Growth hormone administration: is it safe and effective for athletic performance

The Effect of Growth Hormone Administration on the Regulation of Mitochondrial Apoptosis in-Vivo

The purpose of this study was to determine whether recombinant human growth hormone (rhGH) would show any significant effects on the expression of apoptosis regulating proteins in peripheral blood mononuclear cells (PBMCs). Additionally, the potential for post-transcriptional regulation of gene expression by miRNA was assessed in two cellular compartments, the cytosol and the mitochondria. Ten male subjects were subcutaneously injected with either rhGH (1 mg) or saline (0.9%) for seven consecutive days in a double-blinded fashion. Blood sampling was undertaken prior to treatment administration and over a period of three weeks following treatment cessation. Bcl-2 and Bak gene and protein expression levels were measured in PBMCs, while attention was also directed to the expression of miR-181a and miR-125b, known translational inhibitors of Bcl-2 and Bak respectively. Results showed that rhGH significantly decreased Bak protein concentrations compared to placebo samples for up to 8 days post treatment. While cytosolic miRNA expression was not found to be significantly affected by rhGH, measurement of the expression of miR-125b in mitochondrial fractions showed a significant down-regulation eight days post-rhGH administration. These findings suggest that rhGH induces short-term anti-apoptotic effects which may be partially mediated through a novel pathway that alters the concentration of mitochondrially-associated miRNAs.

Blood flow restriction pressure recommendations: the hormesis hypothesis

Blood flow restriction (BFR) alone or in combination with exercise has been shown to result in favorable effects on skeletal muscle form and function. The pressure applied should be high enough to occlude venous return from the muscle but low enough to maintain arterial inflow into the muscle. The optimal pressure for beneficial effects on skeletal muscle are currently unknown; however, preliminary data from our laboratory suggests that there may be a point where greater pressure may not augment the response (e.g. metabolic accumulation, cell swelling) but may actually result in decrements (e.g. muscle activation). This led us to wonder if BFR elicits somewhat of a hormesis effect. The purpose of this manuscript is to discuss whether pressure may be modulated to maximize skeletal muscle adaptation with resistance training in combination with BFR. Furthermore, the potential safety issues that could arise from increasing pressure too high are also briefly reviewed. We hypothesize that with BFR there is likely a moderate (∼ 50% estimated arterial occlusion pressure) pressure that maximizes the anabolic response to skeletal muscle without producing the potential negative consequences of higher pressures. Thus, BFR may follow the hormesis theory to some degree, in that a low/moderate dose of BFR produces beneficial effects while higher pressures (at or near arterial occlusion) may decrease the benefits of exercise and increase the health risk. This hypothesis requires long term studies investigating chronic training adaptations to differential pressures. In addition, how differences in load interact with differences in pressure should also be investigated.

Hormones as doping in sports

Though we may still sing today, as did Pindar in his eighth Olympian Victory Ode, "… of no contest greater than Olympia, Mother of Games, gold-wreathed Olympia…", we must sadly admit that today, besides blatant over-commercialization, there is no more ominous threat to the Olympic games than doping. Drug-use methods are steadily becoming more sophisticated and ever harder to detect, increasingly demanding the use of complex analytical procedures of biotechnology and molecular medicine. Special emphasis is thus given to anabolic androgenic steroids, recombinant growth hormone and erythropoietin as well as to gene doping, the newly developed mode of hormones abuse which, for its detection, necessitates high-tech methodology but also multidisciplinary individual measures incorporating educational and psychological methods. In this Olympic year, the present review offers an update on the current technologically advanced endocrine methods of doping while outlining the latest procedures applied-including both the successes and pitfalls of proteomics and metabolomics-to detect doping while contributing to combating this scourge.

