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Growth hormone deficiency (GHD) is the most frequent pituitary hormone deficiency in childhood, with an incidence of 1 in 4000–10,000 live births. GHD can be congenital (genetic or due to hypothalamic/pituitary abnormalities) or acquired and can be isolated (IGHD) or associated with other pituitary hormone deficiencies, but most cases are idiopathic. GH stimulation testing is commonly used in the diagnostic workup of GHD, except for some clinical conditions that do not require GH stimulation tests for the diagnosis. Children with GHD receive replacement therapy with daily injections of recombinant human GH (rhGH). RhGH therapy is effective in increasing short-term height gain and adult height in patients with GHD. The safety of long term GH therapy has been confirmed in many large international studies. Recently, long-acting weekly GH formulations have been introduced, showing good efficacy and safety profiles. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of recombinant growth hormone (rGH) on body composition and metabolic profile of prepubertal short children born small for gestational age (SGA) before and after 18 months of treatment. Methods: It is a clinical, non-randomized, and paired study. Children born SGA, with birth weight and/or length <-2 standard deviations (SD) for gestational age and sex, prepubertal, born at full term, of both genders, with the indication for treatment with rGH were included. The intervention was performed with biosynthetic rGH at doses ranging from 0.03 to 0.05 mg/kg/day, administered subcutaneously, once a day at bedtime. Total lean mass (LM) and total fat mass (FM) were carried out using dualenergy X-ray absorptiometry (DXA), and the metabolic profile was assessed for insulin, glycemia, IGF-1 levels and lipid profile. Results: Twelve patients (nine girls, 8.17±2.39 y) were evaluated; three patients dropped out of the study. There was an increase of LM adjusted for length (LMI) (p=0.008), LMI standard deviation score (SDS) adjusted for age and sex (p=0.007), and total LM (p<0.001). The percentage of body fat (BF%) and abdominal fat (AF) remained unaltered in relation to the beginning of treatment. Among the metabolic variables, blood glucose remained within normal levels, and there was a reduction in the number of participants with altered cholesterol (p=0.023). Conclusions: The effect of rGH treatment was higher on LM than in FM, with increased LM adjusted for length and standardized for age and sex. Glycemia remained within the normal limits, and there was a decreased number of children with total cholesterol above the recommended levels. [ABSTRACT FROM AUTHOR]

Objective: Reports on the association between growth hormone (GH) therapy and cardiovascular risk factors in children are limited. This study aimed to evaluate carotid intima-media thickness (cIMT) in children treated with recombinant human GH (rhGH) and assess the effects of rhGH therapy and changes in serum carbohydrate metabolism, lipid profile and adipocytokines on cIMT. Methods: Seventy-one isolated idiopathic GH deficiency (GHD) children and 44 age- and sex-matched healthy controls were enrolled in this study. The study group was divided into two subgroups according to insulin resistance (IR) on oral glucose tolerance tests. Insulin secretion [homeostatic model assessment (HOMA) B, total insulin] and sensitivity (HOMA-IR, QUICKI, Matsuda) indices were calculated. cIMT was measured and the standard deviation scores (SDS) were calculated. Associations between cIMT-SDS and insulin secretion and sensitivity indices, serum lipid levels, adipocytokines (leptin, resistin, ghrelin), and other rhGH treatment-related factors were evaluated. Results: cIMT-SDS was increased in GHD children treated with rhGH compared to the controls [0.02 (2.27) vs. -1.01 (1.63), p=0.003]. cIMT-SDS did not differ between those children on rhGH treatment with or without IR. High cIMT-SDS was significantly associated with higher serum ghrelin levels and lower serum high density lipoprotein (HDL) levels (ß=0.491, p=0.001 and ß=-0.027, p=0.017), but not with BMI-SDS, blood pressure, insulin secretion and sensitivity indices, or the dose and duration of rhGH therapy. Conclusion: Our findings showed that GHD children treated with rhGH have increased cIMT. Alterations in carbohydrate metabolism were not associated with cIMT in children treated with rhGH. GH therapy per se appears to be associated with this increased cIMT but causality should be elucidated in further studies. cIMT also appears to be associated with higher ghrelin and lower HDL levels. [ABSTRACT FROM AUTHOR]

