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.
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