This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Inflammatory bowel disease, including Crohn's disease and ulcerative colitis, is a disease of the gastrointestinal tract leading to symptoms of abdominal pain, diarrhea, and growth disturbance. Many patients with inflammatory bowel disease have alterations in growth prior to their diagnosis, and these alterations may persist despite therapy, leading to suboptimal growth outcomes. Alterations in whole body protein metabolism have been characterized in children with inflammatory bowel disease, and demonstrate increased protein breakdown and protein synthesis during active disease. The objective of this application is to characterize protein metabolism at the gastrointestinal mucosal level in children with newly diagnosed inflammatory bowel disease, and determine the contribution of gastrointestinal mucosal protein metabolism to whole body protein metabolism. We hypothesize that children with inflammatory bowel disease will have increased gastrointestinal mucosal protein synthesis compared to patients who have normal endoscopic findings. To test this hypothesis, children with suspected inflammatory bowel disease will be enrolled in a prospective study. Using stable essential amino acid isotopes, rates of whole body protein metabolism and gastrointestinal mucosal protein metabolism will be measured at the time of the patients' endoscopic examinations. In patients with newly diagnosed inflammatory bowel disease, a follow-up metabolic study will be conducted two weeks following the introduction of corticosteroid therapy to determine the effects of this therapy on whole body protein metabolism. These results will be significant because they may help allow for optimization of the treatment of children with inflammatory bowel disease, and may help these children to reach their true growth potential.
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