Effects Of Recombinant Growth Hormone Research Articles

Effect of treatment with growth hormone on body composition and metabolic profile of short children born small for gestational age.

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. 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 dual-energy X-ray absorptiometry (DXA), and the metabolic profile was assessed for insulin, glycemia, IGF-1 levels and lipid profile. 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). 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.

The Effect of Growth Hormone Therapy on Cardiac Outcomes in Noonan Syndrome: Long Term Follow-up Results

Cardiac involvement is common in Noonan syndrome (NS). Concerns have been raised regarding the effect of recombinant growth hormone (rGH) use on ventricular wall thickness and a possible increased risk of cardiac side effects. This study aimed to investigate the effect of rGH on the development of hypertrophic cardiomyopathy and other cardiac findings in NS. Patients under the age of 18 years and diagnosed with NS according to the Van der Burgt criteria, were included. Patients were divided into two groups according to those receiving rGH or not at the time of obtaining cardiac measurements. Before and after the treatment, electrocardiographic and echocardiographic (ECHO) assessments were made, including interventricular septal thickness, left ventricular internal diameter, and left ventricular posterior thickness. Results were expressed as Z scores. Twenty-four NS subjects (16 boys, eight girls) were included. At the beginning of the follow up, the overall height standard deviation score was -2.56±0.94. Sixteen were on rGH. The mean rGH treatment duration was 8.3±3.8 years, and the mean dose was 0.22±0.04 mg/kg/week. The final height was 169±8.2 cm, and 10 of 11 patients who reached the final height received rGH. There was no difference between the rGH and non-rGH groups in terms of ECHO parameters pre-and post-treatment. In this cohort, there was no change in ECHO parameters on rGH and during follow-up. These results suggest that rGH is safe in NS patients with cardiac pathology under close follow-up.

Vitamin B12 in HIV-Infected Patients with Insulin Resistance and Visceral Adiposity in a Randomized Trial of Recombinant Human Growth Hormone and Rosiglitazone (OR12-05-19)

ObjectivesTo 1) examine the burden of vitamin B12 deficiency, 2) determine the effects of recombinant growth hormone and rosiglitazone on vitamin B12 status, and 3) investigate vitamin B12 status as a risk factor for changes in insulin sensitivity (SI) and visceral adipose tissue (VAT), among HIV-infected patients with insulin resistance and visceral adiposity participating in a randomized controlled trial. MethodsParticipants were 72 HIV-infected adults (median [IQR]: 48 [43, 53] y) with insulin resistance and visceral adiposity who participated in a 12-week randomized trial of recombinant growth hormone (GH) and rosiglitazone (R). Venous blood samples were collected at baseline, 4, and 12 weeks, and samples were centrifuged, processed, and stored <−80°C until analysis. Total vitamin B12, methylmalonic acid (MMA), homocysteine, and serum folate were measured in a subset. Vitamin B12 deficiency and insufficiency were defined as <148.0 pmol/L and <221.0 pmol/L, respectively. Elevated MMA was defined as >0.26 μmol/L. Generalized estimating equations were used to evaluate the effects of treatment on vitamin B12 status. Generalized linear models were used to assess the associations of vitamin B12 concentrations with SI and VAT. ResultsA total of 2.3% of patients were vitamin B12 deficient and 13.6% were vitamin B12insufficient at baseline (median [IQR]: 419.8 [287.0, 538.6] pmol/L); 5.4% had elevated MMA concentrations. The GH + R intervention significantly lowered vitamin B12 concentrations at 4 (β: −66.6, 95% CI: −119.6, −13.6, P = 0.01) and 12 (β: −73.3, 95% CI: −117.8, −28.7, P = 0.001) weeks, compared to placebo. The GH-only intervention significantly lowered vitamin B12concentrations at 12 weeks (β: −89.1, 95% CI: −143.0, −35.3, P = 0.001), compared to placebo. Vitamin B12 concentrations did not significantly change in the R-only group. There were no significant changes in MMA concentrations. Vitamin B12 concentrations at baseline were not significantly associated with changes in SI or VAT (P > 0.05). ConclusionsThe prevalence of vitamin B12 deficiency was low in HIV-infected individuals with insulin resistance and visceral adiposity. However, interventions containing recombinant growth hormone decreased vitamin B12 status during follow-up. Funding SourcesBG was supported by NIH/NCATS Grant # TL1-TR-002386; Division of Nutritional Sciences, Cornell University.

