight at disease presentation is the only significant risk factor for LGI. This might indicate that IBD as a disease by itself is having the main negative impact on linear growth.

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“…Nearly 150 000 Canadians suffer from this condition, and notably, one of the highest incidences worldwide is in children aged <10 years and living in Ontario, Canada 3 4. Childhood-onset CD classically presents as a severe phenotype,7 with a potentially significant impairment on child and adolescent linear growths as a complication of undertreated inflammation 8 9. Children may experience poor nutrition and weight loss, frequent school absences and unpredictable flares involving bloody diarrhoea, severe abdominal pain and fatigue 5 6 10.…”

Section: Introductionmentioning

confidence: 99%

Protocol for a double-blind, randomised, placebo-controlled pilot study for assessing the feasibility and efficacy of faecal microbiota transplant in a paediatric Crohn’s disease population: PediCRaFT Trial

et al. 2019

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IntroductionCrohn’s disease (CD) is a chronic inflammatory condition with transmural involvement of the gastrointestinal tract. Extraintestinal manifestations are common, and the disease burden on patients and the healthcare system is significant. While treatment options have expanded in recent years, they have mainly focused on dampening the immune response, thus carrying notable risks associated with long-term immunosuppression. Faecal microbiota transplant (FMT) targets inflammatory bowel disease (IBD) by modifying intestinal dysbiosis. Limited adult and paediatric data have demonstrated a favourable response to FMT in IBD; however, no randomised controlled trial has yet been published in paediatrics. This double-blind, randomised, placebo-controlled pilot study will assess feasibility and efficacy outcomes of FMT in a paediatric CD population.Methods and analysisForty-five patients between the ages of 3 and 17 years, with established CD or IBD unclassified, will be enrolled 2:1 to undergo FMT intervention or placebo control. Participants will undergo a colonoscopic infusion to the terminal ileum at baseline, followed by oral capsules two times per week for 6 weeks. Outcomes will be measured throughout the intervention period and 18 weeks of subsequent follow-up. Primary outcomes will assess feasibility, including patient recruitment, sample collection and rates of adverse events. Secondary outcomes will address clinical efficacy, including change in clinical response, change in urine metabolome and change in microbiome.Ethics and disseminationEthics approval from the local hospital research ethics board was obtained at the primary site (McMaster Children’s Hospital, Hamilton), with ethics pending at the secondary site (Centre Hospitalier Universitaire-Sainte-Justine, Montréal). RBX7455 and RBX2660 are human donor-sourced, microbiota-based therapeutic formulations. Both RBX7455 and RBX2660 are currently undergoing clinical trials to support potential US Food and Drug Administration approval. Approval to conduct this paediatric clinical trial was obtained from Health Canada’s Biologics and Genetic Therapies Directorate. The results of this trial will be published in peer-reviewed journals and will help inform a large, multicentre trial in the future.Trial registration numberNCT03378167; pre-results.

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Impact of pediatric inflammatory bowel disease on linear growth: Data from a national cohort study in Saudi Arabia

Cited by 7 publications

References 5 publications

Pediatric Inflammatory Bowel Disease: A Review of Immune Homeostasis and Genetics with an Emphasis on the IL-10 Pathway

Pediatric Inflammatory Bowel Disease: A Review of Immune Homeostasis and Genetics with an Emphasis on the IL-10 Pathway

Linear Growth Impairment in Patients With Pediatric Inflammatory Bowel Disease

Protocol for a double-blind, randomised, placebo-controlled pilot study for assessing the feasibility and efficacy of faecal microbiota transplant in a paediatric Crohn’s disease population: PediCRaFT Trial

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