Introduction GHD is a chronic and systemic disease requiring daily replacement of growth hormone (GHRT). Adherence and attitudes of adult GHD patients are not well known. We sought to assess patients' knowledge of growth hormone deficiency (GHD) in association with treatment adherence and attitudes regarding available and upcoming treatment options. Methods We performed a cross-sectional survey with a custom-made questionnaire at a single centre assessing data on demographics, knowledge of GHD, adherence and attitudes towards GHRT. Results Of 106 eligible patients actively followed for GHD 70 returned the completed survey (return-rate 66%, 34 m/36 f; age 56±14 years). 46 patients were actively treated, but almost one third (n=24) refused GHRT. 12 patients had participated in clinical trials with LAGH (long-acting growth hormone). Overall, patients with GHRT showed good adherence. Patients refusing GHRT mostly feared side effects and/or had a lack of information/perceived effect. Disease knowledge and level of education were higher in treated than untreated patients (p=0.023/0.017). Only 36% of respondents would initiate treatment with LAGH. Patients with prior LAGH experience and patients with childhood-onset GHD were more likely to adopt LAGH (p=0.048/0.031). Discussion Most often, misinformation causes patients to refuse GHRT. Possibly the understanding of their condition and consequences of non-treatment is limited. To improve adherence more focused educational and behavioural strategies may be needed. Willingness to begin a therapy with LAGH was lower than expected (36%). The reasons for reluctance against LAGH need to be elucidated. [ABSTRACT FROM AUTHOR]

Background and purpose: Beta thalassemia major is one of the most common inherited blood diseases and patients with this condition require regular blood transfusions. The resulting iron overload deposition causes endocrine gland disorders, including growth hormone (GH) abnormality. In this study, we examined the effects of recombinant growth hormone (rGH) in these patients. Materials and methods: This retrospective study was performed in thalassemia major patients in Amirkola Thalassemia Center, using the medical records (2011-2018), to evaluate the therapeutic effects of rGH on growth velocity of six short stature patients aged 7-15 years (four boys and two girls). On the basis of abnormal or normal response to GH provocation test, the patients were included in GH deficiency (GHD) group (n=3) and idiopathic short stature (ISS) group (n=3), respectively. The data were analyzed in SPSS-18. Results: The mean age of patients was 11.00 ± 2.75 years old. The mean values for growth velocity before and after the treatment were 4.00± 0.86 and 7.83 ± 1.25 cm/year in GHD group (P=0.057) and 4.06 ± 0.81 and 6.00 ± 1.50 cm/year in ISS group, respectively (P=0.023). Conclusion: In this study, the positive therapeutic effects of rGh in improvement of growth velocity were seen in thalassemia major patients (both GHD and ISS groups). [ABSTRACT FROM AUTHOR]

Background: In 2007, Omnitrope® was the first biosimilar recombinant human growth hormone (rhGH) to be approved in Sweden for treatment in adults and children. Over 10 years' safety and effectiveness data for biosimilar rhGH can now be presented. Methods: PATRO Children and PATRO Adults are multicenter, longitudinal, observational, post-marketing surveillance studies. Eligible patients include children 0–18 years and adults receiving biosimilar rhGH treatment. Adverse events (AEs) are monitored for safety evaluation. Growth variables in children and metabolic data in adults are recorded for effectiveness evaluation. Results: As of January 2019, data from 136 children (48% male) were reported from Swedish centers. Mean age in rhGH treatment-naïve patients at study entry (n = 114) was 7.5 years, with mean 3.6 years treatment duration. No severe AEs of diabetes, impaired glucose tolerance, or malignancy were reported. The most frequently reported AE was nasopharyngitis (n = 16 patients). No clinically relevant anti-hGH or neutralizing antibodies were observed. The mean change from baseline in height standard deviation score (SDS) in naïve prepubertal GH deficiency patients was + 0.79 at 1 year, + 1.27 at 2 years, and + 1.55 at 3 years. Data from 293 adults (44% rhGH-naïve, 51% male) were included. Fatigue was the most frequently reported AE (n = 26 patients). The incidence of new neoplasms or existing neoplasm progression was 23.8 patients per 1000 patient-years. Type 2 diabetes mellitus was reported in four patients. At baseline in rhGH-naïve adults, mean (SD) body mass index (BMI) was 29.1 (5.6) kg/m2 and mean (SD) insulin-like growth factor (IGF)-I SDS was − 3.0 (1.4). Mean daily dose increased from 0.1 mg at baseline to 0.3 mg after 4 years. IGF-I SDS normalized during the first year of treatment. Mean BMI and glucose were unchanged over 4 years, while low−/high-density lipoprotein cholesterol ratio decreased. Conclusions: For the first time, Swedish data from the PATRO Children and Adults studies are presented. The 10-year data suggest that biosimilar rhGH is well tolerated across pediatric and adult indications. Safety and effectiveness were similar to previous reports for other rhGH preparations. These results need to be confirmed in larger cohorts, highlighting the importance of long-term post-marketing studies. [ABSTRACT FROM AUTHOR]

