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Falah G, Sharvit L, Atzmon G. CRISPR-Cas9 mediated d3GHR knockout in HEK293 cells: Revealing the longevity associated isoform stress resilience. Exp Gerontol 2024; 196:112586. [PMID: 39303817 DOI: 10.1016/j.exger.2024.112586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 09/16/2024] [Accepted: 09/17/2024] [Indexed: 09/22/2024]
Abstract
The Growth Hormone Receptor (GHR) gene encodes a protein that is essential for mediating the biological effects of growth hormone (GH). A series of molecular events are set off when GH binds to its receptor, resulting in a variety of physiological reactions linked to development, growth, and metabolism. Recently a particular genetic variation, within the GHR gene that is labeled as the "d3GHR," which lacks exon 3 was associated with longevity. This specific deletion isoform was connected to changes in the structure of the GHR protein, which may have an impact on the GHR's function. To test in vitro the advantage of the d3 carrier that may link to longevity, we employed the CRISPR/Cas9 technique to produce two isoforms: the homozygotes isoform (d3/d3) and the heterozygotes isoform (d3/fl) using HEK293 cell line. The CRISPR editing effectiveness was >85 %, indicating that we had successfully built the Cas9-gRNA complex that is appropriate for the GHR gene. The viability of the resulted isoform cells was examined under three environmental stressors that mimic some aging processes. In addition, we examined the GHR signaling pathway by selecting potential downstream genes in the GHR signaling cascade. The results show that heterozygotes cells demonstrated higher survival rates under UV radiation compared with the WT cells (87 % compared with 67 % for the WT cells when exposed to 2 min of UV radiation), and in fasting conditions, the d3GHR cells showed a 15 % greater viability than the WT cells. Moreover, the baseline expression levels (without intervention) of the IGF1 and JAK/STAT genes signaling pathways significantly declined in the homozygotes cells compared with the WT (p < 0.05). This noteworthy finding might offer a practical approach to test illness prevention and give the scientific community critical new insights on mechanism associated with lifespan.
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Affiliation(s)
- Ghadeer Falah
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
| | - Lital Sharvit
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
| | - Gil Atzmon
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel; Departments of Medicine and Genetics, Albert Einstein College of Medicine, Bronx, NY, USA.
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Falah G, Kurolap A, Paperna T, Ekhilevitch N, Moustafa N, Damouny-Naoum N, Amir Y, Sharvit L, Moghrabi R, Hassoun G, Fares F, Baris Feldman H, Atzmon G. The d3GHR carrier epigenome in Druze clan longevity. Sci Rep 2024; 14:21419. [PMID: 39271799 PMCID: PMC11399368 DOI: 10.1038/s41598-024-72240-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 09/05/2024] [Indexed: 09/15/2024] Open
Abstract
The Druze are a distinct group known for their close community, traditions, and consanguineous marriages, dating back to the eleventh century. This practice has led to unique genetic variations, impacting both pathology and gene-associated phenotypes. Some Druze clans, particularly those with exceptional long-lived family heads (ELLI), attracted attention. Given that the bulk of these ELLI were men, the d3GHR polymorphism was the first obvious possibility. Among the 73 clan members, 8.2% carried the d3GHR isoform, with nearly 11% being males. There was a significant age-related increase (p = 0.04) in this isoform among males, leading to examination of potential environmental mediators affecting gene regulation among these carriers during life (namely epigenetic). We focused on DNA methylation due to its crucial role in gene regulation, development, and disease progression. We analyzed DNA samples from 14 clan members with different GHR genotypes, finding a significant (p < 0.05) negative correlation between DNA methylation levels and age. Employing a biological age clock, we observed a significant + 4.229 years favoring the d3GHR group over the WT and heterozygous groups. In conclusion, this study highlights the advantage of d3GHR carriers among this unique Druze clan and underscores the importance of genotype-environment interaction in epigenetic regulation and its impact on health.
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Affiliation(s)
- Ghadeer Falah
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
| | - Alina Kurolap
- The Genetics Institute and Genomics Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tamar Paperna
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Nina Ekhilevitch
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Nivin Moustafa
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | | | - Yam Amir
- The Genetics Institute and Genomics Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Lital Sharvit
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
| | - Rihan Moghrabi
- The Genetics Institute, Rambam Health Care Campus, Haifa, Israel
| | - Gamal Hassoun
- Institute of Allergy, Clinical Immunology & AIDS, Rambam Health Care Campus, Haifa, Israel
| | - Fuad Fares
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
| | - Hagit Baris Feldman
- The Genetics Institute and Genomics Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Gil Atzmon
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel.
- Departments of Medicine and Genetics, Albert Einstein College of Medicine, Bronx, NY, USA.
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Chiloiro S, Costanza F, Giampietro A, Infante A, Mattogno PP, Angelini F, Gullì C, Lauretti L, Rigante M, Olivi A, De Marinis L, Doglietto F, Bianchi A, Pontecorvi A. GH receptor polymorphisms guide second-line therapies to prevent acromegaly skeletal fragility: preliminary results of a pilot study. Front Endocrinol (Lausanne) 2024; 15:1414101. [PMID: 39280003 PMCID: PMC11395836 DOI: 10.3389/fendo.2024.1414101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 08/07/2024] [Indexed: 09/18/2024] Open
Abstract
Background Skeletal fragility is characterized by increased frequency of vertebral fractures (VFs) in acromegaly. Several trials were conducted to identify modifiable risk factors and predictors of VFs, with limited data on the prognostic role of GH receptor (GHR) isoforms. In this study, we investigated the potential role of GHR polymorphism on the occurrence of incidental VFs (i-VFs), in patients treated with second-line medical therapies. Methods A longitudinal, retrospective, observational study was conducted on a cohort of 45 acromegalic patients not-responsive to first-generation somatostatin receptor ligands (fg-SRLs) and treated with GHR antagonist (Pegvisomant) or with the second-generation SRLs (Pasireotide long-acting release). Results Second line treatments were Pegvisomant plus fg-SRLs in 26 patients and Pasireotide LAR in 19 patients. From the group treated with fg-SRLs+Peg-V, the fl-GHR isoform was identified in 18 patients (69.2%) and the d3-GHR isoform in 8 patients (30.8%). I-VFs arose exclusively in fl-GHR isoform carriers (p=0.039). From the group treated with Pasireotide LAR, the fl-GHR isoform was identified in 11 patients (57.9%), and the d3-GHR isoform in 8 patients (42.1%). I-VFs arose exclusively in d3-GHR isoform carriers (p=0.018). Patients with fl-GHR isoform had a higher risk for i-VFs if treated with fg-SRL+Peg-V (OR: 1.6 95%IC: 1.1-2.3, p=0.04), and a lower risk if treated with Pasi-LAR (OR: 0.26 IC95%: 0.11-0.66, p=0.038). Conclusions Our data support a predictive role of the GHR isoforms for the occurrence of i-VFs in acromegalic patients treated with second-line drugs, tailored to the individual patient. The knowledge of the GHR polymorphism may facilitate the choice of second-line therapies, improving the therapeutic approach, in the context of personalized medicine.
