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Can 11β-Hydroxysteroid Dehydrogenase Activity Predict the Sensitivity of Bone to Therapeutic Glucocorticoids in Inflammatory Bowel Disease?

Cooper, M. S. et al.

Calcified tissue international. VOL 89; NUMBER 3, ; 2011, 246-251 -- Springer Science + Business Media -- 2011

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  • Title:
    Can 11β-Hydroxysteroid Dehydrogenase Activity Predict the Sensitivity of Bone to Therapeutic Glucocorticoids in Inflammatory Bowel Disease?
  • Author: Cooper, M. S.;
    Kriel, H.;
    Sayers, A.;
    Fraser, W. D.;
    Williams, A. M.;
    Stewart, P. M.;
    Probert, C. S.;
    Tobias, J. H.
  • Found In: Calcified tissue international. VOL 89; NUMBER 3, ; 2011, 246-251
  • Journal Title: Calcified tissue international.
  • Subjects: Medicine; Biotechnology; Pharmaceutical Chemistry; LCC: QP88; Dewey: 611.018
  • Publication Details: Springer Science + Business Media
  • Language: English
  • Abstract: In healthy individuals measures of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) enzyme activity predict the change in bone formation markers in response to therapeutic glucocorticoids. It is unclear whether these measures remain predictive in inflammatory disease. We therefore examined whether 11β-HSD1 activity predicts changes in bone markers and bone mineral density (BMD) in patients with inflammatory bowel disease (IBD) treated with therapeutic glucocorticoids. Prospective and cross-sectional studies were carried out in patients attending a gastroenterology clinic with active (n = 39) or clinically inactive (n = 34) IBD and healthy controls (n = 51). Urinary corticosteroid metabolite profiles were obtained on a spot urine sample and total corticosteroid metabolite excretion and 11β-HSD1 activity (measured as the ratio of tetrahydrocortisol to tetrahydrocortisone metabolites, [THF+alloTHF]/THE) determined. Patients with active disease were treated with an 8-week reducing course of oral prednisolone. The (THF+alloTHF)/THE ratio was significantly increased in patients with IBD, even those in clinical remission. The baseline (THF+alloTHF)/THE ratio failed to predict the decrease in bone formation markers or hip BMD. Measures of 11β-HSD activity do not predict bone loss during glucocorticoid treatment of active IBD, probably due to disease-related increases in 11β-HSD1 activity. Our observation of elevated 11β-HSD1 activity in clinically inactive IBD implicates gastrointestinal glucocorticoid activation in the maintenance of disease remission.
  • Identifier: Journal ISSN: 0171-967X
  • Publication Date: 2011
  • Accrual Information: Monthly
  • Shelfmark(s): 2952.840000
  • UIN: ETOCRN296667144

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