Effects of infliximab and parenteral nutrition on albumin and fibrinogen synthesis rates in pediatric crohn disease

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Abstract

Objectives: Tumor necrosis factor-a (TNF-a) may play a significant role in growth disturbance in pediatric Crohn disease. The aim of this study was to determine the effects of anti-TNF-a therapy on albumin and fibrinogen synthesis during both fasting and parenteral nutrition infusion in pediatric patients with active Crohn disease. Patients and Methods: Children with active Crohn disease scheduled for their initial dose of infliximab underwent assessment immediately before and 2 weeks following infliximab infusion. Using the stable isotope [d5] phenylalanine, rates of fractional and absolute albumin and fibrinogen synthesis were calculated. Measurements were made in both the fasting and parenterally fed states. Results: Fifteen children (mean age 14.9±0.3) completed the study. The mean serum albumin changed from 3.59±0.08 to 3.66±0.04 g/dL, and the mean fibrinogen level decreased from 230±17 to 187±8 mg/dL (P<0.05) following infliximab therapy. During fasting, there were no changes in albumin and fibrinogen synthesis rates following infliximab. During parenteral nutrition infusion, the fractional albumin synthesis rate changed from 11.8% to 15.1%/day (P=0.06), and the absolute albumin synthesis rate increased from 192 to 248mg·kg -1·day -1 (P<0.05), whereas no changes in fibrinogen synthesis rates were observed. Synthesis rates of albumin and fibrinogen were increased during parenteralnutrition infusion compared with the fasting state. Conclusions: Following infliximab therapy, during parenteral nutrition infusion, albumin synthesis increased significantly. Conversely, serum fibrinogen levels decreased following infliximab therapy in the absence of significant change in synthesis rates.

Original languageEnglish
Pages (from-to)579-584
Number of pages6
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume47
Issue number5
DOIs
StatePublished - Nov 2008

Fingerprint

Parenteral Nutrition
Fibrinogen
Albumins
Parenteral Infusions
Fasting
Crohn Disease
Tumor Necrosis Factor-alpha
Therapeutics
Pediatric Crohn's disease
Infliximab
Phenylalanine
Serum Albumin
Isotopes
Pediatrics
Growth
Serum

Keywords

  • α
  • Albumin
  • Crohn disease
  • Fibrinogen
  • Infliximab
  • Tumor necrosis factor

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health

Cite this

@article{b629ca0b48474fc3b1ed54cee9e27cfe,
title = "Effects of infliximab and parenteral nutrition on albumin and fibrinogen synthesis rates in pediatric crohn disease",
abstract = "Objectives: Tumor necrosis factor-a (TNF-a) may play a significant role in growth disturbance in pediatric Crohn disease. The aim of this study was to determine the effects of anti-TNF-a therapy on albumin and fibrinogen synthesis during both fasting and parenteral nutrition infusion in pediatric patients with active Crohn disease. Patients and Methods: Children with active Crohn disease scheduled for their initial dose of infliximab underwent assessment immediately before and 2 weeks following infliximab infusion. Using the stable isotope [d5] phenylalanine, rates of fractional and absolute albumin and fibrinogen synthesis were calculated. Measurements were made in both the fasting and parenterally fed states. Results: Fifteen children (mean age 14.9±0.3) completed the study. The mean serum albumin changed from 3.59±0.08 to 3.66±0.04 g/dL, and the mean fibrinogen level decreased from 230±17 to 187±8 mg/dL (P<0.05) following infliximab therapy. During fasting, there were no changes in albumin and fibrinogen synthesis rates following infliximab. During parenteral nutrition infusion, the fractional albumin synthesis rate changed from 11.8{\%} to 15.1{\%}/day (P=0.06), and the absolute albumin synthesis rate increased from 192 to 248mg·kg -1·day -1 (P<0.05), whereas no changes in fibrinogen synthesis rates were observed. Synthesis rates of albumin and fibrinogen were increased during parenteralnutrition infusion compared with the fasting state. Conclusions: Following infliximab therapy, during parenteral nutrition infusion, albumin synthesis increased significantly. Conversely, serum fibrinogen levels decreased following infliximab therapy in the absence of significant change in synthesis rates.",
keywords = "α, Albumin, Crohn disease, Fibrinogen, Infliximab, Tumor necrosis factor",
author = "Steven Steiner and Marian Pfefferkorn and Fitzgerald, {Joseph F.} and Scott Denne",
year = "2008",
month = "11",
doi = "10.1097/MPG.0b013e3181653a89",
language = "English",
volume = "47",
pages = "579--584",
journal = "Journal of Pediatric Gastroenterology and Nutrition",
issn = "0277-2116",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Effects of infliximab and parenteral nutrition on albumin and fibrinogen synthesis rates in pediatric crohn disease