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Affiliation(s)
- Sabrina Chiloiro
- Dipartimento di Medicina Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Endocrinologia, Diabetologia e Medicina Interna, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
| | - Flavia Costanza
- Dipartimento di Medicina Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Endocrinologia, Diabetologia e Medicina Interna, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
| | - Antonella Giampietro
- Dipartimento di Medicina Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Endocrinologia, Diabetologia e Medicina Interna, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
| | - Amato Infante
- Dipartimento di Diagnostica per Immagini e radioterapia oncologica, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
| | - Pier Paolo Mattogno
- Dipartimento di Neurochirugia, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
- Dipartimento di Science dell’invecchiamento, neuroscienze, delle scienze del capo-collo, ed ortopediche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Flavia Angelini
- Dipartimento di Medicina Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Endocrinologia, Diabetologia e Medicina Interna, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
| | - Consolato Gullì
- Dipartimento di Diagnostica per Immagini e radioterapia oncologica, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
| | - Liverana Lauretti
- Dipartimento di Neurochirugia, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
- Dipartimento di Science dell’invecchiamento, neuroscienze, delle scienze del capo-collo, ed ortopediche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mario Rigante
- Unità di Otorinologingoiatria, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
| | - Alessandro Olivi
- Dipartimento di Neurochirugia, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
- Dipartimento di Science dell’invecchiamento, neuroscienze, delle scienze del capo-collo, ed ortopediche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Laura De Marinis
- Dipartimento di Medicina Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Endocrinologia, Diabetologia e Medicina Interna, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
| | - Francesco Doglietto
- Dipartimento di Neurochirugia, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
- Dipartimento di Science dell’invecchiamento, neuroscienze, delle scienze del capo-collo, ed ortopediche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Bianchi
- Dipartimento di Medicina Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Endocrinologia, Diabetologia e Medicina Interna, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
| | - Alfredo Pontecorvi
- Dipartimento di Medicina Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento di Endocrinologia, Diabetologia e Medicina Interna, Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
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Spurná Z, Čapková P, Punová L, DuchoslavovÁ J, Aleksijevic D, Venháčová P, Srovnal J, Štellmachová J, Curtisová V, Bitnerová V, Petřková J, Kolaříková K, Janíková M, Kratochvílová R, Vrtěl P, Vodička R, Vrtěl R, Zapletalová J. Clinical-genetic analysis of selected genes involved in the development of the human skeleton in 128 Czech patients with suspected congenital skeletal abnormalities. Gene 2024; 892:147881. [PMID: 37806643 DOI: 10.1016/j.gene.2023.147881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Congenital skeletal abnormalities are a heterogeneous group of diseases most commonly associated with small or disproportionate growth, cranial and facial dysmorphisms, delayed bone maturation, etc. Nonetheless, no detailed genotype-phenotype correlation in patients with specific genetic variants is readily available. Ergo, this study focuses on the analysis of patient phenotypes with candidate variants in genes involved in bone growth as detected by molecular genetic analysis. METHODS In this study we used molecular genetic methods to analyse the ACAN, COL2A1, FGFR3, IGFALS, IGF1, IGF1R, GHR, NPR2, STAT5B and SHOX genes in 128 Czech children with suspected congenital skeletal abnormalities. Pathogenic variants and variants of unclear clinical significance were identified and we compared their frequency in this study cohort to the European non-Finnish population. Furthermore, a prediction tool was utilised to determine their possible impact on the final protein. All clinical patient data was obtained during pre-test genetic counselling. RESULTS Pathogenic variants were identified in the FGFR3, GHR, COL2A1 and SHOX genes in a total of six patients. Furthermore, we identified 23 variants with unclear clinical significance and high allelic frequency in this cohort of patients with skeletal abnormalities. Five of them have not yet been reported in the scientific literature. CONCLUSION Congenital skeletal abnormalities may lead to a number of musculoskeletal, neurological, cardiovascular problems. Knowledge of specific pathogenic variants may help us in therapeutic procedures.
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Affiliation(s)
- Z Spurná
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic
| | - P Čapková
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic.
| | - L Punová
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic
| | - J DuchoslavovÁ
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic
| | - D Aleksijevic
- Paediatrics Department, Palacký University and University Hospital, Olomouc, Czech Republic
| | - P Venháčová
- Paediatrics Department, Palacký University and University Hospital, Olomouc, Czech Republic
| | - J Srovnal
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic; Institute of Molecular and Translational Medicine, Czech Advanced Technology and Research Institute, Palacky University in Olomouc, Czech Republic; Cancer Research Czech Republic, Olomouc, Czech Republic
| | - J Štellmachová
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic
| | - V Curtisová
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic
| | - V Bitnerová
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic
| | - J Petřková
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; First Department of Internal Medicine - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic; First Department of Internal Medicine - Cardiology, Palacký University in Olomouc, Olomouc, Czech Republic; Institute of Pathological Physiology, Palacký University in Olomouc, Olomouc, Czech Republic
| | - K Kolaříková
- Department of Neurology, University Hospital Olomouc, Czech Republic; Department of Neurology, Palacky University Olomouc, Czech Republic
| | - M Janíková
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic; Institute of Clinical and Molecular Pathology, Palacký University in Olomouc, Olomouc, Czech Republic
| | - R Kratochvílová
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic
| | - P Vrtěl
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic
| | - R Vodička
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic
| | - R Vrtěl
- Institute of Medical Genetics, Olomouc University Hospital, Olomouc, Czech Republic; Institute of Medical Genetics, Palacký University in Olomouc, Olomouc, Czech Republic
| | - J Zapletalová
- Paediatrics Department, Palacký University and University Hospital, Olomouc, Czech Republic
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Falah G, Sharvit L, Atzmon G. The Exon 3-Deleted Growth Hormone Receptor (d3GHR) Polymorphism-A Favorable Backdoor Mechanism for the GHR Function. Int J Mol Sci 2023; 24:13908. [PMID: 37762211 PMCID: PMC10531306 DOI: 10.3390/ijms241813908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Growth hormone (GH) is a peptide hormone that plays a crucial role in controlling growth, development, and lifespan. Molecular regulation of GH is accomplished via the GH receptor (GHR), which is the main factor influencing human development and is essential to optimal functioning of the GH/IGF-I axis. Two GHR isoforms have been studied, according to the presence (flGHR) or absence (d3GHR) of exon 3. The d3GHR isoform, which lacks exon 3 has recently been related to longevity; individuals carrying this isoform have higher receptor activity, improved signal transduction, and alterations in the treatment response and efficacy compared with those carrying the wild type (WT) isoform (flGHR). Further, studies performed in patients with acromegaly, Prader-Willi syndrome, Turner syndrome, small for gestational age (SGA), and growth hormone deficiency (GHD) suggested that the d3GHR isoform may have an impact on the relationship between GH and IGF-I levels, height, weight, BMI, and other variables. Other research, however, revealed inconsistent results, which might have been caused by confounding factors, including limited sample sizes and different experimental methods. In this review, we lay out the complexity of the GHR isoforms and provide an overview of the major pharmacogenetic research conducted on this ongoing and unresolved subject.
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Affiliation(s)
- Ghadeer Falah
- Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; (G.F.); (L.S.)
| | - Lital Sharvit
- Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; (G.F.); (L.S.)
| | - Gil Atzmon
- Faculty of Natural Sciences, University of Haifa, Haifa 3498838, Israel; (G.F.); (L.S.)
- Departments of Medicine and Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Beck RM, Voss RS, Jansa SA. Craniodental Morphology and Phylogeny of Marsupials. BULLETIN OF THE AMERICAN MUSEUM OF NATURAL HISTORY 2022. [DOI: 10.1206/0003-0090.457.1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Robin M.D. Beck
- School of Science, Engineering and Environment University of Salford, U.K. School of Biological, Earth & Environmental Sciences University of New South Wales, Australia Division of Vertebrate Zoology (Mammalogy) American Museum of Natural History
| | - Robert S. Voss
- Division of Vertebrate Zoology (Mammalogy) American Museum of Natural History
| | - Sharon A. Jansa
- Bell Museum and Department of Ecology, Evolution, and Behavior University of Minnesota
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7
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Chen X, Liu C, Yang S, Yang Y, Chen Y, Zhao X, Zhu W, Zhao Q, Ni C, Huang X, Yan W, Shen C, Gu HF. Gender Specificity and Local Socioeconomic Influence on Association of GHR fl/d3 Polymorphism With Growth and Metabolism in Children and Adolescents. Front Pediatr 2022; 10:546080. [PMID: 35402349 PMCID: PMC8984194 DOI: 10.3389/fped.2022.546080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Growth hormone receptor (GHR) mediates most GH biological actions. This study is aimed to evaluate whether GHR fl/d3 polymorphism contributes to the inter-individual variability of growth and metabolism in healthy children and adolescents. METHODS A total of 4,730 students aged 6-16 years from Yixing and Suqian City in China were included in this cross-sectional study. Height and body mass index (BMI) were transformed into the form of z-score corresponding to age and gender. Logistic regression was used to evaluate the associations of GHR fl/d3 polymorphism with height, BMI, metabolic traits, and hypertension by estimating the odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS GHR d3 allele was inversely associated with overweight, total cholesterol (TC) and triglyceride (TG) levels (OR [95% CI] for overweight: 0.754 [0.593-0.959], P = 0.021; OR [95% CI] for TC: 0.744 [0.614-0.902], P = 0.003; OR [95% CI] for TG: 0.812 [0.654-0.998], P = 0.047). GHR d3 allele was associated with decreased odds of pre-hypertension in boys (OR [95% CI]: 0.791 [0.645-0.971], P = 0.025), but associated with increased odds of pre-hypertension and hypertension in girls (ORs [95% CIs]: 1.379 [1.106-1.719], P = 0.004; OR [95% CI]: 1.240 [1.013-1.519], P = 0.037). Interaction of GHR fl/d3 polymorphism with gender contributed to increased odds of pre-hypertension and hypertension (interactive ORs [95% CIs]: 1.735 [1.214-2.481], P = 0.003; OR [95% CI]: 1.509 [1.092-2.086], P = 0.013). Stratification analysis showed that the correlation tendencies of GHR fl/d3 polymorphism and BMI with age were different between two cities with discrepant economic development levels. CONCLUSION GHR fl/d3 polymorphism is associated with growth, metabolism, and hypertension in children and adolescents with the gender specificity, and the genetic effect of GHR fl/d3 may be modified by the local socioeconomic levels.
