@article{9ad9e0f69c6a451785f6df6ff91e9d8d,
title = "EFFECTS OF HUMAN PANCREATIC TUMOUR GROWTH HORMONE RELEASING FACTOR ON GROWTH HORMONE AND SOMATOMEDIN C LEVELS IN PATIENTS WITH IDIOPATHIC GROWTH HORMONE DEFICIENCY",
abstract = "Human pancreatic tumour growth hormone releasing factor (hpGRF-40) 10 μg/kg was administered intravenously to 6 normal young men and 12 adult patients who had presented in childhood with growth hormone (GH) deficiency (7 patients had isolated GH deficiency, 4 had multiple anterior pituitary hormone deficiencies, and 1 had Hand-Sch{\"u}ller-Christian [HSC] disease). hpGRF-40 administration increased serum GH concentrations in all normal subjects and in 3 of 7 patients with isolated GH deficiency and in the 1 with HSC disease; however, the mean serum GH concentration in the patients who responded was less than that of the normal subjects. Somatomedin C concentrations were increased 24 h after a single dose of hpGRF-40 in 8 of 10 patients with GH deficiency. All subjects experienced flushing in response to hpGRF-40. A patient with isolated GH deficiency received O·33 μg/kg hpGRF-40 every 3 h for 5 days. Despite the modest increase in GH in response to a subsequent dose of 10 μg/kg hpGRF-40, serum somatomedin C levels increased within 12 h from 0·06 to 0·1 U/ml and peaked at 0·36 U/ml at 72 h; in addition the patient with HSC disease, treated with hpGRF-40 daily for 5 days, demonstrated an increase in somatomedin C from 0·4 to 0·58 U/ml. The increase after hpGRF-40 in serum GH levels in this patient and the similar or greater responses in 3 of 7 patients suggest that at least some of these patients may have hypothalamic GH-releasinghormone deficiency. hpGRF-40 may be useful in distinguishing pituitary disease from hypothalamic disease. After hpGRF-40 administration serum somatomedin C levels may increase without a change in serum immunoreactive GH concentrations. Further studies are needed to determine whether hpGRF-40 is useful in promoting linear growth in children with GH deficiency.",
author = "Borges, {Jo{\~a}o L.C.} and Gelato, {Marie C.} and Rogol, {Alan D.} and {Lee Vance}, Mary and Macleod, {Robert M.} and {Lynn Loriaux}, D. and Jean Rivier and Blizzard, {Robert M.} and Richard Furlanetto and Evans, {William S.} and Kaiser, {Donald L.} and Merriam, {George R.} and Joachim Spiess and Wylie Vale and Thorner, {Michael O.}",
note = "Funding Information: responses to those after hypoglycaemia leads us to suggest that the test may be useful in determining GH reserve. Whether hpGRF-40 will distinguish patients with pituitary abnormalities from those with hypothalamic defects remains to be seen. However, longer term administration may be required to identify those patients who will eventually respond with enhanced GH secretion to hpGRF-40. From a therapeutic point of view hpGRF-40-associated somatomedin C response may be more important than the increase in immunoreactive GH for induction of linear growth. Our finding of increased somatomedin C levels in 8 of the 10 patients with idiopathic deficiency 24 h after administration of a single dose of hpGRF-40 is particularly encouraging. A somatomedin C level measured 24 h after hpGRF-40 administration may be a better discriminator of efficacy in GH-deficient patients than are serum GH concentrations, and may avoid difficulties associated with the use of a few serum GH measurements during the day as an index of integrated GH secretion over 24 h. Details of the optimum mode, dose, and frequency of hpGRF-40 administration are being studied. Certain GH-deficient patients, if diagnosed in childhood, may benefit from hpGRF-40 therapy in terms of GH secretion, somatomedin C generation and, ultimately, accelerated linear growth. We thank Dr Michael J. Cronin and Dr Glenn Braunstein for helpful assistance; Mrs Sandra W. Jackson, Mrs Laura Dolan, Mr David Jarvis, and the staff of the Clinical Research Center for their help; the staff of the laboratories at our respective institutions for technical assistance; Ms Donna Harris, Ms Joyce Paciolla, and Ms Linda Evans for assistance in the preparation of the manuscript; and the Pituitary Hormone Distribution Program of the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases for RIA reagents for measurement of human GH and LH. These studies were supported in part by US Public Health Service research grants: general clinical research grant RR-847; HD-13197 (M. 0. T.); CIA 1-K03-HD-00439 (W. S. E.); CA-07535 (R. M. M.); AM-26741 (P. B. L.); AM-20917 (P. B. L.); AA-03504 (P. B. L.) and HD-13527 (P. B. L.). J. L. C. B. is a visiting fellow supported by the Brazilian Ministry of Education and Culture.",
year = "1983",
month = jul,
day = "16",
doi = "10.1016/S0140-6736(83)90113-7",
language = "English (US)",
volume = "322",
pages = "119--124",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "8342",
}