Metabolic Effects of Adjuvant Recombinant Human Growth Hormone in Patients With Continuing Sepsis Receiving Parenteral Nutrition

Bettany, G. E. A.; Camacho-Hübner, C; Obeid, Omar; Halliday, D.; Powell-Tuck, J

doi:10.1177/0148607198022004199

Cited by 12 publications

(4 citation statements)

References 23 publications

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“…However, neither control or septic rats treated with rhGH for 5 days showed a significant increase in plasma IGF‐1. This observation is potentially explained by the effects of nutrient intake and the septic response on the GH/IGF‐I axis and is consistent with the results of others 20,29 …”

Section: Discussionsupporting

confidence: 92%

Growth hormone does not attenuate the inhibitory effects of sepsis on wound healing

Stamm¹,

Cooney²,

Maish³

et al. 2000

Wound Repair Regeneration

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Chronic abdominal sepsis is associated with impaired tissue repair. Treatment of burn patients with growth hormone results in improved healing of skin graft donor sites. The goal of this study was to determine whether administration of growth hormone could attenuate the inhibitory effects of sepsis on cutaneous wound healing. Four groups of male Sprague Dawley rats were studied: control, control + growth hormone, sepsis, and sepsis + growth hormone. Sepsis was caused by implantation of a bacterial focus in the peritoneal cavity. Control animals underwent sham laparotomy, and polyvinyl alcohol sponge implants were placed in subdermal pockets in all animals. Saline or growth hormone (400 microg) was injected subcutaneously every 12 hours. On day 5, the incisional wounds and polyvinyl alcohol sponge implants were harvested. The breaking strength of abdominal incisions was measured. Granulation tissue penetration and quality were determined by scoring polyvinyl alcohol sponge implant histology from 1 to 4 in a blinded fashion. Collagen deposition in polyvinyl alcohol sponge implants was quantitated by hydroxyproline assay. Septic mortality was not altered by growth hormone administration. Septic animals showed a reduction in food consumption for 2 days after surgery (p < 0.05 vs. controls), which was not affected by growth hormone administration. The breaking strength of incisional wounds and hydroxyproline content of polyvinyl alcohol sponge implants was reduced in septic rats (p < 0.001 vs. controls) but administration of growth hormone for 5 days did not improve breaking strength or collagen deposition in either group. We conclude that the administration of growth hormone for 5 days did not improve collagen deposition or breaking strength in cutaneous wounds from control or septic animals. The results suggest that growth hormone treatment is unlikely to improve tissue repair in sepsis-induced catabolic illness.

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Section: Discussionsupporting

confidence: 92%

Growth hormone does not attenuate the inhibitory effects of sepsis on wound healing

Stamm¹,

Cooney²,

Maish³

et al. 2000

Wound Repair Regeneration

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“…Recombinant human GH (rhGH), with the same molecular constitution and characteristics as GH, is reported to promote protein synthesis, to potently correct negative nitrogen balance, and to improve nutrition effectively (Bettany et al 1998, Barry et al 1999, Zhu et al 2004. rhGH is widely accepted clinically to treat severe malnutrition caused by non-malignant diseases (Blake 1995, Waters et al 1996, Zhu et al 2004.…”

Section: Introductionmentioning

confidence: 99%

The effects of recombinant human GH on promoting tumor growth depend on the expression of GH receptor in vivo

Yan

Li²,

Lü³

et al. 2011

Journal of Endocrinology

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Cancer-related malnutrition is a mortal threat to gastric carcinoma patients. However, conventional nutrition treatment is not effective for recovery. Recombinant human GH (rhGH) is widely accepted clinically to treat severe malnutrition caused by non-malignant diseases, but not approved to treat malignant diseases due to the safety concern. To explore the safety of rhGH on gastric cancer, we assessed the effect of rhGH on two tumor-bearing mice models in vivo established by human gastric adenoma cell lines of SGC-7901 and MKN-45. VEGF expression in tumor tissues was detected using immunohistochemistry. The expression of GH receptor (Ghr), Jak-2, Stat3, Vegf, Hif-1a, Fgf, and Mmp-2 was measured by RT-PCR and protein expression of STAT3, phosphorylated STAT3, VEGF, HIF-1a, and MMP-2 was measured by western blotting. The immunocytochemistry results showed that the GHR expression of SGC-7901 was strongly positive (GHR CCC ), while GHR expression of MKN-45 was regarded as negative (GHR K ). After 14 days of rhGH treatment in SGC-7901 (GHR CCC ) tumor-bearing mice, we found that the tumor growth was significantly increased, and the expressions of downstream factors and VEGF were increased. However, in MKN-45 (GHR K ) tumor-bearing mice, tumor growth was not significantly increased by rhGH, but tumor-free body weight was increased especially in high-dose rhGHtreated group (P!0 . 05). These findings suggest that the level of GHR expression is a key target that influences the effectiveness of rhGH on promoting the growth of gastric cancer and angiogenesis. rhGH may promote the activation of tumor angiogenesis factors through the Jak-2-STAT3 pathway.

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“…In one study, rhGH was shown to reduce net protein catabolism significantly and lower the mean systolic and diastolic pressures in five septic surgical patients requiring parenteral nutrition [39]. A similar study in eight patients, however, failed to show any significant difference in whole-body protein turnover with a 1-week course of rhGH [40]. In a randomized study of septic patients requiring intensive care support, 3 days of rhGH administration led to improved nitrogen balance, but the positive effects were lost following the end of treatment [41].…”

Section: Administration Of Growth Factorsmentioning

confidence: 99%

Manipulations of the Metabolic Response for Management of Patients with Severe Surgical Illness: Review

Connolly

Vernon

2000

World j. surg.

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The metabolic response to severe surgical illness is complex and varied. Much recent laboratory and clinical research has focused on increasing our understanding of the metabolic response and the development of new therapies designed to modify this response. Antiinflammatory agents can target harmful aspects of the metabolic response; the immune system can be stimulated; and anabolic factors can be used in an attempt to enhance recovery. The nutritional support of the surgical patient remains crucial, but the effects of new additives are being studied in a variety of surgical conditions. As yet, few of these "novel" agents have found an established role in the management of surgical patients. This review focuses on many "novel" agents or those that do not yet have a clearly defined role in surgical illness. Clinical trials in the areas of severe sepsis, major surgical trauma, and major elective surgery have been emphasized.

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Metabolic Effects of Adjuvant Recombinant Human Growth Hormone in Patients With Continuing Sepsis Receiving Parenteral Nutrition

Cited by 12 publications

References 23 publications

Growth hormone does not attenuate the inhibitory effects of sepsis on wound healing

Growth hormone does not attenuate the inhibitory effects of sepsis on wound healing

The effects of recombinant human GH on promoting tumor growth depend on the expression of GH receptor in vivo

Manipulations of the Metabolic Response for Management of Patients with Severe Surgical Illness: Review

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