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Affiliation(s)
- Xiaotian Chen
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Chunlan Liu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Song Yang
- Department of Cardiology, People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Yixing, China
| | - Yaming Yang
- Center for Disease Control and Prevention of Yixing City, Yixing, China
| | - Yanchun Chen
- Department of Cardiology, People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Yixing, China
| | - Xianghai Zhao
- Department of Cardiology, People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Yixing, China
| | - Weiguang Zhu
- Center for Disease Control and Prevention of Suqian City, Suqian, China
| | - Qihui Zhao
- Center for Disease Control and Prevention of Suqian City, Suqian, China
| | - Chuan Ni
- Center for Disease Control and Prevention of Suqian City, Suqian, China
| | - Xiangyuan Huang
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Weili Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Harvest F Gu
- School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
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8
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Apel A, Iliev DI, Urban C, Weber K, Schweizer R, Blumenstock G, Pasche S, Nieratschker V, Binder G. GH Responsiveness Is not Correlated to IGF1 P2 Promoter Methylation in Children With Turner Syndrome, GHD and SGA Short Stature. Front Endocrinol (Lausanne) 2022; 13:897897. [PMID: 35769084 PMCID: PMC9235359 DOI: 10.3389/fendo.2022.897897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/20/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The methylation of IGF1 promoter P2 was reported to negatively correlate with serum IGF-1 concentration and rhGH treatment response in children with idiopathic short stature. These findings have not yet been confirmed. OBJECTIVE This study aimed to determine IGF1 promoter P2 methylation in short children treated with rhGH and correlate clinical parameters with the methylation status. In addition, long-term stability of methylation during rhGH treatment was studied. DESIGN This was a single tertiary center study analyzing clinical GH response and IGF-1 serum concentration changes in patients with GHD (n=40), SGA short stature (n=36), and Turner syndrome (n=16) treated with rhGH. Data were correlated to the methylation of two cytosine residues (-137, +97) of the P2 promoter of IGF1 in blood cells measured by pyrosequencing in 443 patient samples. RESULTS Basal and stimulated IGF-1 concentrations, first year increment in height velocity and studentized residuals of a prediction model did not correlate to the methylation of -137 und +97 in IGF1 P2 promoter. The methylation of these two sites was relatively stable during treatment. CONCLUSIONS This study did not confirm IGF1 P2 promotor being a major epigenetic locus for GH responsiveness in patients treated with a normal dose of rhGH. Additional studies are warranted.
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Affiliation(s)
- Anja Apel
- Pediatric Endocrinology, University Children`s Hospital Tübingen, Tübingen, Germany
| | - Daniel I. Iliev
- Pediatric Endocrinology, University Children`s Hospital Tübingen, Tübingen, Germany
| | - Christina Urban
- Pediatric Endocrinology, University Children`s Hospital Tübingen, Tübingen, Germany
| | - Karin Weber
- Pediatric Endocrinology, University Children`s Hospital Tübingen, Tübingen, Germany
| | - Roland Schweizer
- Pediatric Endocrinology, University Children`s Hospital Tübingen, Tübingen, Germany
| | - Gunnar Blumenstock
- Department of Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany
| | - Sarah Pasche
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital Tübingen, Tübingen, Germany
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University Hospital Tübingen, Tübingen, Germany
| | - Gerhard Binder
- Pediatric Endocrinology, University Children`s Hospital Tübingen, Tübingen, Germany
- *Correspondence: Gerhard Binder,
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9
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Saitou M, Resendez S, Pradhan AJ, Wu F, Lie NC, Hall NJ, Zhu Q, Reinholdt L, Satta Y, Speidel L, Nakagome S, Hanchard NA, Churchill G, Lee C, Atilla-Gokcumen GE, Mu X, Gokcumen O. Sex-specific phenotypic effects and evolutionary history of an ancient polymorphic deletion of the human growth hormone receptor. SCIENCE ADVANCES 2021; 7:eabi4476. [PMID: 34559564 PMCID: PMC8462886 DOI: 10.1126/sciadv.abi4476] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
The common deletion of the third exon of the growth hormone receptor gene (GHRd3) in humans is associated with birth weight, growth after birth, and time of puberty. However, its evolutionary history and the molecular mechanisms through which it affects phenotypes remain unresolved. We present evidence that this deletion was nearly fixed in the ancestral population of anatomically modern humans and Neanderthals but underwent a recent adaptive reduction in frequency in East Asia. We documented that GHRd3 is associated with protection from severe malnutrition. Using a novel mouse model, we found that, under calorie restriction, Ghrd3 leads to the female-like gene expression in male livers and the disappearance of sexual dimorphism in weight. The sex- and diet-dependent effects of GHRd3 in our mouse model are consistent with a model in which the allele frequency of GHRd3 varies throughout human evolution as a response to fluctuations in resource availability.
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Affiliation(s)
- Marie Saitou
- Department of Biological Sciences, University at Buffalo, Buffalo, NY, USA
| | - Skyler Resendez
- Department of Biological Sciences, University at Buffalo, Buffalo, NY, USA
| | | | - Fuguo Wu
- Department of Ophthalmology, Ross Eye Institute, Jacobs School of Medicine and Biological Sciences, University at Buffalo, Buffalo, NY, USA
| | - Natasha C. Lie
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Nancy J. Hall
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Qihui Zhu
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | | | - Yoko Satta
- Department of Evolutionary Studies of Biosystems, SOKENDAI (Graduate University for Advanced Studies), Kanagawa Prefecture, Japan
| | - Leo Speidel
- University College London, Genetics Institute, London, UK
- The Francis Crick Institute, London, UK
| | | | - Neil A. Hanchard
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | | | - Charles Lee
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
- Precision Medicine Center, The First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi, People’s Republic of China
| | | | - Xiuqian Mu
- Department of Ophthalmology, Ross Eye Institute, Jacobs School of Medicine and Biological Sciences, University at Buffalo, Buffalo, NY, USA
| | - Omer Gokcumen
- Department of Biological Sciences, University at Buffalo, Buffalo, NY, USA
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10
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Dixit M, Poudel SB, Yakar S. Effects of GH/IGF axis on bone and cartilage. Mol Cell Endocrinol 2021; 519:111052. [PMID: 33068640 PMCID: PMC7736189 DOI: 10.1016/j.mce.2020.111052] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 12/11/2022]
Abstract
Growth hormone (GH) and its mediator, the insulin-like growth factor-1 (IGF-1) regulate somatic growth, metabolism and many aspects of aging. As such, actions of GH/IGF have been studied in many tissues and organs over decades. GH and IGF-1 are part of the hypothalamic/pituitary somatotrophic axis that consists of many other regulatory hormones, receptors, binding proteins, and proteases. In humans, GH/IGF actions peak during pubertal growth and regulate skeletal acquisition through stimulation of extracellular matrix production and increases in bone mineral density. During aging the activity of these hormones declines, a state called somatopaguss, which associates with deleterious effects on the musculoskeletal system. In this review, we will focus on GH/IGF-1 action in bone and cartilage. We will cover many studies that have utilized congenital ablation or overexpression of members of this axis, as well as cell-specific gene-targeting approaches used to unravel the nature of the GH/IGF-1 actions in the skeleton in vivo.