Growth hormone (GH) regulates metabolic processes, modulates the growth of the body, stimulates cell proliferation and differentiation. Human recombinant growth hormone is administered in growth disorders related to GH deficiency, wound treatment, as well as, contrary to the recommendations, in aesthetic medicine. GH and IGF affect skin homeostasis, primarily through the influence on the dermis and synthesis of collagen fibers but also on the epidermis and appendages of the skin. GH and IGF have also been shown to be involved in the pathogenesis of skin lesions and diseases, primarily of the proliferative basis. Particular attention is paid to the proven positive effects of GH, IGF-I and IGF-II on the healing process, including wound healing. The work outlines the effects of GH i rhGH on skin processes, skin diseases, chronic wound healing, the occurrence and dysplasia of melanocytic nevi and also describes the role of GH in melanoma pathogenesis and metastasis. [ABSTRACT FROM AUTHOR]

An increase in growth rates of children suffering from growth hormone deficiency (GHD) subjected to recombinant growth hormone treatment (rGHT) was shown to be accompanied by acceleration of metabolic processes that may stimulate oxygen consumption in various organs and tissues. Therefore, oxygen-transporting properties of RBC should undergo considerable changes during the rGHT. The aim of this study was to examine the effects of rGHT on erythrocyte shape and hemoglobin state in GHD children. The level of oxyhemoglobin (Oxy-Hb) in RBC was analyzed by Raman spectroscopy. The RBC count, mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV) and other parameters were calculated. The blood of eleven treatment-naive prepubertal children with GHD (aged 3–9, median 5.7 years) was examined and compared with control group (aged 5–7; median 6.0 years) at three time points: 0, 3 and 12 months of rGHT. Before rGHT, the MI in GHD children was higher (median 0.48 vs 0.14 p = 0.0018) and the RBC count was lower (median 4.20 vs 4.96 10 12 cells/L p = 0.0022) than in control group. After the treatment, cell count in GHD patients did not differ significantly from the control group, but Oxy-Hb level became higher (median 0.64 vs 0.41 p = 0.0075). During rGHT, MCV decreased (median 80.3 vs 83.2 μm 3 p = 0.0231). Morphological and functional characteristics of erythrocytes in GHD children were shown to differ significantly from the healthy control group. A twelve-month rGHT partially improved some of the studied parameters but Oxy-Hb level and echinocyte count remained high. [ABSTRACT FROM AUTHOR]

Humpback grouper take a long time to grow to marketable size. In this study, recombinant Epinephelus lanceolatus growth hormone (rElGH) was applied orally and by intraperitoneal injection to accelerate their growth. Daily application of crude rElGH at a dose of 50 mg kg−1 in commercial diet for 42 days or with injections of 0.2 μg rElGH g−1 total body weight every 2 weeks resulted in significant increases in growth performance, protein and lipid content, plasma glucose, liver glycogen and innate immunity compared to control groups. Relative weight gain from the oral and injection doses above compared to C− (Control negative, only commercial diet without rElGH treatment or chemical substances related to treatment, either for oral or injection route) were 40.25% and 38.77%, respectively. There was no specific histological damage to the kidneys, liver or spleen that was attributable to rElGH administration. These results strongly suggested that the stimulation of growth and immunity following oral and intraperitoneal administration was due to a specific action of rElGH and that recombinant GH is safe for fish consumption. [ABSTRACT FROM AUTHOR]

