# Skeletal Health and Bone Marrow Composition in Adolescents with Crohn’s Disease

> **NIH NIH K23** · BOSTON CHILDREN'S HOSPITAL · 2024 · $194,940

## Abstract

Project Summary
Children with Crohn’s disease (CD) often have low bone mineral density (BMD) and altered bone structure,
resulting in increased skeletal fragility. While bone formation is compromised in pediatric and adolescent patients
at diagnosis with CD, the factors mediating these disease-related complications remain poorly understood and
represent a critical opportunity to identify proactive measures and therapies for young patients with CD. The
majority of bone mass is acquired by late adolescence through the acceleration of bone turnover, including bone
formation and resorption. A failure to achieve peak bone mass increases the lifetime risk of osteoporosis.
Hematopoietic (red) bone marrow converts to lipid-rich (yellow) marrow during normal skeletal development in
healthy children and adolescents. Conditions that accelerate the conversion of premature red to yellow marrow
- and possibly its reversibility - are central to the deficits in bone health in youth with CD. The presence of
increased marrow fat in adolescents and adults is associated with reduced biomechanical strength, with
implications for fracture risk. In other pediatric diseases, the hormonal milieu can alter mesenchymal stem cells
to differentiate preferentially into adipocytes over osteoblasts, compromising osteogenesis. We will examine
adolescents with newly-diagnosed CD at baseline and one year later to evaluate the impact of CD inflammatory
activity on marrow fat, BMD, bone turnover markers, and to correlate with peripheral blood immune parameters.
This project is a prospective, longitudinal, case-control study with the following aims: (1) Using magnetic
resonance imaging (MRI), dual-energy x-ray absorptiometry (DXA), and peripheral quantitative computed
tomography (pQCT), evaluate bone marrow composition, areal and volumetric BMD in adolescents with newly-
diagnosed CD and compare to healthy matched controls; (2) Examine changes in marrow fat and BMD at one
year after diagnosis, across patients with CD versus in healthy matched controls, and investigate the
associations between marrow fat, BMD, and body composition; and (3) To evaluate the mechanism of
compromised bone formation in patients with CD, we will investigate bone turnover markers and immune
cellular/molecular parameters and their associations with BMD and marrow fat.
Dr. Gordon’s career goal is to become an independent clinical researcher, applying state-of-the-art research
methods to clinically relevant problems in pediatric bone health. During the K23 award, Dr. Gordon will acquire
the requisite skills in clinical and translational investigation through a combination of formal didactic coursework,
attendance at seminars and conferences, personalized mentoring, and hands-on research experience in the
supportive environment of Boston Children’s Hospital and Harvard Medical School. She will be mentored by
leading investigators in the fields of inflammatory bowel disease and bone and mineral metabolism. In sum...

## Key facts

- **NIH application ID:** 10898727
- **Project number:** 5K23DK134881-02
- **Recipient organization:** BOSTON CHILDREN'S HOSPITAL
- **Principal Investigator:** Rebecca Judith Gordon
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $194,940
- **Award type:** 5
- **Project period:** 2023-08-04 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10898727

## Citation

> US National Institutes of Health, RePORTER application 10898727, Skeletal Health and Bone Marrow Composition in Adolescents with Crohn’s Disease (5K23DK134881-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10898727. Licensed CC0.

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