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Affiliation(s)
- Manisha Dixit
- David B. Kriser Dental Center, Department of Molecular Pathobiology, New York University College of Dentistry, NY, 10010, USA
| | - Sher Bahadur Poudel
- David B. Kriser Dental Center, Department of Molecular Pathobiology, New York University College of Dentistry, NY, 10010, USA
| | - Shoshana Yakar
- David B. Kriser Dental Center, Department of Molecular Pathobiology, New York University College of Dentistry, NY, 10010, USA.
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11
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Jensen RB, Boas M, Nielsen JE, Maroun LL, Jørgensen A, Larsen T, Main KM, Juul A. A common deletion in the growth hormone receptor gene (d3-GHR) in the offspring is related to maternal placental GH levels during pregnancy. Growth Horm IGF Res 2020; 55:101360. [PMID: 33096343 DOI: 10.1016/j.ghir.2020.101360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 09/02/2020] [Accepted: 10/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND A common growth hormone receptor polymorphism with deletion of exon 3 (d3-GHR) has previously been linked to increased postnatal growth on the one hand and decreased fetal growth on the other. Regulation of fetal growth is positively dependent on secretion of placental GH (hGH-V). OBJECTIVE We explored the effect of the fetal d3-GHR genotype on maternal serum levels of hGH-V and fetal growth. The cellular localization of hGH-V synthesis and the GH receptors were determined in normal placentas. METHODS 43 healthy mother-child pairs were examined during pregnancy with measurements of hGH-V during third trimester, and serial ultrasound measurements determined fetal growth rate. Birth anthropometrics were obtained. The GHR genotype of the child was analysed postnatally. Immunohistochemical (IHC) analysis was conducted on four placentas. RESULTS The presence of the d3-GHR genotype was associated with a markedly reduced concentration of hGH-V in maternal serum (β -0.52, SE 0.24, p = 0.04) compared to those who had a fl/fl genotype. Accordingly, a tendency towards reduced fetal growth rate during third trimester (β -25.8, SE 12.7, p = 0.05) and a lower birth weight were found among carriers of the d3-GHR allele, but these associations did not reach statistical significance (p = 0.08). IHC analysis showed expression of placental GH and GHR in the villous syncytiotrophoblast, the extravillous trophoblast, and the decidual cells and smooth muscle cells in chorionic vessels. CONCLUSIONS The presence of the d3-GHR polymorphism in the fetus was associated with lower maternal serum levels of hGH-V, decreased fetal growth rate in third trimester and lower birth weight compared to the wildtype.
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Affiliation(s)
- Rikke Beck Jensen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark.
| | - Malene Boas
- Department of Pediatrics, Herlev Hospital, University of Copenhagen, Denmark
| | - John E Nielsen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark
| | - Lisa Leth Maroun
- Department of Pathology, Rigshospitalet, University of Copenhagen, Denmark
| | - Anne Jørgensen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark
| | - Torben Larsen
- Department of Obstetrics and Gynecology, Holbæk Hospital, Holbæk, Denmark
| | - Katharina M Main
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark
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12
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Pontes J, Madeira M, Lima CHA, Ogino LL, de Paula Paranhos Neto F, de Mendonça LMC, Farias MLF, Kasuki L, Gadelha MR. Exon 3-deleted growth hormone receptor isoform is not related to worse bone mineral density or microarchitecture or to increased fracture risk in acromegaly. J Endocrinol Invest 2020; 43:163-171. [PMID: 31392573 DOI: 10.1007/s40618-019-01096-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 08/02/2019] [Indexed: 01/09/2023]
Abstract
PURPOSE Acromegaly is a cause of secondary osteoporosis and is associated with increased risk of vertebral fractures (VFs). The influence of exon 3-deleted isoform of growth hormone receptor (d3-GHR) on bone microarchitecture has not been studied in acromegaly. AIM The aim of this study was to analyze the associations between d3-GHR isoform and bone mineral density (BMD), bone microarchitecture, and VFs in acromegaly patients. METHODS Consecutive acromegaly patients treated at a single reference center were included. BMD was analyzed using dual-energy X-ray absorptiometry (DXA) and bone microarchitecture was analyzed by high-resolution peripheral quantitative computed tomography (HR-pQCT). The presence of moderate to severe VFs was assessed by thoracic and lumbar X-ray. GHR genotyping was analyzed by PCR, and full-length isoform of GHR (fl-GHR) was represented by a 935-bp fragment and d3-GHR by a 532-bp fragment. RESULTS Eighty-nine patients were included [56 females; median age at diagnosis: 43 years (17-78)]. Disease was uncontrolled in 63% of patients. At least one d3-GHR allele was present in 60% of patients. Frequency of active disease (p = 0.276) and hypogonadism (p = 1.000) was not different between patients with fl-GHR and those with at least one d3-GHR. There was no difference in any DXA or HR-pQCT parameters between patients with fl-GHR and those with d3-GHR. Significant VFs were observed in 14% of patients, but there was no difference in frequency between patients with fl-GHR and those with at least one d3-GHR allele (p = 0.578). CONCLUSIONS Presence of d3-GHR was not associated with worse BMD or bone microarchitecture or with higher frequency of significant VFs.
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Affiliation(s)
- J Pontes
- Neuroendocrinology Research Center, Rio de Janeiro, Brazil
| | - M Madeira
- Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - C H A Lima
- Neuropathology and Molecular Genetic Laboratory, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde, Rio de Janeiro, Brazil
| | - L L Ogino
- Neuropathology and Molecular Genetic Laboratory, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde, Rio de Janeiro, Brazil
| | - F de Paula Paranhos Neto
- Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - L M C de Mendonça
- Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - M L F Farias
- Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - L Kasuki
- Neuroendocrinology Research Center, Rio de Janeiro, Brazil
- Neuroendocrine Unit, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde, Rio de Janeiro, Brazil
| | - M R Gadelha
- Neuroendocrinology Research Center, Rio de Janeiro, Brazil.
- Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
- Neuropathology and Molecular Genetic Laboratory, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde, Rio de Janeiro, Brazil.
- Neuroendocrine Unit, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde, Rio de Janeiro, Brazil.
- Rua Professor Rodolpho Paulo Rocco, 255, 9° andar, Setor 9F, Sala de Pesquisa em Neuroendocrinologia IIha do Fundão, Rio De Janeiro, 21941-913, Brazil.
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13
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Quigley CA, Li YG, Brown MR, Pillai SG, Banerjee P, Scott RS, Blum WF, Parks JS. Genetic Polymorphisms Associated with Idiopathic Short Stature and First-Year Response to Growth Hormone Treatment. Horm Res Paediatr 2019; 91:164-174. [PMID: 30970347 DOI: 10.1159/000496989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/14/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The term idiopathic short stature (ISS) describes short stature of unknown, but likely polygenic, etiology. This study aimed to identify genetic polymorphisms associated with the ISS phenotype, and with growth response to supplemental GH. METHODS Using a case-control analysis we compared the prevalence of "tall" versus "short" alleles at 52 polymorphic loci (17 in growth-related candidate genes, 35 identified in prior genome-wide association studies of adult height) in 94 children with ISS followed in the Genetics and Neuroendocrinology of Short Stature International Study, versus 143 controls from the Fels Longitudinal Study. RESULTS Four variants were nominally associated with ISS using a genotypic model, confirmed by a simultaneous confident inference approach: compared with controls children with ISS had lower odds of "tall" alleles (odds ratio, 95% CI) for GHR (0.52, 0.29-0.96); rs2234693/ESR1 (0.50, 0.25-0.98); rs967417/BMP2 (0.39, 0.17-0.93), and rs4743034/ZNF462 (0.40, 0.18-0.89). Children with ISS also had lower odds of the "tall" allele (A) at the IGFBP3 -202 promoter polymorphism (rs2855744; 0.40, 0.20-0.80) in the simultaneous confident inference analysis. A significant association with 1st-year height SD score increase during GH treatment was observed with rs11205277, located near 4 known genes: MTMR11, SV2A, HIST2H2AA3, and SF3B4; the latter, in which heterozygous mutations occur in Nager acrofacial dysostosis, appears the most relevant gene. CONCLUSIONS In children with ISS we identified associations with "short" alleles at a number of height-related loci. In addition, a polymorphic variant located near SF3B4 was associated with the GH treatment response in our cohort. The findings in our small study warrant further investigation.