Recombinant protein technology represents one of the best solutions to achieve rapid, efficient, and cost-effective protein expression and purification of therapeutic proteins. Growth hormone (GH) is an excellent example of these proteins used in the therapy of hormone deficiencies. In this work, a plasmid, pRSET–TEV–rhGH, has been constructed to overexpress recombinant human GH (rhGH) by cloning its gene downstream of an N-terminal 6× His-tagged polypeptide (43 aa) in the T7 promoter-plasmid pRSET. This polypeptide was cleavable by means of the integrated recognition site for the tobaccos etch virus (TEV) protease, resulting in an rhGH protein at an exact length and sequence. After IPTG induction, this plasmid effectively expressed TEV–rhGH protein (27kDa) in the cytoplasm of Escherichia coli, which accumulated in the form of inclusion bodies. The 6× His-tagged protein, with a yield of ~150mg/L of culture, was purified from the cell extract using metal affinity chromatography, as shown after SDS-PAGE blue staining, and was confirmed by immunoblotting using specific commercial monoclonal antibodies. In order to detect TEV–rhGH, in ELISA and immunoblotting, specific polyclonal antibody, with high titer (~10−5 fold dilution), was produced in a rabbit and purified using affinity chromatography. Preliminary tests have proved that TEV–rhGH protein and its specific purified IgG antibody could provide valuable tools for rhGH productive and diagnostic purposes. [ABSTRACT FROM AUTHOR]

We investigated the regulatory effects of recombinant growth hormone (rGH) on growth and immunity in an ornamental seawater fish species, the cinnamon clownfish (Amphiprion melanopus). Cinnamon clownfish received intraperitoneal injections of rGH or saline at doses of 0.1 or 1 µg/g, weekly, for 12 weeks. At the end of the experiment, the rGH injection group exhibited the greatest total length (5.3±0.3 and 5.6±0.2 cm, respectively, for the two doses). Moreover, after injection of rGH, the expression levels of pituitary GH mRNA and liver insulin-like growth factor I (IGF-I) mRNA increased significantly (by 18.9-fold and 5.7-fold, respectively), as assessed by quantitative real-time polymerase chain reaction, while the splenic levels of immunoglobulin M protein increased significantly (by 10.5-fold) as assessed by Western blot analysis. Plasma lysozyme and melatonin levels also increased by 2.1- and 1.37-fold, respectively, over those of the control group. Plasma alanine and aspartate aminotransferase levels at 12 weeks (764±46.4 and 3002±101.2 IU/l, respectively) were significantly higher than those at baseline; however, treatment with rGH decreased these values at 12 weeks (276±30.4 and 600.5±59.2 IU/l, respectively). These findings support the hypothesis that rGH plays important roles in the regulation of the GH–IGF-I axis for growth and immunity in the cinnamon clownfish. [ABSTRACT FROM AUTHOR]

We report a case of 9.5-year-old boy with isolated GH deficiency and osteogenesis imperfecta type IV. The basis for prevention of pathological fractures in patients with this „brittle bone disease“ is the therapy with antiresorptive drugs - bisphosphonates. Experimental therapy of osteogenesis imperfecta is based on treatment with growth hormone because of its osteoanabolic effect. Due to combination of his two major diagnoses, we start simultaneous treatment with intravenous pamidronate and rHuGH (recombinant growth hormone). [ABSTRACT FROM AUTHOR]

Highlights: [•] We employed hydrogel nanoparticles to concentrate urinary hGH into the linear range of isoform differential immunoassays. [•] The pre-processing step allowed measurement of urine spiked with recombinant and pituitary hGH. [•] Nanoparticles pre-treatment was applied to urine from healthy volunteers administered with recombinant hGH. [•] The recombinant/pituitary hGH concentration ratios remained above the established WADA criterion for hGH misuse up to 24h after the last administration dose. [•] The use of nanoparticles appears to open the possibility of assessing rhGH misuse in urine. [ABSTRACT FROM AUTHOR]

