“…It has been reported that mutations in GHRHR gene are being detected with increasing frequency. More than 20 GHRHR mutations were reported to date, including missense mutations ( 13 , 25 , 26 , 27 , 28 , 29 ), nonsense mutations ( 13 , 25 , 29 , 30 , 31 ), splice site mutations ( 12 , 29 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ), promoter mutation ( 20 ), micro-deletion mutations ( 19 , 26 , 40 ) that lead to loss of GHRHR function. The missense mutations show defective ligand binding resulting in blocking GHRH-GHRHR signaling ( 33 ); promoter mutations affect promoter activity and thus change GHRHR expression ( 26 ); nonsense and splicing mutations produce truncated GHRHR receptor and can be involved in mRNA instability ( 29 ).…”