Growth increase of Silver Pompano (Trachinotus blochii) Stimulated by Recombinant Growth Hormone (rGH) Addition on Their Commercial Feed

The aims of the study was to determine the effect of recombinant growth hormone (rGH) on the growth of Silver pompano (Trachinotus blochii). This research was conducted using Complete Random Device) design experimentation i.e. control (non rGH), A (2 mg.kg-1), B (of 3 mg.kg-1), and C (4 mg.kg-1) of feed dry wieght (w/w) by four individual restating (each test 15 fish). Several parameter was observeb included absolute Growth, Specific Growth, feed convertion ratio, survival rate, mortality and water quality (DO, pH, temperature and salinity). The results showed that treatment C resulting an absolute growth of 19.9 g with a specific growth 0.71 g/ day). Feed convertion ratio was 5.8 while survival rate was 16.67% and Mortality reached 83.33 %. Results The analysis of water quality parameters are range DO (5.2-7.1mg L-1), salinity (25-28 ppt), pH (6.8-7.1) and temperature (30-31.2° C). Reviews These results indicate that rGH can increase the growth S. pompano fish compared to the control treatment.Keyword: recombinant Growth Hormone, Growth, Silver pompano

Effect of recombinant growth hormone on immune response in pediatric burn patients

Background Management of severely burnt children is one of the most challenging situations in the ICU. Control of the hypercatabolic state is the most limiting step that determines patient survival. Immunocompromisation and delayed wound healing usually result in severe sepsis, which is the most common direct cause of death in these patients. There is debate about the efficacy and safety of recombinant human growth hormone (rGH), although it has been used to improve healing of burnt patients. Role of growth hormone in immunomodulation has been proposed theoretically and serologically, but it has not been tested clinically. We reported in this study how far the use of rGH in the management of burnt patients can improve their immune status and increase survival. Patients and methods Forty pediatric patients were enrolled in this study, randomly assigned into two groups. Group A received rGH and was compared with group B, which did not receive rGH. Those two groups were compared with respect to overall mortality rate, hospital and ICU stay, serum transferrin, C-reactive protein, and positivity of blood culture. Results The overall mortality rate was slightly lower in group A (20%) compared with B group (25%). No significant decrease in hospital stay was noticed between the two groups. There was significant improvement in serum transferrin especially by day 14 in addition to a significant drop in C-reactive protein in group A. Group A was found to be more protected from bacteremia. Conclusion The use of rGH in pediatric burnt patients improves overall mortality and optimizes immune status, in addition to improvement of wound healing and donor site healing. This eventually reduces the length of hospital stay.

Growth hormone and the risk of atherosclerosis in growth hormone-deficient children

ObjectiveGrowth hormone-deficient (GHD) children have been found to have higher cardiovascular mortality rates and an increased carotid intima-media thickness (CIMT). This study investigated the risk of atherosclerosis and the effect of recombinant growth hormone (rhGH) replacement therapy on the lipid profile and CIMT in GHD children. DesignA total of 40 GHD children (mean age: 12.3±2.04years) were investigated before and after 1year of rhGH therapy at a dosage of 0.03mg/kg/day and 40 age- and sex-matched healthy children (mean age: 12.1±2.23years) were enrolled as a control group, in the same pubertal stage. Fasting blood samples were obtained for lipid profile, IGF-1, and IGFBP-3 analyses. The patients and controls underwent CIMT measurements before and after 1year of rhGH treatment. ResultsThe growth velocity and height standard deviation scores increased significantly over 1year of treatment in all patients. The total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, and atherogenic index (Ai) values were increased while the high-density lipoprotein (HDL) cholesterol value was decreased in the GHD children, as compared to the controls; however, the triglyceride (TG) level was comparable. After 1year of treatment, a significant decrease in the TC, LDL cholesterol, and Ai values as well as a significant increase in the HDL value were observed in the GHD patients, with the values becoming similar to those in the control group. The mean CIMT was significantly greater in the GHD subjects than in the controls. After 1year of therapy, the CIMT in the GHD subjects had decreased significantly; however, it was still greater than that in the control group. IGF-1 was negatively correlated with TC, LDL cholesterol, Ai, right CIMT, and left CIMT. ConclusionsGHD is associated with increased atherosclerotic risk in children. An improved lipid profile and CIMT were detected after 1year of hormone replacement therapy.