A cost-effective method for producing and using recombinant growth hormone (GH) has been developed. A cell-surface protein display system was constructed to produce recombinant Japanese flounder growth hormone (r-JfGH) in yeast Saccharomyces cerevisiae and the biological activity of expressed r-JfGH was evaluated by oral delivery to juvenile Japanese flounder. The expression vector pYD-E2, containing the JfGH gene, S. cerevisiae GAL1 promoter, and the S.cerevisiae URA3 gene downstream and upstream sequences, was designed and constructed to integrate the GH gene into the yeast genome and secrete r-JfGH stably on the surface of the yeast cell. Expression of r-JfGH was confirmed by flow cytometry until the 50th continuous generation of transgenic yeast strain y-E2, and over 0.98 μg r-JfGH per 1 mg total protein of y-E2 was estimated by an ELISA-RA assay. Growth of Japanese flounder was promoted significantly by the direct supplementation of freeze-dried transgenic yeast into the Japanese flounder juvenile feed at levels of 0.5 and 1%. The weight-specific growth rate and feed conversion ratio of the treated groups were 23.07 and 21.57% (0.5% feeding level) and 28.85 and 41.18% (1% feeding level), respectively, higher than that of the control group in a 7-week bioactivity study. [ABSTRACT FROM AUTHOR]

• Recombinant Japanese eel growth hormones with CTP were produced. • Recombinant Gh was found to promote the growth of eel larvae. • Addition of CTP to recombinant Gh enhanced growth promoting effect. • Recombinant Gh may have negative effects on the Gh receptors and Igf-I. Growth hormone (Gh) regulates somatic growth in fishes, particularly through the Gh - insulin-like growth factor-I (Igf-I) axis. In this study, recombinant Japanese eel Ghs with or without C-terminal peptides of human chorionic gonadotropin (CTP), which are known to prolong the half-life, were produced using the HEK 293 and CHO expression system. The effect of recombinant Gh administration to eel larvae on their somatic growth was investigated in short-term feeding experiments, and it was found that three types of recombinant Ghs with CTP (CTP-reGh, reGh-CTP and reGh-CTP × 2) were more effective in promoting somatic growth in eel larvae than recombinant Ghs without CTP. Among the three recombinant Ghs with CTP, reGh-CTP × 2 had the highest growth-promoting effects, however only when provided in the short term. After long-term administration of reGh-CTP × 2, there was no difference in growth between the Gh administrated group and the control group. The survival rate of eel larvae were not affected by recombinant Ghs. In addition, the mRNA expression of gh , Gh receptors, Igf-I and IGF-II were measured by quantitative real-time PCR, and significant reductions in the expression of gh, Gh receptors and Igf-I were observed. These findings provide useful tools to study the mechanisms of somatic growth and increase understanding of Gh regulation in anguillid eel larvae. [ABSTRACT FROM AUTHOR]

As genetically modified (GM) foods are starting to intrude in our diet concerns have been expressed regarding GM food safety. These concerns as well as the limitations of the procedures followed in the evaluation of their safety are presented. Animal toxicity studies with certain GM foods have shown that they may toxically affect several organs and systems. The review of these studies should not be conducted separately for each GM food, but according to the effects exerted on certain organs it may help us create a better picture of the possible health effects on human beings. The results of most studies with GM foods indicate that they may cause some common toxic effects such as hepatic, pancreatic, renal, or reproductive effects and may alter the hematological, biochemical, and immunologic parameters. However, many years of research with animals and clinical trials are required for this assessment. The use of recombinant GH or its expression in animals should be re-examined since it has been shown that it increases IGF-1 which may promote cancer. [ABSTRACT FROM AUTHOR]

The separation and purification of recombinant pharmaceutical proteins is a fundamental and challenging step in the biotechnology industry. Hierarchical nanostructures with unique features and high stability can be used as efficient adsorbents. In this study, hierarchical magnetic polydopamine-copper phosphate nanoflowers (Cu-PDA MNFs) were synthesized as high-performance magnetic adsorbents in a simple and low-cost method based on green chemistry. The prepared hybrid Cu-PDA MNFs revealed great performance for separating pure recombinant human growth hormone (rhGH) and the rhGH acquired from recombinant Pichia pastoris yeast fermentation. The analysis confirmed that Cu-PDA MNFs exhibited a high adsorption capacity of 257.4 mg rhGH g−1 Cu-PDA MNFs and a fast adsorption rate for approaching the adsorption equilibrium within less than 30 min with a recovery efficiency of 74% of rhGH from the real sample. In addition, recycling tests demonstrated the stability and recyclability of Cu-PDA MNFs for at least six cycles with almost constant adsorption capacity and no toxicity. Based on these results, Cu-PDA MNFs could be considered as a promising candidate for separation and purification of rhGH. This work presents a new approach to using organic-inorganic nanoflowers as the hierarchical nanostructure for purification of pharmaceutical proteins with high performance. [Display omitted] • Hierarchical magnetic polydopamine-copper phosphate nanoflowers (Cu-PDA MNF) were prepared via a self-assembly method. • The Cu-PDA MNFs were used as adsorbent for recombinant human growth hormone (rhGH) separation. • The hybrid nanoflowers exhibited good selectivity and high recyclability for rhGH. [ABSTRACT FROM AUTHOR]