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Affiliation(s)
- Charmian A Quigley
- Endocrinology, Sydney Children's Hospital, Sydney, New South Wales, Australia,
| | - Ying Grace Li
- Lilly Research Laboratories, Indianapolis, Indiana, USA
| | - Milton R Brown
- Pediatric Endocrinology, Emory University, Atlanta, Georgia, USA
| | | | | | | | | | - John S Parks
- Pediatric Endocrinology, Emory University, Atlanta, Georgia, USA
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14
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Espinosa E, Salame L, Marrero-Rodriguez D, Romero-Nieves AM, Cuenca D, Castelan-Martínez OD, Mendoza V, Ponce-Navarrete G, Salcedo M, Luque-Leòn E, Rodriguez-Gonzalez A, Mercado M. Expression of the growth hormone receptor isoforms and its correlation with the metabolic profile in morbidly obese subjects. Endocrine 2019; 63:573-581. [PMID: 30361972 DOI: 10.1007/s12020-018-1794-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 10/15/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIM OF THE STUDY Given the lipolytic effect of GH and its potential role in determining adipose tissue distribution, we evaluated the expression of the GH hormone receptor (GHR) isoforms in patients with morbid obesity seeking associations with metabolic parameters. METHODS 262 morbidly obese subjects (mean age 42.5 ± 11 years, 75% women) underwent PCR-genotyping of the exon 3 GHR polymorphism. In 17 of these subjects, who proved to be heterozygous for the exon 3 genotype (+3/-3), subcutaneous and visceral adipose tissue was obtained during bariatric surgery; total RNA was extracted, reversely transcribed, and the different isoforms of the GHR (exon 3 containing and lacking flGHR as well as the trGHR) were PCR-amplified using specific primers. RESULTS 27% were +3/+3 homozygous, 20% -3/-3 homozygous and 53% were +3/-3 heterozygous. Compared to subjects homozygous for the +3 genotype, homozygous and heterozygous carriers of the -3 genotype were significantly heavier and tended to have a higher HOMA 2-IR. Expression of the flGHR and trGHR mRNA was demonstrated in all evaluated samples of subcutaneous and visceral adipose tissue from the 17 patients. The exon 3+ isoform was expressed in all adipose tissue samples, whereas only six subjects expressed the 3- isoform as well. The only distinctive feature of these six patients was a higher HbA1c. CONCLUSIONS The heterozygous GHR +3/-3 genotype is more prevalent in subjects with morbid obesity. Patients expressing the exon +3 and exon -3 isoforms in adipose tissue had a higher HbA1c, than those expressing only the exon -3 isoform.
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Affiliation(s)
- Etual Espinosa
- Endocrinology Service/Experimental Endocrinology Unit and Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Juárez, Mexico
| | - Latife Salame
- Endocrinology Service/Experimental Endocrinology Unit and Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Juárez, Mexico
| | - Daniel Marrero-Rodriguez
- Obesity Clinic Hospital de Especialidades and Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Juárez, Mexico
| | - Andy-Michel Romero-Nieves
- Oncology Research Unit, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Juárez, Mexico
| | - Dalia Cuenca
- Endocrinology Service/Experimental Endocrinology Unit and Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Juárez, Mexico
| | | | - Victoria Mendoza
- Endocrinology Service/Experimental Endocrinology Unit and Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Juárez, Mexico
| | - Gustavo Ponce-Navarrete
- Obesity Clinic Hospital de Especialidades and Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Juárez, Mexico
| | - Mauricio Salcedo
- Obesity Clinic Hospital de Especialidades and Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Juárez, Mexico
| | | | | | - Moisés Mercado
- Endocrinology Service/Experimental Endocrinology Unit and Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Juárez, Mexico.
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15
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Kasuki L, Wildemberg LE, Gadelha MR. MANAGEMENT OF ENDOCRINE DISEASE: Personalized medicine in the treatment of acromegaly. Eur J Endocrinol 2018; 178:R89-R100. [PMID: 29339530 DOI: 10.1530/eje-17-1006] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 01/16/2018] [Indexed: 12/31/2022]
Abstract
Acromegaly is associated with high morbidity and elevated mortality when not adequately treated. Surgery is the first-line treatment for most patients as it is the only one that can lead to immediate cure. In patients who are not cured by surgery, treatment is currently based on a trial-and-error approach. First-generation somatostatin receptor ligands (fg-SRL) are initiated for most patients, although approximately 25% of patients present resistance to this drug class. Some biomarkers of treatment outcome are described in the literature, with the aim of categorizing patients into different groups to individualize their treatments using a personalized approach. In this review, we will discuss the current status of precision medicine for the treatment of acromegaly and future perspectives on the use of personalized medicine for this purpose.
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Affiliation(s)
- Leandro Kasuki
- Neuroendocrinology Research Center/Endocrine Section and Medical School, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Neuroendocrine Section, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil
- Endocrine Unit, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil
| | - Luiz Eduardo Wildemberg
- Neuroendocrinology Research Center/Endocrine Section and Medical School, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Neuroendocrine Section, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mônica R Gadelha
- Neuroendocrinology Research Center/Endocrine Section and Medical School, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Neuroendocrine Section, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil
- Neuropathology and Molecular Genetics Laboratory, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil
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16
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Boguszewski CL, Barbosa EJL, Svensson PA, Johannsson G, Glad CAM. MECHANISMS IN ENDOCRINOLOGY: Clinical and pharmacogenetic aspects of the growth hormone receptor polymorphism. Eur J Endocrinol 2017; 177:R309-R321. [PMID: 28904008 DOI: 10.1530/eje-17-0549] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/07/2017] [Accepted: 09/12/2017] [Indexed: 11/08/2022]
Abstract
Pharmacogenetics aims to maximize the beneficial effects of a medical therapy by identifying genetic finger prints from responders and non-responders and, thereby improving safety and efficacy profile of the drug. Most subjects who are deficient in growth hormone (GHD) are candidates for recombinant human GH (rhGH) therapy. To date, it is well established that even after adjustments for several clinical variables, such as age, gender, body composition and the age at onset of the GHD, response to rhGH treatment is highly variable among individuals, part of which is believed to be due to genetic factors within the GH system. As the first genetic variant to potentially influence the individual response to rhGH therapy in children with growth disorders, polymorphism in the GH receptor (GHR) has attracted a great interest as a target for pharmacogenetics. Studies have been conducted to compare the functional and molecular effects of the full-length GHR (fl-GHR) isoform with the exon 3 deleted (d3-GHR) isoform in children and adults treated with rhGH therapy. Additionally, the impact of the GHR polymorphism has been investigated in relation to the clinical status and response to medical treatment in acromegaly, especially to the GHR antagonist drug pegvisomant. We have performed a narrative review of the studies performed to date on the association of GHR polymorphism with rhGH response in children and adults, and its potential influence in the medical management of acromegaly. In addition, data from studies on the general population and in other chronic diseases examining a role of this genetic variant in the regulation of growth and metabolism are summarized.
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Affiliation(s)
- Cesar L Boguszewski
- SEMPREndocrine Division, Department of Internal Medicine, Federal University of Parana, Curitiba, Brazil
| | - Edna J L Barbosa
- SEMPREndocrine Division, Department of Internal Medicine, Federal University of Parana, Curitiba, Brazil
| | - Per-Arne Svensson
- Department of Molecular and Clinical MedicineInstitute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care SciencesThe Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gudmundur Johannsson
- Department of EndocrinologySahlgrenska University Hospital and Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Camilla A M Glad
- Department of Molecular and Clinical MedicineInstitute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of EndocrinologySahlgrenska University Hospital and Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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17
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Kaabi YA. Frequency of the exon 3-deleted/full-length growth hormone receptor polymorphism in Saudi Arabian population. Saudi Med J 2017; 38:1090-1095. [PMID: 29114695 PMCID: PMC5767610 DOI: 10.15537/smj.2017.11.21109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objectives: To investigate the frequency of the growth hormone receptor (GHR)-d3 polymorphism in a random sample of Saudi Arabian population from Jazan province, and test the effects of the polymorphism on some anthropometric factors. Methods: This cross-sectional population-based study was conducted during the period from January to April 2017 at the College of Applied Medical Sciences, Jazan University, Southwestern Saudi Arabia. A total of 230 healthy adult male and female volunteers were randomly recruited. Genomic DNA was extracted from the whole blood, and the GHR exon 3 locus was genotyped using multiplex polymerase chain reaction. Results: The distributions of the GHR genotypes were as follows: fl/fl (39.1%), fl/d3 (44.8%), and d3/d3 (16.1%). No statistically significant differences were found between fl/fl, fl/d3, or d3/d3 GHR genotypes in terms of weight (p=0.90), height (p=0.12), or body mass index (BMI) (p=0.83) values. Conclusion: No correlations were found between the GHR-d3 polymorphism and weight, height, or BMI.