Effects of recombinant growth hormone on growth factor and immune component levels in the cinnamon clownfish, Amphiprion melanopus

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.

Effects of recombinant growth hormone (GH) replacement and psychomotor and cognitive stimulation in the neurodevelopment of GH-deficient (GHD) children with cerebral palsy: a pilot study

Cerebral palsy (CP) is the main cause of physical disability in childhood and is an important health issue that has a strong socioeconomic impact. There is no effective treatment for CP and therapeutic approaches report only partial benefits for affected people. In this study we assessed the effects of growth hormone (GH) treatment combined with psychomotor and cognitive stimulation in the neurodevelopment of children with CP and GH deficiency (GHD). The study was carried out in 11 patients (7 boys and 4 girls; 4.12 ± 1.31 years) with GHD and CP who were treated with recombinant GH (rGH) and psychomotor and cognitive stimulation during 2 months. Battelle Developmental Inventory Screening Test (BDIST) was performed 2 months before commencing GH treatment, just before commencing GH administration, and after 2 months of combined treatment involving GH and cognitive stimulation. Psychomotor and cognitive status did not change during the period in which only cognitive stimulation was performed; however, significant improvements in personal and social skills, adaptive behavior, gross motor skills and total psychomotor abilities, receptive and total communication, cognitive skills and in the total score of the test (P < 0.01), and in fine motor skills and expressive communication (P < 0.02) were observed after the combined treatment period. Therefore, GH replacement together with psychomotor and cognitive stimulation seem to be useful for the appropriate neurodevelopment of children with GHD and CP.

Effect of recombinant growth hormone on leptin, adiponectin, resistin, interleukin-6, tumor necrosis factor-α and ghrelin levels in growth hormone-deficient children

Treatment with GH promotes linear growth and decreases body fat in patients with isolated GH deficiency (GHD). However, few studies have analyzed how GH replacement modifies ghrelin levels and the adipokine profile and the relationship of these modifications with the metabolic changes. To analyze the eventual differences between serum levels of leptin, leptin soluble receptor (sOBR), resistin, adiponectin, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), total (TG) and acylated ghrelin (AG) and lipid and glycemic profiles in children with GHD, as well as to determine the effect of GH replacement on these parameters during the first year of therapy. Thirty pre-pubertal (Tanner stage I) GHD children and 30 matched controls were enrolled. Children with GHD were studied before and after 6 and 12 months of GH treatment. Weight, height, BMI, fasting glucose, insulin, lipid profile and serum levels of adipokines and ghrelin were studied at every visit. Adi - pokines, insulin and ghrelin levels were determined by using commercial radio- and enzymoimmunoassays. At baseline children with GHD had significantly higher sOBR (p<0.01) and adiponectin (p<0.01) levels than controls. Treatment with GH resulted in a decline in leptin (p<0.05) and TG (p<0.001) levels, an increase of homeostasis model assessment index and restored IGF-I levels (p<0.001). These data indicate that GH replacement has a negative effect on leptin levels and may also produce a slight unfavorable effect on carbohydrate metabolism. In addition, the changes observed in the adipokine profile appear to be independent of body mass index.

