Inflammatory cytokines and growth in childhood.

Purpose of review: In this review we report an update on the current knowledge on growth disorders in children with chronic inflammatory diseases, mainly inflammatory bowel disease and juvenile idiopathic arthritis, with a particular focus on the role of inflammatory cytokines as mediators of growth impairment. Recent findings: Growth disorders are common among patients with inflammatory diseases. Several factors can contribute to growth failure: poor nutrition, immobilization, drugs, disease activity, duration and severity. There is extensive evidence suggesting that inflammatory cytokines are key players in mediating growth failure. Recent studies have confirmed a direct association between levels of inflammatory cytokines, such as tumour necrosis factor-α and interleukin-6, and reduced growth velocity, as well as impaired body composition. Recent studies have also highlighted the beneficial effect of new drugs, such biologics, not only in controlling disease activity, but also in improving growth. Summary: Growth retardation remains a major problem in patients with chronic inflammatory diseases, and proinflammatory cytokines are key players in this context. New drugs, specifically targeting inflammatory cytokines appear to be promising for their effect on growth. Further studies are required to better characterize the cytokine profile in children with inflammatory disease and help in developing effective treatment strategies