Infliximab reverses inflammatory muscle wasting (sarcopenia) in Crohn's disease
Date
2015
Authors
Subramaniam, Kavitha
Fallon, Kieran
Ruut, Tom
Lane, D
McKay, R.
Shadbolt, Bruce
Ang, S.
Cook, Matthew
Platten, J.
Pavli, Paul
Journal Title
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Volume Title
Publisher
Wiley-Blackwell
Abstract
Background
Muscle wasting or sarcopenia arising from chronic inflammation is found in 60% of patients with Crohn's disease. Transcriptional protein NF-κB reduces muscle formation through MyoD transcription and increases muscle breakdown by proteolysis.
Aim
As TNF is a potent activator of NF-κB, and anti-TNF agent infliximab (IFX) prevents NF-κB activation, to determine whether or not Crohn's patients treated with IFX gain muscle volume and strength.
Methods
We performed a prospective, repeated-measures cohort study in adult Crohn's disease patients with an acute disease flare. Patients were instructed not to vary diet or activity. Concomitant medications were kept stable. At week 1 (pre-treatment), week 16 (post-IFX induction) and week 25 (post-first IFX maintenance dose), we assessed (i) MRI volume of quadriceps femoris at anatomical mid-thigh; (ii) maximal concentric quadriceps contractions strength at three specific speeds of contraction; (iii) physical activity by validated instrument (IPAQ); (iv) Three-day food record of intake and composition (food-weighing method); (v) Serum levels of IL6.
Results
Nineteen patients (58% female; mean age 33.2 ± 10.7 years) were recruited. IFX increased muscle volume in both legs from baseline (right, 1505 cm3) to week 25 (right, 1569 cm3; P = 0.010). IFX also increased muscle strength in both legs from baseline (right 30°/s, 184.8 Nm) to week 25 (right 30°/s, 213.6 Nm; P = 0.002). Muscle volume gain correlated with male gender (P = 0.003). Significant gains in muscle volume and strength were unrelated to prednisolone use. Serum IL6 levels decreased by week 25 (P = 0.037).
Conclusion
The anti-TNF agent infliximab reverses inflammatory sarcopenia in patients with Crohn's disease.
Description
Keywords
C reactive protein, immunomodulating agent, infliximab, interleukin 6, mesalazine, prednisolone, autacoid, immunoglobulin enhancer binding protein, infliximab, monoclonal antibody, tumor necrosis factor alpha, acute disease, adult, aged, Article, caloric
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Source
Alimentary pharmacology & therapeutics
Type
Journal article
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2037-12-31
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