Additional Beneficial Effects of Recombinant Growth Hormone in Alendronate-treated Patients with Idiopathic Osteoporosis

In order to study the benefit of adding recombinant human growth hormone (rhGH) to antiresorptive therapy, six patients with idiopathic osteoporosis (IO) receiving alendronate plus calcium and vitamin D were started on daily subcutaneous injections of rhGH 2.0 IU for one year. Fasting morning urine and serum samples were collected for N telopeptide of type-1 collagen (NTX), serum bone-specific alkaline phosphatase (BSAP) and insulin-like growth factor 1 (IGF-1) during the study. Bone mineral density (BMD) was determined by dual-energy x-ray absorptiometry at baseline and 01 year. The effect of rhGH was evaluated comparing the percentage changes in BMD during the last year on ALN with the results obtained with the combined therapy. Serum IGF-1 increased in all patients but variations were not significant (p=0.266). Serum BSAP did not significantly change (p=0.078) but median NTX increased at 45 days from 12.3 to 19.8 nMBCE/mMCr (p=0.012) and tended to return to baseline values at 12 months (15.2 nMBCE/mMCr). Comparing with isolated ALN therapy, a beneficial effect on bone density was observed in 2/3 of the patients at lumbar spine, and percentage change (median and quartiles) varied from -0.65% (-2.33 and 2.23) on ALN to 0.70% (-0.35 and 3.03) on ALN+GH. Although no bone gain occurred at the femoral neck, our data point to a positive effect of rhGH in patients with idiopathic osteoporosis.

Recombinant growth hormone for children and adolescents with Turner syndrome

Turner syndrome (TS) affects about one in 1500 to 2500 live-born females. One of the most prevalent and salient features of the syndrome is extremely short stature. Untreated women are approximately 20 to 21 cm shorter than normal women within their respective populations. Recombinant human growth hormone (hGH) has been used to increase growth and final height in girls who have Turner syndrome. To assess the effects of recombinant growth hormone in children and adolescents with TS. MEDLINE, EMBASE, The Cochrane Library, LILACS, BIOSIS, Science Citation Index and reference lists were used to identify relevant trials. Randomised controlled trials were included if they were carried out in children with TS before achieving final height. Growth hormone had to be administered for a minimum of six months and compared with a placebo or no treatment control condition. Two reviewers assessed studies for inclusion criteria and for methodological quality. The primary outcomes were final height and growth. Secondary outcomes included bone age, quality of life, cognitive performance, and adverse effects. Four RCTs that included 365 participants after one year of treatment were included. Only one trial reported final height in 61 treated women to be 148 cm and 141 cm in 43 untreated women (mean difference (MD) seven cm, 95% CI 6 to 8). Short-term growth velocity was greater in treated than untreated girls after one year (two trials, MD three cm per year, 95% CI 2 to 4) and after two years (one trial, MD two cm per year, 95% CI 1 to 2.3). Skeletal maturity was not accelerated by treatment with recombinant growth hormone (hGH). Adverse effects were minimally reported. Recombinant human growth hormone (hGH) doses between 0.3 to 0.375 mg/kg/wk increase short-term growth in girls with Turner syndrome by approximately three (two) cm in the first (second) year of treatment. Treatment in one trial increased final height by approximately six cm over an untreated control group. Despite this increase, the final height of treated women was still outside the normal range. Additional trials of the effects of hGH carried out with control groups until final height is achieved would allow better informed decisions about whether the benefits of hGH treatment outweigh the requirement of treatment over several years at considerable cost.

In vivo effect of growth hormone on the expression of connexin‐43 in bovine ovarian follicles

