SUPPRESSION OF THE GROWTH HORMONE/INSULIN-LIKE GROWTH FACTOR-1 (GH/IGF-1) AXI

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。这是一项在患有类风湿性关节炎（RA）的绝经前女性中进行的为期6个月、开放标签、初步研究，将在约翰霍普金斯湾景医学中心（巴尔的摩，MD）的综合临床研究中心（GCRC）和美国国立卫生研究院临床中心进行。本研究将探讨系统性释放的炎性细胞因子对GH/IGF-1轴抑制的可能影响，以及内分泌免疫功能改变与身体成分、代谢和血管功能的关系，这些功能被认为与RA相关的肌肉减少症、骨质减少症和心血管疾病风险增加有关。在研究的I期，我们将在临床中心收治RA患者和对照受试者，为期36小时，以评估GH/IGF-1轴、细胞因子、身体成分、内分泌代谢和心血管功能以及生活质量。在II期研究中，我们将在用依那西普（一种可溶性p75 TNF受体分子，最近已被FDA批准用于治疗早期RA患者）治疗RA患者6个月后重新评估上述结局指标。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This is a 6-month, open label, pilot study in pre-menopausal women with rheumatoid arthritis (RA) of less than 3 years duration to be conducted at the General Clinical Research Center (GCRC) of the Johns Hopkins Bayview Medical Center, Baltimore, MD and the Clinical Center of National Institutes of Health. This investigation will explore the possible impact of systematically released inflammatory cytokines on suppression of the GH/IGF-1 axis, and the relationships of altered endocrine-immune function with body composition, metabolic and vascular functions thought to be associated with RA-related sarcopenia, osteopenia, and increased risk of cardiovascular disease. In phase I of the study, we shall admit RA patients and control subjects to the Clinical Center for a 36 hour period for assessments of the GH/IGF-1 axis, cytokines, body composition, endocrine-metabolic and cardiovascular functions, and quality of life. In Phase II of the study, we shall re-evaluate the above outcome measures after six months of treatment of the RA patients with Etanercept, a soluble p75 TNF receptor molecule, which has recently been approved by the FDA for the treatment of patients with early RA.