AU - Steiner, Steven

AU - Pfefferkorn, Marian

AU - Fitzgerald, Joseph F.

AU - Denne, Scott

PY - 2008/11

Y1 - 2008/11

N2 - Objectives: Tumor necrosis factor-a (TNF-a) may play a significant role in growth disturbance in pediatric Crohn disease. The aim of this study was to determine the effects of anti-TNF-a therapy on albumin and fibrinogen synthesis during both fasting and parenteral nutrition infusion in pediatric patients with active Crohn disease. Patients and Methods: Children with active Crohn disease scheduled for their initial dose of infliximab underwent assessment immediately before and 2 weeks following infliximab infusion. Using the stable isotope [d5] phenylalanine, rates of fractional and absolute albumin and fibrinogen synthesis were calculated. Measurements were made in both the fasting and parenterally fed states. Results: Fifteen children (mean age 14.9±0.3) completed the study. The mean serum albumin changed from 3.59±0.08 to 3.66±0.04 g/dL, and the mean fibrinogen level decreased from 230±17 to 187±8 mg/dL (P<0.05) following infliximab therapy. During fasting, there were no changes in albumin and fibrinogen synthesis rates following infliximab. During parenteral nutrition infusion, the fractional albumin synthesis rate changed from 11.8% to 15.1%/day (P=0.06), and the absolute albumin synthesis rate increased from 192 to 248mg·kg -1·day -1 (P<0.05), whereas no changes in fibrinogen synthesis rates were observed. Synthesis rates of albumin and fibrinogen were increased during parenteralnutrition infusion compared with the fasting state. Conclusions: Following infliximab therapy, during parenteral nutrition infusion, albumin synthesis increased significantly. Conversely, serum fibrinogen levels decreased following infliximab therapy in the absence of significant change in synthesis rates.

AB - Objectives: Tumor necrosis factor-a (TNF-a) may play a significant role in growth disturbance in pediatric Crohn disease. The aim of this study was to determine the effects of anti-TNF-a therapy on albumin and fibrinogen synthesis during both fasting and parenteral nutrition infusion in pediatric patients with active Crohn disease. Patients and Methods: Children with active Crohn disease scheduled for their initial dose of infliximab underwent assessment immediately before and 2 weeks following infliximab infusion. Using the stable isotope [d5] phenylalanine, rates of fractional and absolute albumin and fibrinogen synthesis were calculated. Measurements were made in both the fasting and parenterally fed states. Results: Fifteen children (mean age 14.9±0.3) completed the study. The mean serum albumin changed from 3.59±0.08 to 3.66±0.04 g/dL, and the mean fibrinogen level decreased from 230±17 to 187±8 mg/dL (P<0.05) following infliximab therapy. During fasting, there were no changes in albumin and fibrinogen synthesis rates following infliximab. During parenteral nutrition infusion, the fractional albumin synthesis rate changed from 11.8% to 15.1%/day (P=0.06), and the absolute albumin synthesis rate increased from 192 to 248mg·kg -1·day -1 (P<0.05), whereas no changes in fibrinogen synthesis rates were observed. Synthesis rates of albumin and fibrinogen were increased during parenteralnutrition infusion compared with the fasting state. Conclusions: Following infliximab therapy, during parenteral nutrition infusion, albumin synthesis increased significantly. Conversely, serum fibrinogen levels decreased following infliximab therapy in the absence of significant change in synthesis rates.

KW - α

KW - Albumin

KW - Crohn disease

KW - Fibrinogen

KW - Infliximab

KW - Tumor necrosis factor

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DO - 10.1097/MPG.0b013e3181653a89

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C2 - 18979581

AN - SCOPUS:59849111080

VL - 47

SP - 579

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JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

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