This study assessed the in vivo effects of recombinant growth hormone (rGH) administration on the expression of connexin-43 (Cx43) in bovine ovarian follicles. Two independent experiments were carried out using either estrous unsynchronized or synchronized multiparous Aberdeen Angus cows. rGH-treated animals were inoculated with a single dose of hormone (500 mg, intramuscular) while control animals were inoculated with hormone diluent. Five and 14 days after treatment (Experiments 1 and 2, respectively), ovarian Cx43 and apoptosis expression were assessed using immunohistochemistry. In both experiments primary, secondary, and tertiary follicles from rGH-treated and control groups distinctly expressed Cx43 protein. Primordial and atretic follicles were Cx43-negative. Interestingly, the number of Cx43 dots per granulosa cell did not show significant variation at different folliculogenesis stages neither in the rGH-treated nor in the control group. In unsynchronized animals, Cx43-positive follicles per total number of follicles ratio showed an interaction between stage of folliculogenesis and treatment due to significant differences between treatment groups in the early secondary follicle stage. In synchronized animals, there were significant differences between treatment groups and folliculogenesis stage. In both experiments, atretic follicles showed apoptosis-related DNA-fragmentation as determined by terminal uridin nick end labeling (TUNEL) assay. Tertiary follicles presented moderate TUNEL staining. Our results show significant increment in the number of ovarian follicles expressing the gap junction subunit Cx43 after in vivo rGH treatment. Therefore, we conclude that growth hormone can modulate in vivo gap junction assembly at early stages of folliculogenesis.

Effects of Recombinant Growth Hormone on Visceral Fat Accumulation: Pilot Study in Human Immunodeficiency Virus-Infected Adolescents

Recombinant human GH (rhGH) reduces excess accumulation of intraabdominal adipose tissue (IAT) in lipodystrophic HIV-infected adults, whereas data in pediatric patients are lacking. The objective of this study was to assess the efficacy of rhGH treatment on lipodystrophy in HIV-infected adolescents. The study is a prospective, 24-wk open-label study of rhGH. The study was conducted at a referral center for pediatric HIV infection. Eight HIV-infected adolescents (ages, 13.7-18.5 yr), with abnormal IAT accumulation (>41 cm(2) at L4-magnetic resonance imaging) and 97 healthy controls (HC) (ages, 9.5-19.9 yr) were enrolled. rhGH was given by sc injection at a daily dose of 0.028 mg/kg. The main outcome was change in IAT at L4-magnetic resonance imaging. Body composition by dual-energy x-ray absorptiometry, glucose and lipid metabolism, and IGF-I changes were also evaluated. All patients completed the study period; none of them showed adverse event, and no change in the daily dose of rhGH was required. The treatment was associated with a mean height increase of 2.4 cm. From baseline to wk 24, IAT area decreased significantly by a median of 34.5% (-19.2 to -70%). Fat mass decreased significantly in patients, compared with HC, with a median loss of total, trunk, and arm and leg fat mass of 10.4, 10.9, 12.7, and 5.4%, respectively. Total, arm, and leg lean masses increased significantly, compared with HC. IGF-I increased significantly, but supraphysiological values of mild degree (2-23% over the upper normal limit) were detected in only nine of 24 samples. No significant effects on glucose metabolism, triglyceride, and cholesterol levels were observed. Our data showed that rhGH 0.028 mg/kg daily for 24 wk in HIV-infected adolescents reduces IAT, trunk, and also limb fat and increases lean mass. Overall, short-term rhGH is well tolerated and is not associated with a worsening of glucose and lipid metabolism.

Effect of recombinant growth hormone on expression of growth hormone receptor, insulin-like growth factor mRNA and serum level of leptin in growing pigs

Sixteen Large White x Landrace castrated male pigs were allotted into treatment and control group. The treatment group was injected intramuscularly with recombinant porcine growth hormone (rpGH, 4 mg d(-1)) and the control group with vehicle for 28 days. Animals were slaughtered 4 h after final injection for liver, longissimus dorsi (LD) muscle and blood sampling. Serum concentration of insulin-like growth factor 1 (IGF-I) and leptin were determined by RIA. The total RNA was extracted from tissues to measure the abundance of growth hormone receptor (GHR), IGF-I mRNA by RT-PCR with 18S rRNA internal standard. Results showed that rpGH enhanced the average daily weight gain by 26.1% (P < 0.05), the serum IGF-I concentration by 70.94% (P < 0.01), decreased serum leptin by 34.8% (P < 0.01). The relative abundance of GHR and IGF-I mRNA in liver were increased by 24.45% (P < 0.05) and 45.30% (P < 0.01), respectively, but no difference of GHR (P > 0.05) and IGF-I mRNA (P > 0.05) in LD between GH treated and control group was found. These results suggest that rpGH can up-regulate hepatic GHR and IGF-I gene expression and improve animal growth. However the effect of rpGH on GHR and IGF-I gene expression are tissue-specific.

