Does Interferon Alfa Therapy Prevent Osteoporosis in Children?
The objective of the current study was to determinate bone mineral density (BMD),
levels of biochemical markers and cytokines in children
with chronic hepatitis B
treated with interferon (IFN)-alfa
and to investigate effect of IFN-alfa therapy on these variables.
This
is first study carried out about BMD and cytokine levels
in pediatric patients with chronic hepatitis B treated with
IFN-alfa.
BMD,
levels of parathyroid hormone (PTH), osteocalcin, C- terminal
cross-linking telopeptide of type I collagen (CTX), calcium,
alkaline phosphates (ALP), cytokines as TNF-alfa, interleukin
(IL)-1beta, IL-2r, IL-6, and IL-8 were studied in 54 children
with chronic hepatitis B (4-15 years old) treated with interferon
alone (n=19) or in combination with lamivudine (n=35)
for six months and as controls in 50 age-matched healthy
children.
Results
· There
was no significant difference in respect to serum IL-1beta,
TNF-alfa and osteocalcin levels while serum IL-2r (p=0.002),
IL-6 (p=0.001), IL-8 (p=0.013), PTH (p=0.029), and CTX (p=0.021)
levels were higher in children with chronic hepatitis B
than in healthy controls.
· BMD
of femur neck (p=0.012) and trochanter (p=0.046) in patients
were higher than in healthy controls.
· There
was a statistically significant correlation between serum
IL-1beta and osteocalcin (r=-0.355, p<0.01); between
serum IL-8 and CTX levels (r=0.372, p=0.01), and ALP (r=0.361,
p=0.01); between serum ALP and femur neck BMD (r=0.303,
p=0.05), and trochanter BMD (r=0.365, p=0.01); between spine
BMD and IL-2R (r=-0.330, p<0.05).
In
conclusion, the authors write, “Our study suggests that BMD
of femur, serum IL-2r, IL-6, IL-8, PTH, and CTX levels were
higher in children with chronic hepatitis B treated with IFN-alfa
alone or combination with lamivudine than in healthy children.”
“High
femur BMD measurements found in patients may suggest that
IFN-alfa therapy in children with chronic hepatitis B could
contribute indirectly to prevention of hip
osteoporosis.
“Further
investigations on effects of IFN-alfa for bone structure
in children should be performed in the future.”
09/28/05
Reference
A
Gur and others. Bone mineral density and cytokine levels
during interferon therapy in children with chronic hepatitis
B: does interferon therapy prevent osteoporosis? BMC
Gastroenterology 5(1):30. September 29, 2005. [Epub
ahead of print ]
