Inflammation, low hormone levels tied to poor growth in RDEB kids
Treatments aimed at controlling inflammation could help promote growth
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Children with recessive dystrophic epidermolysis bullosa (RDEB) have lower-than-normal levels of hormones that are important for growth, likely due to chronic inflammation, a study found.
The data suggest that chronic inflammation in these children may lead to low levels of growth-driving hormones, ultimately resulting in poor growth. If that’s true, it follows that treatments aimed at dampening inflammation may help promote growth in children with this disease, the researchers said.
The study, “Assessment of Growth Hormone and Insulin-Like Growth Factor 1 in Children With Epidermolysis Bullosa Dystrophica,” was published in Pediatric Dermatology.
RDEB is a genetic disorder characterized mainly by fragile skin that’s prone to wounds and blisters. Children with RDEB are usually shorter and weigh less than their similarly aged peers. Although this is a well-established clinical feature of the disease, it’s not clear exactly why it happens.
To learn more, a team of scientists at Cairo University in Egypt conducted a clinical trial (NCT05390073) aiming to measure levels of growth hormone (GH) in children with RDEB.
Chronic inflammation and growth hormone
GH is a signaling molecule key to driving growth during childhood. GH normally signals the liver, prompting it to release sugar that the body’s cells can use for fuel to grow. GH also prompts the release of another growth-related signaling molecule, insulin-like growth factor 1 (IGF-1).
The study involved 51 kids with RDEB, ages 1 to 12. Compared with norms for typically developing children, most of these kids had “severe growth delay,” the researchers said.
The scientists found that levels of both GH and IGF-1 were significantly lower than typical norms in the children with RDEB. At the same time, the erythrocyte sedimentation rate (ESR) — a marker of inflammation — was elevated. This is particularly noteworthy, the researchers said, because chronic inflammation is known to be able to reduce GH’s activity in the body.
“Children with severe generalized RDEB exhibit low circulating GH and IGF-1 levels,” the scientists wrote. “We propose this is primarily attributed to chronic inflammation, evidenced by elevated ESR, which suppresses the GH/IGF-1 axis. Future therapeutic strategies for RDEB should explore controlling the underlying inflammatory state as a potential means to address the profound growth failure observed in these patients.”
