Subcutaneous Treatment with Growth Hormone-Releasing Hormone for Short Stature

Abstract

In the present study we report the effects of therapy with growth hormone-releasing factor (1–29)NH2 (GRF) on growth rate, plasma levels of insulin growth factor I (IGF-I) and growth hormone (GH) secretion in 11 children who were selected solely on the basis of their short stature and normal GH secretion on standard provocative tests. All children received GRF for 6 months (5 µg/kg body weight subcutaneously) each evening. The 24-hour GH secretory profile was studied before and after 6 months of treatment. Simultaneously, GH secretory responses to single intravenous bolus GRF (1.5 µg/kg body weight) were also studied before, during, and 6 months off therapy with GRF(1–29)NH2. Plasma levels of IGF-I were measured before, during (1,2 and 6 months), and after 6 months off therapy with GRF. Statural growth was measured at 3-month intervals. The peak plasma GH level in response to GRF was 56.04 ± (SD) 24.46 ng/ml before treatment, and similar results were found after therapy. The 24-hour GH secretory profile did not show differences before, during, and after treatment. Comparably, no differences were found in GH pulse frequency, pulse amplitude, pulse height, pulse increment, pulse area and total area before, and 6 months off therapy with GRF. The increments in serum IGF-I achieved were not significantly different at all intervals studied. All patients increased growth velocities (mean ± SD, cm/year) in response to GRF therapy. Our results demonstrate that GRF administration was effective in accelerating growth velocity in 11 children without GH deficiency.

Treatment with GHRH(1‐29)NH2 in children with idiopathic short stature induces a sustained increase in growth velocity

“…Short-term therapy with GH over one year with GH in short children without GH insufficiency has been shown to increase height velocity in children who are growing slowly (Albertsson-Wikland, 1988, Wit et al, 1989 or 'normally' (Hindmarsh & Brook, 1987). As in the present study, the growth response to both GH (Albertsson-Wikland, 1988) and GHRH (Hernandez et al, 1988) in children who are not GH insufficient appears to be dependent on the pretreatment height velocity. Unlike growth hormone, however, we administered twice-daily injections, as we have previously shown this regime to be effective (Ross et al, 1987) and other studies have shown waning of the growth response (Rochiccioli et al, 1987) on once-daily injection.…”

Idiopathic short stature: Management and growth hormone treatment

“…In spite of several short-term positive results, clinical trials of longer duration have shown that these agents did not increase growth or adult height. More recently, short-term clinical trials with GHRH or GHreleasing peptides (GHRPs) have been performed, which appear to have led to some increase of height velocity [127][128][129][130]. However, no long-term results have been reported.…”

Clonidine pretreatment modifies the growth hormone secretory pattern induced by shortterm continuous GRF infusion in normal man

“…In conclusion, and in spite of the fact that the effects demonstrated in this study are only acute, it is tempting to speculate that the combination of clonidine (one or two daily doses, orally) and G R F (slow-releasing forms) may result in a useful new treatment for hypothalamic GH-deficient children. Potential benefits expected to occur would be (1) the establishment of a more physiological pulsatile pattern of G H secretion, which would imply better growth-promoting effects (Clark et al, 1985); and (2) the avoidance of a time and dose-dependent increased somatostatinergic tone blunting the secretion of GH (Hernandez et al, 1988).…”