Autonomic nervous system activity in children with Crohn disease: Short-term effect of anti-TNFα therapy

  • F. Telliez
    Correspondence
    Corresponding author.
    Affiliations
    PériTox Laboratory (UMR-I 01 Ineris), Health Research University Center-Faculty of Medicine, Jules Verne University of Picardy, Amiens
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  • R. Cheriet
    Affiliations
    PériTox Laboratory (UMR-I 01 Ineris), Health Research University Center-Faculty of Medicine, Jules Verne University of Picardy, Amiens

    Pediatric Gastroenterology Unit, Amiens University Medical Center, Amiens, France
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  • A. Vanrenthergem
    Affiliations
    PériTox Laboratory (UMR-I 01 Ineris), Health Research University Center-Faculty of Medicine, Jules Verne University of Picardy, Amiens

    Pediatric Gastroenterology Unit, Amiens University Medical Center, Amiens, France
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  • C. Bretagne
    Affiliations
    Pediatric Gastroenterology Unit, Amiens University Medical Center, Amiens, France
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  • E. Stephan-Blanchard
    Affiliations
    PériTox Laboratory (UMR-I 01 Ineris), Health Research University Center-Faculty of Medicine, Jules Verne University of Picardy, Amiens
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  • D. Djeddi
    Affiliations
    PériTox Laboratory (UMR-I 01 Ineris), Health Research University Center-Faculty of Medicine, Jules Verne University of Picardy, Amiens

    Pediatric Gastroenterology Unit, Amiens University Medical Center, Amiens, France
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      Background: A parasympathetic impairment seems involved in the dysfunction of gut inflammatory process regulation. This cholinergic anti-inflammatory pathway is well described in animals and adults but not in infants. The goal of our study was to assess the autonomic nervous system activity in pediatric patients with Crohn disease. The second part of the study analyzes the short-term effect of anti-tumour necrosis factor (anti-TNFα) therapy on sympatho-vagal balance. Methods: A heart rate variability (HRV) analysis, non-invasive method for assessing sympathetic-parasympathetic activities, and weighed Pediatric Crohn Disease Activity Index (wPCDAI) were correlated in 18 pediatric patients with Crohn disease (13.5 ± 4 years). Then short-term effect of anti-TNFα therapy on HRV parameters was also investigated. Results: In temporal domain, total variability and parasympathetic parameters were negatively correlated with wPCDAI index. Anti-TNFα therapy significantly increased the power in High Frequency band (parasympathetic activity) (+103%). It results a decrease of sympatho-vagal balance (-76%) after treatment. Conclusion: Our preliminary findings points out that the vagal activity is negatively correlated to the activity of the disease. This could suggest the involvement of vagal anti-inflammatory pathway dysfunction in children with Crohn disease. Interestingly, this alteration of autonomic nervous system activity seems to be restored by anti-TNF perfusion.
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