Protective effects of recombinant growth hormone on intestinal mucosa in rats receiving abdominal radiotherapy

Background and Aims: Radiation injury to the gut induces nutrient losses that compromise the body ability to adequately fight infection, heal wounds and recover from illness. Recombinant growth hormone (rhGH), is known to enhance anabolism, therefore, we tested the hypothesis that rhGH preserves whole body growth and trophism of the jejunum and ileum of irradiated rats. Methods: After acclimatization period, the rats were divided in three groups: (1) control rats (C), (2) rats irradiated with a single dose of 10 Gy (group A); (3) rats irradiated with a single dose of 5 Gy (Group B); after irradiation, rats were given subcutaneously (sc) saline or 0.25 or 0.50 mg rhGH/kg BW/d for the following 6 days. Body weight changes were recorded during this time. On day 6 post-radiation, rats were killed and small intestine mucosa dry and wet weights were measured, as well as mucosa protein content. Results: Group A rats lost body weight during the 6-day post-radiation period, regardless of rhGH treatment and dosage. rhGH was effective in preventing weight loss and normalizing growth in group B rats (saline 23.1±11.1, vs. controls P<0.05; rhGH: 35.0±10.0 g BW/d, vs. controls P = ns). Trophic effect of rhGH was observed on mucosa weight and mucosa protein content in rats irradiated with 5 Gy, but not in those receiving 10 Gy. Conclusion: rhGH seems to normalize growth and mucosa protein content in irradiated rats. However, rhGH beneficial effects were observed only in rats receiving the lower dose of radiation.

Recombinant growth hormone therapy in patients with ischemic cardiomyopathy : effects on hemodynamics, left ventricular function, and cardiopulmonary exercise capacity.

We studied the effects of recombinant growth hormone (rhGH) on exercise capacity and cardiac function in patients with ischemic cardiomyopathy. Seven patients (aged 55+/-9 years) with mild to moderate congestive heart failure (ejection fraction 31+/-4%) who were on standard therapy were included. The patients were studied at baseline, after 3 months of rhGH treatment, and 3 months after rhGH discontinuation. Cardiac function was assessed by exercise capacity, right heart catheterization at rest and after submaximal exercise, MRI, echocardiography, and Holter monitoring. When administered at a dose of 2 IU/d, rhGH doubled the serum concentration of insulin-like growth factor-I. rhGH improved clinical symptoms and exercise capacity significantly (New York Heart Association class 2.4+/-0.5 initially versus 1.4+/-0.5 at 3 months [mean+/-SD], P<0.05; VO2max 13.6+/-3.8 versus 17.4+/-5.4 mL. kg-1. min-1, P<0.05). Additionally, pulmonary capillary wedge pressures at rest and after submaximal exercise were reduced significantly. Cardiac output increased, particularly at rest (5.0+/-1.1 versus 5.8+/-1.3 L/min; P<0.05). Posterior wall thickness was increased (1.08+/-0.1 versus 1. 24+/-0.3 cm; P<0.05), and the end-diastolic and end-systolic volume indexes decreased significantly after rhGH treatment. There was no significant increase in left ventricular ejection fraction. The improvements were partially reversed 3 months after rhGH discontinuation. The administration of rhGH for 3 months in patients with ischemic cardiomyopathy results in significant improvement in hemodynamics and clinical function. The attenuation of left ventricular remodeling persisted 3 months after discontinuation of treatment.

