EFFECTS OF GROWTH HORMONE IN CHRONICALLY ILL CHILDREN

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。儿科的许多慢性病妨碍了足够的体重增加和正常的纵向生长。为了解决这一问题，儿科医生通常建议严格的口服补充，放置胃造瘘管过夜喂养，或完全肠外营养(TPN)。人们希望增长和体重增加会有所改善；然而，通常只实现了少量的潜在增长。然而，可以想见，潜在炎症引起的细胞因子的慢性升高可能会通过干扰IGF-1的产生来干扰生长反应。在许多慢性疾病中，体重增加不佳会导致临床结果恶化；因此，改善营养和生长对慢性病患者的成功治疗和最终生存至关重要。这项研究的假设是，生长激素(GH)的合成代谢作用将改善患有慢性疾病的儿童的身高和体重，这些儿童尽管通过胃造瘘管或口服补充剂获得了足够的营养，但仍无法生长。它还假设，这种增长的改善将是次要的细胞因子减少。这些假设将通过12名患有慢性病的儿童参与的先导性研究来检验。患者将接受为期12个月的生长激素治疗，并将他们的生长发育与治疗前进行比较。

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. Many chronic illnesses in pediatrics interfere with adequate weight gain and normal longitudinal growth. To combat this problem, pediatric physicians often recommend either stringent oral supplementation, placement of a gastrostomy tube for overnight feeding, or total parenteral nutrition (TPN). The hope is that growth and weight gain will improve; however, often only a small amount of potential growth is achieved. However, chronic elevation of cytokines from underlying inflammation could conceivably interfere with growth response by interfering with IGF-1 production. In many chronic illnesses, poor weight gain contributes to worsened clinical outcome; therefore improved nutrition and growth are of paramount importance to the successful treatment and ultimate survival of chronically ill patients. The hypothesis of this study is that the anabolic effects of growth hormone (GH) will improve the height and weight of chronically ill children who have failed to grow despite receiving adequate nutrition via gastrostomy tube or oral supplementation. It is also hypothesized that this improvement in growth will be secondary to decreased cytokines. The hypotheses will be tested using a pilot study inwhich 12 chronically ill children will participate. Patients will receive treatment with GH for 12 months and their growth will be compared to pretreatment.