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Affiliation(s)
- Yahia A Kaabi
- Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Jazan, Kingdom of Saudi Arabia. E-mail.
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18
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Wegmann MG, Thankamony A, Roche E, Hoey H, Kirk J, Shaikh G, Ivarsson SA, Söder O, Dunger DB, Juul A, Jensen RB. The exon3-deleted growth hormone receptor gene polymorphism (d3-GHR) is associated with insulin and spontaneous growth in short SGA children (NESGAS). Growth Horm IGF Res 2017; 35:45-51. [PMID: 28719834 DOI: 10.1016/j.ghir.2017.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/04/2017] [Accepted: 07/09/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The effect of a common polymorphism in the Growth Hormone (GH) receptor (d3-GHR) gene on growth, metabolism and body composition was examined in short children born small for gestational age (SGA) on GH treatment. DESIGN In 96 prepubertal, short SGA children treated with high-dose GH (67μg/kg/day) in the NESGAS study, insulin sensitivity (IS), insulin secretion and disposition index (DI) were determined during the first year of treatment. Body composition was analysed by DXA. The d3-GHR locus was determined by simple multiplex PCR. RESULTS At baseline, children in the d3-GHR group (d3/fl (n=37), d3/d3 (n=7)) had significantly lower IS (median (25-75 percentile)) (223.3% (154.4-304.8)) vs. (269.7% (185.1-356.7)) (p=0.03) and higher concentrations of glucose (mean (SD)) (4.4mmol/L (0.6) vs. 4.2mmol/L (0.7)) (p=0.03), C-peptide (232.1pmol/L (168.8-304.1) vs. 185.1pmol/L (137.7-253.9)) (p=0.04) and insulin (19.2pmol/L (11.8-32.2)) vs. (13.7pmol/L (9.3-20.8)) (p=0.04) compared to children homozygous for the full length allele (fl/fl-GHR (n=52)). There were no differences in DI or insulin secretion. Postnatal, spontaneous growth was significantly greater in the d3-GHR group compared to the fl/fl-GHR group (p=0.02). There were no significant differences in growth response, body composition or metabolism after one year of GH therapy. CONCLUSION Short SGA children carrying the d3-GHR polymorphism had increased spontaneous growth, lower IS and a compensatory increase in glucose, C-peptide and insulin before GH therapy compared to children homozygous for the full-length allele.
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Affiliation(s)
- Mathilde Gersel Wegmann
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark; International Center for Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark.
| | - Ajay Thankamony
- Department of Pediatrics, Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Edna Roche
- Department of Pediatrics, The National Children's Hospital, Trinity College Dublin, The University of Dublin, Ireland
| | - Hilary Hoey
- Department of Pediatrics, The National Children's Hospital, Trinity College Dublin, The University of Dublin, Ireland
| | - Jeremy Kirk
- Department of Endocrinology, Birmingham Children's Hospital, Birmingham, United Kingdom
| | - Guftar Shaikh
- Department of Endocrinology, Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - Sten-A Ivarsson
- Department of Clinical Sciences, Endocrine and Diabetes Unit, University of Lund, Malmø, Sweden
| | - Olle Söder
- Pediatric Endocrinology Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - David B Dunger
- Department of Pediatrics, Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
| | - Anders Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark; International Center for Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - Rikke Beck Jensen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark; International Center for Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
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Ben-Avraham D, Govindaraju DR, Budagov T, Fradin D, Durda P, Liu B, Ott S, Gutman D, Sharvit L, Kaplan R, Bougnères P, Reiner A, Shuldiner AR, Cohen P, Barzilai N, Atzmon G. The GH receptor exon 3 deletion is a marker of male-specific exceptional longevity associated with increased GH sensitivity and taller stature. SCIENCE ADVANCES 2017; 3:e1602025. [PMID: 28630896 PMCID: PMC5473676 DOI: 10.1126/sciadv.1602025] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 04/26/2017] [Indexed: 05/26/2023]
Abstract
Although both growth hormone (GH) and insulin-like growth factor 1 (IGF-1) signaling were shown to regulate life span in lower organisms, the role of GH signaling in human longevity remains unclear. Because a GH receptor exon 3 deletion (d3-GHR) appears to modulate GH sensitivity in humans, we hypothesized that this polymorphism could play a role in human longevity. We report a linear increased prevalence of d3-GHR homozygosity with age in four independent cohorts of long-lived individuals: 841 participants [567 of the Longevity Genes Project (LGP) (8% increase; P = 0.01), 152 of the Old Order Amish (16% increase; P = 0.02), 61 of the Cardiovascular Health Study (14.2% increase; P = 0.14), and 61 of the French Long-Lived Study (23.5% increase; P = 0.02)]. In addition, mega analysis of males in all cohorts resulted in a significant positive trend with age (26% increase; P = 0.007), suggesting sexual dimorphism for GH action in longevity. Further, on average, LGP d3/d3 homozygotes were 1 inch taller than the wild-type (WT) allele carriers (P = 0.05) and also showed lower serum IGF-1 levels (P = 0.003). Multivariate regression analysis indicated that the presence of d3/d3 genotype adds approximately 10 years to life span. The LGP d3/d3-GHR transformed lymphocytes exhibited superior growth and extracellular signal-regulated kinase activation, to GH treatment relative to WT GHR lymphocytes (P < 0.01), indicating a GH dose response. The d3-GHR variant is a common genetic polymorphism that modulates GH responsiveness throughout the life span and positively affects male longevity.
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Affiliation(s)
- Danny Ben-Avraham
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Institute of Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Diddahally R. Govindaraju
- Institute of Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA
| | - Temuri Budagov
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Institute of Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Delphine Fradin
- INSERM U986, Pincus Building, Bicêtre Hospital, Paris Sud University, 94275 Le Kremlin Bicêtre, France
| | - Peter Durda
- Department of Pathology University of Vermont, 208 South Park Drive, Colchester, VT 05446, USA
| | - Bing Liu
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Sandy Ott
- University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Danielle Gutman
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
| | - Lital Sharvit
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
| | - Robert Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Pierre Bougnères
- INSERM U986, Pincus Building, Bicêtre Hospital, Paris Sud University, 94275 Le Kremlin Bicêtre, France
- INSERM U1169 and Department of Pediatric Endocrinology and Diabetes, Bicêtre Hospital, Pôle I3E, Paris Sud University, 94275 Le Kremlin Bicêtre, France
| | - Alex Reiner
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA 98195, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Alan R. Shuldiner
- University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Geriatrics Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, MD 20420, USA
| | - Pinchas Cohen
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA
| | - Nir Barzilai
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Institute of Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Gil Atzmon
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Institute of Aging Research, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Department of Human Biology, Faculty of Natural Sciences, University of Haifa, Haifa, Israel
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20
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Dias C, Giordano M, Frechette R, Bellone S, Polychronakos C, Legault L, Deal CL, Goodyer CG. Genetic variations at the human growth hormone receptor (GHR) gene locus are associated with idiopathic short stature. J Cell Mol Med 2017; 21:2985-2999. [PMID: 28557176 PMCID: PMC5661101 DOI: 10.1111/jcmm.13210] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/17/2017] [Indexed: 12/15/2022] Open
Abstract
GH plays an essential role in the growing child by binding to the growth hormone receptor (GHR) on target cells and regulating multiple growth promoting and metabolic effects. Mutations in the GHR gene coding regions result in GH insensitivity (dwarfism) due to a dysfunctional receptor protein. However, children with idiopathic short stature (ISS) show growth impairment without GH or GHR defects. We hypothesized that decreased expression of the GHR gene may be involved. To test this, we investigated whether common genetic variants (microsatellites, SNPs) in regulatory regions of the GHR gene region were associated with the ISS phenotype. Genotyping of a GT‐repeat microsatellite in the GHR 5′UTR in a Montreal ISS cohort (n = 37 ISS, n = 105 controls) revealed that the incidence of the long/short (L/S) genotype was 3.3× higher in ISS children than controls (P = 0.04, OR = 3.85). In an Italian replication cohort (n = 143 ISS, n = 282 controls), the medium/short (M/S) genotype was 1.9× more frequent in the male ISS than controls (P = 0.017, OR = 2.26). In both ISS cohorts, logistic regression analysis of 27 SNPs showed an association of ISS with rs4292454, while haplotype analysis revealed specific risk haplotypes in the 3′ haploblocks. In contrast, there were no differences in GT genotype frequencies in a cohort of short stature (SS) adults versus controls (CARTaGENE: n = 168 SS, n = 207 controls) and the risk haplotype in the SS cohort was located in the most 5′ haploblock. These data suggest that the variants identified are potentially genetic markers specifically associated with the ISS phenotype.
