Pulsatile Secretion of Growth Hormone (GH) Persists during Continuous Stimulation by CJC-1295, a Long-Acting GH-Releasing Hormone Analog

Ionescu, Madalina; Frohman, Lawrence A.

doi:10.1210/jc.2006-1702

Cited by 31 publications

(23 citation statements)

References 16 publications

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“…Pulsatile GH secretion is considered important for many of the physiological effects of GH. 17 More GH pulses are released during sleep than when awake at all ages, but especially in the prepubertal child. [18][19][20] After the onset of puberty, daytime GH pulses increase and GH pulses are higher and more frequent in girls than in boys, leading to rising daytime mean GH and higher night mean GH in girls than in boys (see Figure 3).…”

Section: Normal Growth Hormone and Insulin-like Growth Factor Secretionmentioning

confidence: 99%

“…17,75,80 GHRH therapy produces pulsatile release of GH, similar to normal physiology; however, therapy using GHRH requires several injections daily or an infusion. If it were possible to develop a depot form of GHRH, then it could be given monthly, every three months, yearly and theoretically still could induce pulsatile GH release.…”

Section: Matching Of Physiological Levels and Pattern Of Growth Hormomentioning

confidence: 99%

“…The depot GHRH was well tolerated in healthy adults, with no significant side effects. 17,80 A depot therapy that releases pulses of GH could mimic normal physiology better than weekly or even daily GH injections.…”

Section: Matching Of Physiological Levels and Pattern Of Growth Hormomentioning

confidence: 99%

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Optimal Therapy of Growth Hormone Deficiency in the Child and Adolescent

Rose¹

2010

European Endocrinology

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Paediatric endocrinologists aspire to provide the best care for children, including improving outcomes in growth hormone deficiency (GHD).The challenging issues are sometimes simple ones, such as which children should be seen in the endocrine clinic for evaluation of their growth, or standards for diagnosis of GHD, or methods of delivering standard therapy for GHD.1 Historically accepted solutions require review as knowledge and technology advance. 2-4This article addresses ways to optimise treatment strategy for children diagnosed with GHD. Optimal therapy of growth disorders depends on accurate diagnosis of the aetiology and identification of the goals of therapy. It is important to understand normal patterns of growth hormone (GH) and insulin-like growth factor (IGF) secretion in order to appreciate differences between normal physiology and hormone patterns induced by therapy. Finally, monitoring for efficacy and safety, identification of interfering factors and making appropriate dose adjustment are all part of optimising GH therapy in childhood GHD. Accurate DiagnosisMany factors besides GH participate in the regulation of normal growth (nutrition, thyroid hormone, genetics, prenatal health, family growth patterns and psychosocial adjustment [see Figure 1]). GH has been administered to children with severe GHD since 1958. Of course, there is no difficulty in making the diagnosis of GHD when the condition is severe. However, with the increasing availability of synthetic recombinant GH, GH therapy has been used in more conditions (see Figure 2). 5 There continues to be controversy about methods for accurate diagnosis of milder degrees of GHD, as well as controversy about which children should be treated with GH.Standardisation of GH assays and cutoff values for normal GH secretion may permit more uniform diagnosis, enabling therapy decisions to be based on reliable data from assays. Goals of TherapyThe purpose of GH treatment must be considered. GH therapy clearly speeds up linear growth in the GHD child and adolescent. However, GHD leads to metabolic effects in addition to slowed linear growth. In untreated GHD, body composition is altered with increased fat mass, decreased lean body mass and decreased accrual of bone mineral. 8-10In addition, individuals with GHD may have decreased exercise tolerance and a sense of fatigue, along with a raised risk for AbstractOptimal therapy of growth disorders depends on accurate diagnosis and clear goals for therapy. Understanding normal patterns of growth hormone (GH) and insulin-like growth factor (IGF) secretion are necessary to appreciate the different hormone pattern induced by therapy.Finally, monitoring efficacy and safety, identifying interfering factors and adjusting doses are all part of optimising GH therapy in childhood GH deficiency (GHD). Prevention of development of GHD would avoid the need for therapy. Options for optimising GH therapy in childhood GHD include initiating treatment as young as possible, facilitating adherence to a therapy plan and adjusti...

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Section: Normal Growth Hormone and Insulin-like Growth Factor Secretionmentioning

confidence: 99%

Section: Matching Of Physiological Levels and Pattern Of Growth Hormomentioning

confidence: 99%

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Optimal Therapy of Growth Hormone Deficiency in the Child and Adolescent

Rose¹

2010

European Endocrinology

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“…Os autores concluíram que este composto é capaz de aumentar significativamente a secreção de GH e de IGF-1, visto que este último permanece elevado pelo período de sete dias. Entretanto, altas doses deste composto estão associadas à ocorrência de cefaléia, diarréia e reações cutâneas no local da injeção (84,85).…”

Section: Ghrh De Depósitounclassified

Novas opções e preparações na terapia com hormônio de crescimento

Aguiar‐Oliveira

Meneguz‐Moreno

Nascimento-Junior

2008

Arq Bras Endocrinol Metab

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RESUMOnos últimos 20 anos, o hormônio de crescimento recombinante humano (gHhr) vem sendo utilizado para tratar a deficiência do hormônio de crescimento (gH) em crianças e, mais recentemente, em adultos. Porém, a necessidade de injeções diárias compromete a aderência ao tratamento. esforços de melhorar esta aderência incluem o uso de canetas e dispositivos desprovidos de agulha, haja vista que as bombas de infusão, nem sempre são fisiológicas e são de uso restrito. quando a finalidade do tratamento for o crescimento, a terapêutica diária com gHhr continua a mais recomendada. contudo, a expansão da terapêutica com gH, especialmente nos usos mais recentes e em adultos, necessitará de outras preparações. no momento atual, os secretagogos orais não têm eficácia comprovada para a utilização clínica, e as formulações de depósito de gHrH e de gH, que melhorariam a aderência dos pacientes, ainda requerem mais estudos de eficácia em longo prazo e segurança. ABSTRAcTNews Options and Preparations in Growth Hormone Therapy. in the last twenty years, recombinant human growth hormone (hrgH) has been available for the treatment of growth Hormone deficiency (gHd) in children and more recently in adults. However, the necessity of daily injections compromises the patient's compliance. Attempts to improve this compliance includes the use of pens and needle free devices, once the infusion pumps, not always physiologic, are of restricted use. When growth is the purpose of treatment, daily subcutaneous hrgH is still the most indicated. nevertheless the expansion of gH replacement to new uses and especially in adults will need new preparations. nowadays, the oral secretagogues have not proved efficacy to be used in clinical practice and the slow-release preparations of gH and gH releasing hormone that could improve the patient's compliance will need to be studied considering long term efficacy and safety. (1). Desde 1986, o GH recombinante humano (GHhr) vem sendo usado para tratar crianças com deficiência de GH (DGH) e déficit de crescimento (2,3). Posteriormente, foi reconhecido que o GH não é somente requerido

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“…These include growth hormone releasers such as CJC-1295, GHRP-2 and GHRP-6 [2][3][4][5][6][7]. These drugs have similar effects on the body, mainly triggering the pulsatile releasing activity of human growth hormone (hGH) from the anterior pituitary gland [8]. This hormone, in turn, is involved in the regulation of body composition, due to its anabolic and lipolytic actions, as well as physical performance and wellbeing [9].…”

mentioning

confidence: 99%