Impact of Growth Hormone (GH) Deficiency and GH Replacement upon Thymus Function in Adult Patients (138.26)

Abstract

Abstract Context: In rodents, growth hormone (GH), insulin-like growth factor-1 (IGF-1), and GH secretagogues (such as ghrelin) reverse age-related changes in thymus cytoarchitecture and increase thymopoiesis. GH administration also enhances thymic mass and function in HIV-infected patients. Until now, thymic function has not been investigated in adult GH deficiency (AGHD). Objectives: The objective of this clinical study was to evaluate thymic function in AGHD, as well as the repercussion upon thymopoiesis of GH treatment for restoration of GH/IGF-1 physiological levels. Design: Twenty-two patients with documented AGHD were enrolled in this study. The following parameters were measured: plasma IGF-1 concentrations, signal-joint T-cell receptor excision circle (sjTREC) frequency, and sj/ß TREC ratio. Analyses were performed at three time points: firstly on GH treatment at maintenance dose, secondly one month after GH withdrawal, and thirdly one month after GH resumption. Results: After 1-month interruption of GH treatment, both plasma IGF-1 concentrations and sjTREC frequency were significantly decreased. Decreases in IGF-1 and sjTREC levels were significantly correlated. There was also a significant decrease in intrathymic T cell proliferation as indicated by the reduced sj/ß TREC ratio. One month after reintroduction of GH treatment, IGF-1 concentration and sjTREC frequency were restored at the level before arrest of GH treatment. The sj/ß TREC ratio also increased with GH resumption, but did not return to the level measured before GH withdrawal. Conclusions: In patients with AGHD under GH treatment, GH withdrawal decreases thymic T cell output, as well as intrathymic T cell proliferation. These parameters of thymopoiesis are completely or partially restored one month after GH resumption.