The Effect of Recombinant Growth Hormone on the Strength of Ileal Anastomoses in a Rat Model

In gynecologic surgery, the ileum is the primary site of bowel injury. Recombinant growth hormone (rGH) has been shown to improve the strength of colonic anastomoses in experimental models. The purpose of this study is to evaluate the effect of rGH on small bowel anastomoses, specifically in the ileum. Twenty large female rats underwent segmental ileal resections and end-to-end ileoileostomies. The rats were randomized to be treated for 7 postoperative days with either rGH (2.0 mg/kg/day) or placebo starting on the day of surgery. On the seventh postoperative day, a segment of ileum surrounding the anastomosis was resected. The anastomoses were tested for breaking strength on a tensiometer and for tissue concentrations of hydroxyproline. The ileal anastomotic breaking strength in the rGH group was 163.5 +/- 6.0 g (mean +/- standard error). In the placebo group, the breaking strength of ileal anastomoses was 125.0 +/- 3.0 g (P < .001). No significant difference was demonstrated with respect to the hydroxyproline concentration between the rGH group (15.2 +/- 2.0 micrograms/mg) and the placebo group (14.6 +/- 1.0 micrograms/mg). In an animal model, a 31% increase in ileal anastomotic breaking strength was induced by rGH administration. With further research this may translate into decreases in the surgical complications that occur in ileal anastomoses. Furthermore, these serve as preliminary data to a study that evaluates the effect of rGH on ileal anastomoses in radiation-injured bowel.

The Effect of Recombinant Growth Hormone on the Strength of Ileal Anastomoses in a Rat Model

The Effect of Recombinant Growth Hormone on the Strength of Ileal Anastomoses in a Rat Model

THE EFFECT OF RECOMBINANT GROWTH HORMONE ON NITROGEN BALANCE IN MALNOURISHED PATIENTS AFTER MAJOR ABDOMINAL SURGERY

The effect of recombinant growth hormone (rGH) on nitrogen balance was studied in malnourished patients receiving total parenteral nutrition after major abdominal surgery. Fifteen patients were randomized to receive either subcutaneous rGH (0.2 iu/kg) or placebo (saline) injection daily for seven days after surgery. Positive nitrogen balance was achieved throughout the treatment period with rGH administration and was significant on days 3 and 6. This was associated with increase in mid-arm muscle circumference and significant weight gain. Plasma insulin-like growth factor-1 (IGF-1) concentration was significantly raised in the rGH group at day 7, suggesting its role in the anabolic effect of growth hormone. Plasma pre-albumin and retinol-binding protein concentrations were raised in both the rGH and control groups, indicating improvement in the nutritional status. We conclude that the postoperative catabolic response can be attenuated using recombinant growth hormone.

Effect of recombinant growth hormone and chromium picolinate on cytokine production and growth performance in swine.

The effect of dietary chromium picolinate (CrP) and recombinant porcine growth hormone, somatotropin (rPST) administration on growth performance and cytokine production in Landrace-Poland China gilts was determined using a 2 by 2 treatment array. Treatments were: (1) control (basal diet), (2) CrP-supplemented diet (basal diet + 300 micrograms Cr3+/kg diet as CrP), (3) rPST (100 pg/kg body weight/day), and (4) rPST+CrP. CrP-supplemented diets were fed beginning at 20 kg body weight through 90 kg. Administration of rPST was begun at 60 kg weight and continued through 90 kg. All rPST treated pigs demonstrated improvements in growth performance versus controls. Pigs given CrP-supplemented diets showed no differences in growth performance. At 90 kg, pigs were challenged with endotoxin (lipopolysaccharide, 0.2 microgram/kg i.v.). Blood samples were collected at 0, 1, and 3 h postchallenge. Plasma IL-6 levels increased from 23 U/ml at time 0 to 1,927 U/ml at 3 h for control swine. Swine from the CrP treatment group had IL-6 levels of 8,130 U/ml at 3 h post-LPS. There were no differences in plasma IL-6 from pigs in the rPST and rPST+CrP treatment groups compared to the controls. Endotoxin challenge had no effect on either blood glucose levels or induction of TNF-alpha in any treatment group. PBMC from CrP-treated animals produced more IL-2 than peripheral blood mononuclear cells from all other groups.