Biosynthetic human growth hormone in burned patients: a pilot study

Belcher, H. J. C. R.; Mercer, D; Judkins, K.C.; Shalaby, Shimaa I.; Wise, Steven; Marks, Vincent; Tanner, N.S.B.

doi:10.1016/0305-4179(89)90138-1

Cited by 64 publications

(16 citation statements)

References 33 publications

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“…Therefore, the lack of an anabolic response is associated with an attenuation in the rise of IGF-I concentrations, suggesting that there is reduced secretion of IGF-I in response to rhGH therapy. This would be in accordance with the observation in critically ill malnourished patients, catabolic patients after burns or major surgery where pharmacological rhGH doses could not improve nitrogen balance and albumin concentrations [37, 38, 39]. Thus, it appears that sepsis or severe catabolic stress as well as severe malnutrition abolish the anabolic effects of rhGH.…”

Section: Discussionsupporting

confidence: 87%

One-Year Growth Hormone Therapy Improves Granulocyte Function without Major Effects on Nutritional and Anthropometric Parameters in Malnourished Hemodialysis Patients

Kotzmann¹,

Schmidt²,

Lercher³

et al. 2004

Nephron Clin Pract

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Background/Aims: Growth hormone (GH) resistance leads to enhanced protein catabolism and contributes to the malnutrition of patients with chronic renal failure (CRF). In short-term trials anabolic effects of rhGH therapy have been demonstrated in patients on chronic hemodialysis. Methods: This study was initiated to determine the effects of 12 months of rhGH therapy on polymorphonuclear leukocyte (PMNL) function as well as on nutritional and anthropometric parameters. 0.125 IU/kg rhGH was given 3 times a week during the first 4 weeks and 0.25 IU/kg thereafter to 19 malnourished hemodialysis patients with a mean age of 59.3 ± 13.4 years. Results: Insulin-like growth factor I (IGF-I) concentrations rose significantly from 169.2 ± 95.6 to 262.9 ± 144.4 ng/ml (p < 0.01) in the first 3 months, but declined thereafter. Phagocytic activity of PMNLs also increased significantly in response to rhGH therapy and this activation remained stable over the whole 12-month period. Other parameters of PMNL function were not influenced by rhGH therapy. In addition, nutritional parameters such as albumin, prealbumin, transferrin, cholesterol, HDL-cholesterol, cholinesterase, predialytic creatinine and blood urea nitrogen were not affected by rhGH therapy. A decline of total body fat (TBF) was observed after 3 and 9 months of rhGH therapy (17.5 ± 10 vs. 16.7 ± 10% after 3 months, p < 0.017 and 16.8 ± 8.7% after 9 months, p < 0.049), whereas lean body mass remained stable. Conclusions: Twelve months of rhGH therapy caused a significant increase in IGF-I levels, stimulated phagocytic activity of PMNLs and induced a decline of TBF. Other anthropometric and nutritional parameters were not affected, which might be related to the persistence of GH resistance.

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Section: Discussionsupporting

confidence: 87%

One-Year Growth Hormone Therapy Improves Granulocyte Function without Major Effects on Nutritional and Anthropometric Parameters in Malnourished Hemodialysis Patients

Kotzmann¹,

Schmidt²,

Lercher³

et al. 2004

Nephron Clin Pract

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“…Since a variety of illnesses lead to either suppression ofappetite or reduced nutrient absorption, therapy with GH and IGF-I could shorten the convalescent phase. Patients with extensive surface burns or sepsis have been reported to be refractory to GH (9,10). The combination of GH and IGF-I could potentially be more effective in such patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, GH has failed to improve nitrogen retention in some patients with sepsis (9) or burn injury (10). Furthermore, GH's tendency to cause insulin resistance ( 11 ) worsens the glucose intolerance associated with glucocorticoid therapy (5) or severe stress, such as that caused by extensive surface bums (10).…”

Section: Introductionmentioning

confidence: 99%

Enhancement of the anabolic effects of growth hormone and insulin-like growth factor I by use of both agents simultaneously.

Kupfer¹,

Underwood²,

Baxter³

et al. 1993

J. Clin. Invest.

347

138

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“…Growth hormone and insulin-like growth factors (IGF), either alone or in combination, have been used in an attempt to improve N balance in a variety of states in which catabolism andor malnutrition are likely to occur, e.g. low-energy dieting, elective surgery, corticosteroid-induced catabolism, burns, AIDS and chronic obstructive airways disease (Manson & Wilmore, 1986;Dahn et al 1988: Snyder et al 1988Belcher et al 1989;Jiang et al 1989;Horber & Haymond, 1990;Chwals & Bistrian, 1991;Pape el al. 1991;Kupfer etal.…”

Section: Precursor Substratesmentioning

confidence: 99%

The application of nutritional science to clinical practice

Elia

1994

Proc. Nutr. Soc.

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Nutritional science consists of multiple overlapping disciplines: agricultural science including animal husbandry; food science; public health; nutritional physiology; and therapeutic or clinical nutrition. The application of nutritional science to clinical practice has undoubtedly resulted in improved survival and improved quality of life in certain groups of patients. It has also resulted in new concepts that are not only of fundamental importance to physiology and human biology, but also to the development of new therapeutic strategies. Several of these new concepts have arisen from three interrelated areas that are essentially unique to human and veterinary clinical nutrition. These are:(1) the consequences of bypassing the gut, which occurs during intravenous nutrition; (2) the effects of administering nutrients in quantities and proportions that are not normally possible with normal diets; (3) the effects of using continuous feeding over 24 h rather than intermittent feeding. B Y P A S S I N G THE G U T Bacteriological, metabolic and clinical consequencesMammals have evolved complex biochemical, immunological and mechanical defence systems that are located at the interfaces between the external environment and their own tissues, i.e. the integument, the gastrointestinal tract and the respiratory tract. The administration of feeds directly into central veins bypasses all these defences, making infection much more likely. Indeed, in the early 1970s, just a few years after the first successful use of prolonged parenteral nutrition in man (Dudrick et al. 1968) was hailed as one of the most important advances in nutritional support for decades, serious infections, mainly in the form of catheter-related sepsis, became a major problem. Catheter-related sepsis occurred in as many as 25-30% of patients being fed parenterally. In the late 1970s the incidence of catheter-related sepsis was reduced to about 5% in many centres, because the central line came to be regarded as a 'lifeline' for administration of feed only and not for the convenience of administering blood products, drugs and fluids, or for withdrawing blood, especially by individuals not employing strict aseptic techniques. In the 1980s the incidence of catheter-related sepsis was reduced further to about 3% through the use of polyurethane catheters which replaced the older more 'adhesive' and thrombogenic polyvinyl catheters which were more likely to predispose to bacterial seeding. In the 1990s new catheters coated with silver sulphaavailable at https://www.cambridge.org/core/terms. https://doi

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Biosynthetic human growth hormone in burned patients: a pilot study

Cited by 64 publications

References 33 publications

One-Year Growth Hormone Therapy Improves Granulocyte Function without Major Effects on Nutritional and Anthropometric Parameters in Malnourished Hemodialysis Patients

One-Year Growth Hormone Therapy Improves Granulocyte Function without Major Effects on Nutritional and Anthropometric Parameters in Malnourished Hemodialysis Patients

Enhancement of the anabolic effects of growth hormone and insulin-like growth factor I by use of both agents simultaneously.

The application of nutritional science to clinical practice

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