Development and validation of the appearance and performance enhancing drug use schedule

Appearance-and-performance enhancing drug (APED) use is a form of drug use that includes use of a wide range of substances such as anabolic-androgenic steroids (AASs) and associated behaviors including intense exercise and dietary control. To date, there are no reliable or valid measures of the core features of APED use. The present study describes the development and psychometric evaluation of the Appearance and Performance Enhancing Drug Use Schedule (APEDUS) which is a semi-structured interview designed to assess the spectrum of drug use and related features of APED use. Eighty-five current APED using men and women (having used an illicit APED in the past year and planning to use an illicit APED in the future) completed the APEDUS and measures of convergent and divergent validity. Inter-rater agreement, scale reliability, one-week test-retest reliability, convergent and divergent validity, and construct validity were evaluated for each of the APEDUS scales. The APEDUS is a modular interview with 10 sections designed to assess the core drug and non-drug phenomena associated with APED use. All scales and individual items demonstrated high inter-rater agreement and reliability. Individual scales significantly correlated with convergent measures (DSM-IV diagnoses, aggression, impulsivity, eating disorder pathology) and were uncorrelated with a measure of social desirability. APEDUS subscale scores were also accurate measures of AAS dependence. The APEDUS is a reliable and valid measure of APED phenomena and an accurate measure of the core pathology associated with APED use. Issues with assessing APED use are considered and future research is considered.

New onset diabetes associated with bovine growth hormone and testosterone abuse in a young body builder

Case: A 33-year-old male presented to the emergency department with complaints of polydipsia, polyuria, nausea, headaches, blurry vision and malaise. Lab work revealed a serum glucose level of 1166 mg/dl (64.8 mmol/L). The patient admitted to completing a cycle of androgenic anabolic steroids (AASs) for bodybuilding. His regimen consisted of supraphysiologic intramuscular injections of a bovine growth hormone, trenbolone acetate and testosterone. The patient received intravenous fluids and insulin to restore metabolic balance. Previously healthy with a non-contributory family history, he was diagnosed with new onset diabetes. Discussion: It has been demonstrated that AAS use, specifically growth hormone, can affect glucose homeostasis through increasing cellular insulin resistance and reducing glucose uptake. Excess growth hormone has been shown to cause symptoms of acromegaly which predisposes up to 40% of patients to diabetes. As trenbolone acetate is not indicated for human use and athletes are known to use supraphysiologic doses of this underground, performance enhancing drug, the correlation of the timing of events and the use of this veterinary growth hormone likely exacerbated an underlying condition or caused this new onset diabetes. Conclusion: We report a case of a young bodybuilder with no significant past medical history who was diagnosed with new onset diabetes associated with supraphysiologic self-injections of the bovine growth hormone, trenbolone acetate, combined with testosterone. AAS have the potential to induce or exacerbate diabetic conditions due to decreased glucose tolerance and increased insulin resistance.

Cancer cachexia therapy: a key weapon in the fight against cancer

PURPOSE OF REVIEW

Cachexia affects millions of cancer patients around the world. Though its causes are poorly understood, its devastating impact on the patient and their loved ones underscore the urgency of this unmet medical need. Recent research efforts suggest multiple body systems are dysregulated in cachexia, not only increasing the challenge in effectively treating the disease but also expanding the opportunities for intervention.

RECENT FINDINGS

Agents as diverse as anti-inflammatory monoclonal antibodies and novel anabolic small molecules are under clinical evaluation for their ability to prevent and treat wasting. The therapies evaluated to date range in their ability to improve appetite, mitigate weight loss and reverse undesirable changes in body composition and physical function.

SUMMARY

An increased understanding of cancer cachexia, both mechanistically and its impact on cancer patients' struggle with their disease, has resulted in diverse therapeutic concepts. Recent clinical efforts demonstrate progress with novel therapies but fall short of effectively treating most cachectic patients and highlight a clear need for further research. Given the inherent heterogeneity of cancer patients and the significant impact of muscle wasting on morbidity and mortality, continued research efforts are critical in developing effective therapies to prevent and treat cancer cachexia.

Interdental spacing and orthodontic treatment in competitive athletes: clues to doping with growth hormones?

The aim of this report is to examine clues of a suspected link between the artificial ingestion of human growth hormone (rh- GH) and resulting interdental spaces in adult athletes. We conducted an electronic search in the German-language versions of the search engines Google and Google Scholar as well as in the database PubMed. While no explicit articles could be identified in PubMed, the search in Google and Google Scholar produced 1370 and 6 hits, respectively. Original quotes from 20 sources show that in the media the wearing of orthodontic multibracket appliances among athletes is largely attributed to changes in tooth position as a consequence of the illegal ingestion of rhGH. On the other hand, there are few references to the possibility that orthodontic treatments with fixed appliances might be carried out for reasons unrelated to doping.

CONCLUSION

A definitive assessment of this issue is not possible at present. In view of its major importance of the subject, the relationships depicted here should be investigated in greater depth.