Infectious diseases and immunological responses in adult subjects with lifetime untreated, congenital GH deficiency

Abstract

Growth hormone is important for the development and function of the immune system, but there is controversy on whether growth hormone deficiency is associated to immune disorders. A model of isolated growth hormone deficiency may clarify if the lack of growth hormone is associated with increased susceptibility to infections, or with an altered responsiveness of the immune system. We have studied the frequency of infectious diseases and the immune function in adults with congenital, untreated isolated growth hormone deficiency. In a cross-sectional study, 35 adults with isolated growth hormone deficiency due to a homozygous mutation in the growth hormone releasing hormone receptor gene and 31 controls were submitted to a clinical questionnaire, physical examination serology for tripanosomiasis, leishmaniasis, HIV, tetanus, hepatitis B and C, and serum total immunoglobulin G, M, E and A measurement. The immune response was evaluated in a subset of these subjects by skin tests and response to vaccination for hepatitis B, tetanus, and bacillus Calmette-Guérin. There was no difference between the groups in history of infectious diseases and baseline serology. Isolated growth hormone deficiency subjects had lower total IgG, but within normal range. There was no difference in the response to any of the vaccinations or in the positivity to protein Purified Derived, streptokinase or candidin. Adult untreated isolated growth hormone deficiency does not cause an increased frequency of infectious diseases, and does not alter serologic tests, but is associated with lower total IgG levels, without detectable clinical impact.

Hypopituitarism and Hepatitis E Genotype 3 Infection - First Case Report and Review on Immunocompetence in Hypopituitarism

“…Best characterized and well known to every physician is the effect of [endogenous] cortisone on immune function [12]. However, studies in humans with isolated defects in pituitary hormone secretion or with panhypopituitarism are rare, have conflicting results and do not necessarily link an abnormal findings to clinical pathology [4,5,7,[13][14][15]. Furthermore, many studies have small patient numbers and no control group [13,15] and focus on the impact of GH [growth Hormone] excess [16] or deficiency.…”

“…Mukherjee et al [4] reported significant humoral immune deficiency in twenty-one panhypopituitary patients although they were under stable pituitary hormone replacement. The reduced immune function accounted most strikingly in patients with low insulinlike growth factor 1 levels, which was not reproduced in more recent studies [5,7]. The case of a patient with panhypopituitarism under pituitary hormone replacement with acute hepatitis E is reported.…”

“…Laboratory analysis of liver function 3/17: pathological were the levels of gamma GT, alanine aminotransferase [4][5][6][7][8][9][10][11][12][13][14][15]. At discharge, the patient was in good clinical condition.…”

“…Among these could be hypopituitarism. The immune function and immunocompetence in hypopituitaric patients is still a matter of debate [3][4][5]. There is a wide body of literature on immunological perturbations in animal models with deficiency or excess of pituitary hormones [6].…”

MECHANISMS IN ENDOCRINOLOGY: The multiple facets of GHRH/GH/IGF-I axis: lessons from lifetime, untreated, isolated GH deficiency due to a GHRH receptor gene mutation

“…These features have been published in 42 different publications (2,19,22,25,27,29,30,31,32,33,36,37,38,40,41,44,45,46,47,48,49,50,51,52,53,54,56,57,61,62,63,64,66,67,68,74,75,76,77,78,79,80). We have used this experiment of nature to discover 'usual laws of nature' as suggested by William Harvey, and to understand some aspects of more common conditions such as short stature, insulin resistance, diabetes, atherosclerosis, osteoporosis, cancer and ultimately longevity.…”