Abstract: Recombinant rabbitfish growth hormone (rfGH) protein was expressed in Escherichia coli, BL21(DE3) cells. The cDNA encoding the mature protein of rfGH was first cloned in pGEM-Teasy vector and then transferred to pET-3d expression vector. Expression in E. coli cells was then induced by IPTG (0.4 mM). Inclusion bodies (IB) containing the expressed protein were purified by treating bacterial cells pellet with lysozyme followed by repeated washings in cold water containing Triton X-100, sonication, and centrifugation. IB were then solubilized in 4.5 M urea, refolded at pH 11.3 in the presence of catalytic amounts of cysteine and purified by Q-Sepharose column. Gel filtration on Superdex column showed the purified protein to be a monomeric GH. Based on SDS–PAGE, the purity of the recombinant rfGH preparation is approximately 98%. The recombinant rfGH was tested for its biological activity both in vitro, by its ability to stimulate IGF-I mRNA expression in the liver, and in vivo, by its ability to accelerate growth in rabbitfish fry injected with the hormone. A significant increase in growth was observed in rabbitfish fry given the recombinant hormone. Polyclonal antibody raised against the native rfGH immunoreacted with the recombinant rfGH in Western blots and in ELISA, indicating the suitability of these reagents for future quantification of GH in rabbitfish plasma. [Copyright &y& Elsevier]

Discusses the approach to diagnosis and treatment of HIV wasting, the loss of lean body mass in patients with HIV. Re-evaluation of guidelines for diagnosis and treatment of wasting; Therapies for preventing weight loss; Limitation of the pharmacologic options for restoring body cell mass.

The purpose of this study was to prove whether homologous growth hormone has a beneficial effect in the early phase of bone healing. Therefore the left tibias of 24 Yucatan micropigs were osteotomized and stabilized by plate fixation. The treatment group (12 animals) received 100 μg of recombinant porcine growth hormone (rpGH)/kg body w/day sc, whereas the control pigs (12 animals) received 1 ml sodium chloride as placebo. After a healing period of 4 weeks the animals were sacrificed and destructive torsional testing was performed. For histological evaluation 6-μm serial slices of the tibiae were stained with von Kossa. The total area of callus formation (CA) and the mineralized bone area (BA) were quantified by image analysis. The fraction of mineralized bone tissue within the callus area, the bone density (BD), was calculated as follows: BD = (BA/CA) × 100. Torsional failure load was 91% higher and torsional stiffness 61% higher in the treatment group than in the control group (P < 0.05). The histomorphometric measurements revealed an advance for the CA (GH: 127.6 ± 38.9 mm2; placebo: 75.9 ± 50.7 mm2; P < 0.005) as well as for the BA (GH: 89.3 ± 25.8 mm2; placebo: 55.9 ± 38.5 mm2; P < 0.001) for the GH-treated animals in comparison to the control animals. The BD was similar in both groups (GH: 70.6 ± 8.4%; placebo: 74.0 ± 6.24%; P = 0.28). These data indicate that administration of homologous GH stimulates callus formation and ossification in the early phase of bone healing, which consequently results in an increased mechanical strength and stiffness. [Copyright &y& Elsevier]