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Affiliation(s)
- Christel Dias
- Department of Experimental Medicine, McGill University, Montreal, QC, Canada
| | - Mara Giordano
- Laboratory of Human Genetics, Department of Health Science, University of Eastern Piedmont, Novara, Italy
| | | | - Simonetta Bellone
- Division of Pediatrics, Department of Health Science, University of Eastern Piedmont, Novara, Italy
| | - Constantin Polychronakos
- Departments of Experimental Medicine, Human Genetics and Pediatrics, McGill University, Montreal, QC, Canada
| | - Laurent Legault
- Department of Pediatrics, McGill University, Montreal, QC, Canada
| | - Cheri L Deal
- CHU Ste-Justine Research Centre and Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
| | - Cynthia Gates Goodyer
- Department of Experimental Medicine, McGill University, Montreal, QC, Canada.,Departments of Experimental Medicine and Pediatrics, McGill University, Montreal, QC, Canada
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21
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Franck SE, Broer L, van der Lely AJ, Kamenicky P, Bernabéu I, Malchiodi E, Delhanty PJ, Rivadeneira F, Neggers SJ. The Effect of the Exon-3-Deleted Growth Hormone Receptor on Pegvisomant-Treated Acromegaly: A Systematic Review and Meta-Analysis. Neuroendocrinology 2017; 105:131-140. [PMID: 27513761 PMCID: PMC5637298 DOI: 10.1159/000448844] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 08/02/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND The common exon 3 deletion polymorphism of the growth hormone receptor (d3-GHR) is associated with disease severity in acromegaly patients. The GHR antagonist pegvisomant (PEGV) is highly effective in treating severe acromegaly. Response to PEGV treatment seems to be influenced by d3-GHR and appears to be more responsive to PEGV, although available results remain conflicting. OBJECTIVE To assess the influence of d3-GHR on the responsiveness of acromegaly patients to PEGV by compiling the evidence derived from the largest available studies. DESIGN A systematic review of the literature identified three published studies and one conference abstract. Acromegaly patients (n = 324, 49.7% d3-GHR carriers) were treated with either PEGV monotherapy or PEGV combined with long-acting somatostatin analogues and/or cabergoline. A meta-analysis of raw data from these studies was performed. RESULTS No significant effect of the d3-GHR was observed while bringing insulin-like growth factor I (IGF-I) levels below the upper limit of normal with PEGV, which was defined as the lowest IGF-I level during PEGV treatment (mean difference: -2.3%; 95% CI: -6.5 to 1.8, p = 0.270). The PEGV dose required to achieve the lowest IGF-I levels was also not significantly influenced by individuals carrying d3-GHR (mean difference: 4.1 mg weekly; 95% CI: -5.1 to 13.2, p = 0.385). For both outcomes, separate analysis of PEGV monotherapy and combination treatment gave similar results. CONCLUSION Our findings suggest that the d3-GHR polymorphism has no effect on biochemical disease control in acromegaly, as it is not of added value for either the prediction of PEGV responsiveness or the determination of the required PEGV dose.
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Affiliation(s)
- Sanne E. Franck
- Department of Internal Medicine, Endocrinology Section Rotterdam, Rotterdam, The Netherlands
- *S.E. Franck, Department of Internal Medicine, Endocrinology Section, Erasmus University Medical Center, PO Box 2040, NL-3000 CA Rotterdam (The Netherlands), E-Mail
| | - Linda Broer
- Department of Internal Medicine, Endocrinology Section Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Aart Jan van der Lely
- Department of Internal Medicine, Endocrinology Section Rotterdam, Rotterdam, The Netherlands
| | - Peter Kamenicky
- Department of Assistance Publique-Hôpitaux de Paris, Service d'Endocrinologie et des Maladies de la Reproduction, Hôpital de Bicêtre, Paris, France
- Department of Faculté de Médecine, UMR-S1185, Université Paris-Sud, Le Kremlin Bicêtre, Paris, France
- Department of Institut National de la Santé et de la Recherche Médicale (INSERM) U1185, Paris, France
| | - Ignacio Bernabéu
- Department of Endocrinology, Clinic University Hospital - Santiago de Compostela (SERGAS), Santiago de Compostela, Spain
| | - Elena Malchiodi
- Department of Department of Clinical Sciences and Community Health, Endocrinology and Diabetology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Patric J.D. Delhanty
- Department of Internal Medicine, Endocrinology Section Rotterdam, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Endocrinology Section Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
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22
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Mormando M, Chiloiro S, Bianchi A, Giampietro A, Angelini F, Tartaglione L, Nasto L, Milardi D, Formenti AM, Giustina A, De Marinis L. Growth hormone receptor isoforms and fracture risk in adult-onset growth hormone-deficient patients. Clin Endocrinol (Oxf) 2016; 85:717-724. [PMID: 27437620 DOI: 10.1111/cen.13161] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/21/2016] [Accepted: 07/18/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Growth hormone deficiency is considered the most important factor determining skeletal fragility in hypopituitary patients. Osteoblasts and chondrocytes express growth hormone (GH) receptor. Two GH receptor isoforms (GHRi) have been identified: they differ for the presence/absence of a protein fragment encoded by exon 3 of GHR gene. Consequently, three genotypes were identified: carriers of both the full-length proteins (flfl-GHR), carriers of one full-length protein and one deleted protein (fld3-GHR) and carriers of both deleted proteins (d3d3-GHR). This polymorphism confers a higher sensitivity to endogenous GH and to recombinant human GH (rhGH); its effect on bone metabolism and skeletal fragility is unknown. The aim of this article was to investigate the role of GHRi in predicting skeletal fragility in adult-onset GHD (AO-GHD) patients. SUBJECTS AND METHODS A cross-sectional study was conducted to investigate the association between the d3-GHR isoform and the prevalence of morphometric vertebral fractures (VFs) in AO-GHD. Ninety-three AO-GHD were enrolled. Forty-nine patients carried flfl-GHRi (52·7%), and 44 patients (47·3%) carried at least one allele of the d3-GHR isoform. Thirty-two VFs were documented. Fifty-seven patients underwent rhGH replacement therapy. RESULTS Median age was significantly higher in fractured patients as compared to nonfractured ones; d3-carrier patients showed a lower VF risk as compared to flfl-GHRi (OR: 0·37, 95% IC: 0·24-0·55, P < 0·0001). This finding was also confirmed in AO-GHD undergoing rhGH replacement therapy. CONCLUSION This study suggests that d3-GHR may protect AO-GHD particularly when treated with rhGH from the risk of VFs.
