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Objectives: In mice, body weight is regulated by adipocyte-derived leptin. TNFα is a critical mediator of inflammation-induced cachexia in Crohn’s disease (CD). The regulation of leptin by TNFα is poorly understood in CD. Pharmacological neutralization of TNFα with infliximab offers a unique opportunity to study TNFα-mediated regulation of leptin in CD patients.

Methods: We prospectively followed up CD patients treated with infliximab (n = 20). Body composition was assessed before and after treatment at 1 and 4 wk. Serum leptin, IL-6, soluble TNF receptor type II, and soluble intercellular antiadhesion molecule-1 levels were measured as well as cholesterol levels and free urinary cortisol. Because methylprednisolone (MP) increases leptin production in vivo, CD patients treated with MP (n = 9) were studied separately as a positive control group.

Results: Infliximab induced clinical …