Aims: To examine the final height (FH) outcome of girls with Turner's syndrome (TS) treated at a single Scottish centre (Glasgow group), to compare it with an earlier national analysis (Scottish group) and to suggest reasons for any change. Methods: Retrospective growth and treatment data for 29 Glasgow patients were compared with those of 26 Scottish patients. Results: Age at GH start (mean ± SD) was 10.1 ± 2.6 vs 12.1 ± 1.7 y ( p < 0.01) in the Glasgow versus Scottish groups, with overall duration of treatment 6.2 ± 2.4 vs 3.7 ± 1.1 y ( p < 0.001) and years of GH treatment before pubertal induction 2.7 ± 2.8 vs 0.3 ± 0.8 y ( p < 0.001), respectively. Pubertal induction was at a similar age: 12.7 ± 1.8 vs 12.8 ± 1.8 y (ns). FH was 151.1 ± 4.6 cm in the Glasgow group compared with 142.6 ± 5.6 cm in the Scottish group ( p < 0.001), with FH - projected adult height (PAH) 5.7 ± 4.6 cm vs 0.6 ± 3.6 cm ( p < 0.001), respectively. Univariate analysis of the Glasgow group's FH - PAH with a number of growth and treatment variables identified no statistically significant relationships. Conclusion: This group's improved FH and FH - PAH, relative to an earlier sample, are attributed to the introduction of GH treatment from a younger age and for longer, overall and before pubertal induction. In addition, the authors believe that compliance with treatment has been enhanced by this single centre's dedicated Turner clinic and the efforts of its established "growth team". These data demonstrate that a favourable FH can be achieved using a safe and financially viable dose of GH, while inducing puberty at a "normal" age. [ABSTRACT FROM AUTHOR]

The effect of growth hormone (GH) on secondary fracture healing and callus formation has been demonstrated in several previously investigated animal models. The aim of this study was to investigate and quantify the effects of GH on bone regenerates in a distraction osteogenesis model. In 20 mature female Yucatan micropigs, the tibia and fibula were osteotomized, stabilized with an external fixator, and distracted at 2 mm/day for 10 days after a 4 day latency period. The regenerates were allowed to consolidate for 10 days. Micropigs in the study group (ten animals) received a daily injection of 100 μg per kilogram body weight of recombinant porcine growth hormone (r-pGH). Micropigs in the control group (ten animals) received sodium chloride as placebo. After killing on day 25, a quantitative histomorphometrical analysis of the formed callus and the adjacent cortical bone was performed and the results of polychrome in vivo labeling were assessed. The regenerates of the r-pGH-treated animals showed a significantly larger callus area but no change in callus structure. We found islands of cartilage tissue in the regenerates of both groups; the calli from the control group exhibited a higher fraction of cartilage compared with the r-pGH group, but this was not significant. Quantification of the fluorescent in vivo labeling revealed that the distraction gap in GH-treated group showed significant ossification even during distraction. These results demonstrate that growth hormone can accelerate the maturation of the regenerate in distraction osteogenesis without changing the callus microstructure. This may prove to be a useful clinical tool for shortening the healing time in limb lengthening and bone segment transport. [ABSTRACT FROM AUTHOR]

Background: Human growth is a complex mechanism that depends on genetic, environmental, nutritional and hormonal factors. The main hormone involved in growth at each stage of development is growth hormone (GH) and its mediator, insulin-like growth factor 1 (IGF-1). In contrast, vitamin D is involved in the processes of bone growth and mineralization through the regulation of calcium and phosphorus metabolism. Nevertheless, no scientific study has yet elucidated how they interact with one another, especially as a dysfunction in which one influences the other, even if numerous biochemical and clinical studies confirm the presence of a close relationship.Main Body: We reviewed and analyzed the clinical studies that have considered the relationship between vitamin D and the GH/IGF-1 axis in pediatric populations. We found two main areas of interest: the vitamin D deficiency status in patients affected by GH deficit (GHD) and the relationship between serum vitamin D metabolites and IGF-1. Although limited by some bias, from the analysis of the studies presented in the scientific literature, it is possible to hypothesize a greater frequency of hypovitaminosis D in the subjects affected by GHD, a reduced possibility of its correction with only substitution treatment with recombinant growth hormone (rGH) and an improvement of IGF-1 levels after supplementation treatment with vitamin D.Conclusions: These results could be followed by preventive interventions aimed at reducing the vitamin D deficit in pediatric age. In addition, further research is needed to fully understand how vitamin D and growth are intertwined. [ABSTRACT FROM AUTHOR]