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Affiliation(s)
- M Mormando
- Pituitary Unit, Section of Endocrinology, Department of Internal Medicine, Catholic University, School of Medicine, 'A. Gemelli' University Hospital, Rome, Italy
| | - S Chiloiro
- Pituitary Unit, Section of Endocrinology, Department of Internal Medicine, Catholic University, School of Medicine, 'A. Gemelli' University Hospital, Rome, Italy
| | - A Bianchi
- Pituitary Unit, Section of Endocrinology, Department of Internal Medicine, Catholic University, School of Medicine, 'A. Gemelli' University Hospital, Rome, Italy
| | - A Giampietro
- Pituitary Unit, Section of Endocrinology, Department of Internal Medicine, Catholic University, School of Medicine, 'A. Gemelli' University Hospital, Rome, Italy
| | - F Angelini
- Laboratory of Vascular Biology and Genetics, Department of Medicine, Catholic University School of Medicine, Rome, Italy
| | - L Tartaglione
- Pituitary Unit, Section of Endocrinology, Department of Internal Medicine, Catholic University, School of Medicine, 'A. Gemelli' University Hospital, Rome, Italy
| | - L Nasto
- Division of Spine Surgery, Department of Orthopaedics and Traumatology, Catholic University, School of Medicine, 'A. Gemelli' University Hospital, Rome, Italy
| | - D Milardi
- Pituitary Unit, Section of Endocrinology, Department of Internal Medicine, Catholic University, School of Medicine, 'A. Gemelli' University Hospital, Rome, Italy
| | - A M Formenti
- Chair of Endocrinology, Spedali Civili, University of Brescia, Brescia, Italy
| | - A Giustina
- Chair of Endocrinology, Spedali Civili, University of Brescia, Brescia, Italy
| | - L De Marinis
- Pituitary Unit, Section of Endocrinology, Department of Internal Medicine, Catholic University, School of Medicine, 'A. Gemelli' University Hospital, Rome, Italy.
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23
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de Oliveira Machado E, Lima CHA, Ogino LL, Kasuki L, Gadelha MR. Growth hormone receptor exon 3 isoforms may have no importance in the clinical setting of multiethnic Brazilian acromegaly patients. Pituitary 2016; 19:375-80. [PMID: 27001494 DOI: 10.1007/s11102-016-0715-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Acromegaly is associated with significant morbidity and increased mortality, but has a variable severity phenotype. The presence of the exon 3-deleted isoform of the growth hormone receptor (d3-GHR) may influence the disease phenotype and treatment outcomes, including the frequency of biochemical discordance after medical treatment. AIMS The objective of this study was to analyze the influence of the d3-GHR isoform on clinical and biochemical characteristics and in the treatment outcomes of Brazilian multiethnic acromegaly patients. METHODS We retrospectively analyzed our acromegaly outpatient clinic databank and collected demographic, clinical, biochemical and treatment outcome data from those patients who agreed to participate in the study. A blood sample was collected from all patients, the DNA was extracted and the GHR isoforms were evaluated by PCR, with the full length (fl)-GHR represented by a 935-bp fragment and the d3-GHR represented by a 532-bp fragment. RESULTS A total of 121 patients were included. Fifty-six patients (46.3 %) were full-length homozygous (fl/fl), 48 (39.7 %) were heterozygous (fl/d3) and 17 (14.0 %) were d3-GHR homozygous (d3/d3). There was no difference between patients homozygous for the fl isoform and those harboring at least one d3-GHR allele in the demographic, clinical and biochemical data or in the treatment outcomes, including somatostatin receptor ligands (SRL) monotherapy, combination therapy with SRL and cabergoline and pegvisomant treatment. There was also no difference between the groups for the frequency of GH and IGF-I discordance after medical treatment. CONCLUSION GHR exon 3 genotyping appears to have no clinical significance, at least in Brazilian acromegaly patients.
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Affiliation(s)
- Evelyn de Oliveira Machado
- Neuroendocrinology Research Center/Endocrine Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255, 9th floor, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil
| | - Carlos Henrique Azeredo Lima
- Neuroendocrine Section and Molecular Genetics Laboratory, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil
| | - Liana Lumi Ogino
- Neuroendocrine Section and Molecular Genetics Laboratory, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil
| | - Leandro Kasuki
- Neuroendocrinology Research Center/Endocrine Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255, 9th floor, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil
- Neuroendocrine Section and Molecular Genetics Laboratory, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil
- Endocrine Section, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil
| | - Mônica R Gadelha
- Neuroendocrinology Research Center/Endocrine Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco, 255, 9th floor, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil.
- Neuroendocrine Section and Molecular Genetics Laboratory, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
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Cuny T, Zeiller C, Bidlingmaier M, Défilles C, Roche C, Blanchard MP, Theodoropoulou M, Graillon T, Pertuit M, Figarella-Branger D, Enjalbert A, Brue T, Barlier A. In vitro impact of pegvisomant on growth hormone-secreting pituitary adenoma cells. Endocr Relat Cancer 2016; 23:509-19. [PMID: 27267119 PMCID: PMC5064756 DOI: 10.1530/erc-16-0140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 12/30/2022]
Abstract
Pegvisomant (PEG), an antagonist of growth hormone (GH)-receptor (GHR), normalizes insulin-like growth factor 1 (IGF1) oversecretion in most acromegalic patients unresponsive to somatostatin analogs (SSAs) and/or uncontrolled by transsphenoidal surgery. The residual GH-secreting tumor is therefore exposed to the action of circulating PEG. However, the biological effect of PEG at the pituitary level remains unknown. To assess the impact of PEG in vitro on the hormonal secretion (GH and prolactin (PRL)), proliferation and cellular viability of eight human GH-secreting tumors in primary cultures and of the rat somatolactotroph cell line GH4C1. We found that the mRNA expression levels of GHR were characterized in 31 human GH-secreting adenomas (0.086 copy/copy β-Gus) and the GHR was identified by immunocytochemistry staining. In 5/8 adenomas, a dose-dependent inhibition of GH secretion was observed under PEG with a maximum of 38.2±17% at 1μg/mL (P<0.0001 vs control). A dose-dependent inhibition of PRL secretion occurred in three mixed GH/PRL adenomas under PEG with a maximum of 52.8±11.5% at 10μg/mL (P<0.0001 vs control). No impact on proliferation of either human primary tumors or GH4C1 cell line was observed. We conclude that PEG inhibits the secretion of GH and PRL in primary cultures of human GH(/PRL)-secreting pituitary adenomas without effect on cell viability or cell proliferation.
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Affiliation(s)
- Thomas Cuny
- Aix-Marseille UniversityCNRS, CRN2M UMR7286, Marseille, France
| | | | - Martin Bidlingmaier
- Endocrine Research UnitMedizinische Klinik und Poliklinik IV, Klinikum der LMU, Munich, Germany
| | - Céline Défilles
- Aix-Marseille UniversityCNRS, CRN2M UMR7286, Marseille, France
| | - Catherine Roche
- APHMConception, Laboratory of Molecular Biology, Marseille, France
| | | | | | - Thomas Graillon
- Aix-Marseille UniversityCNRS, CRN2M UMR7286, Marseille, France APHM TimoneDepartment of Neurosurgery, Marseille, France
| | - Morgane Pertuit
- APHMConception, Laboratory of Molecular Biology, Marseille, France
| | - Dominique Figarella-Branger
- APHM TimoneLaboratory of Neuropathology and Aix-Marseille University, INSERM, CRO2 UMR911, Marseille, France
| | - Alain Enjalbert
- Aix-Marseille UniversityCNRS, CRN2M UMR7286, Marseille, France APHMConception, Laboratory of Molecular Biology, Marseille, France
| | - Thierry Brue
- Aix-Marseille UniversityCNRS, CRN2M UMR7286, Marseille, France APHM ConceptionDepartment of Endocrinology, Marseille, France
| | - Anne Barlier
- Aix-Marseille UniversityCNRS, CRN2M UMR7286, Marseille, France APHMConception, Laboratory of Molecular Biology, Marseille, France
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25
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Ramos-Leví AM, Bernabeu I, Sampedro-Núñez M, Marazuela M. Genetic Predictors of Response to Different Medical Therapies in Acromegaly. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2016; 138:85-114. [PMID: 26940388 DOI: 10.1016/bs.pmbts.2015.10.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the era of predictive medicine, management of diseases is evolving into a more personal and individualized approach, as more data are available regarding clinical, biochemical, radiological, molecular, histopathological, and genetic aspects. In the particular setting of acromegaly, which is a rare, chronic, debilitating, and disfiguring disease, an optimized approach deems even more necessary, especially because of an associated increased morbidity and mortality, the impact on patients' quality of life, and the increased cost of frequently necessary life-long treatments. In this paper, we review the available studies that address potential genetic influences on acromegaly, their role in the outcome, and response to treatments, as well as their contribution to the risk of developing side effects. We focus mainly on pharmacogenetic factors involved during treatment with dopamine agonists, somatostatin analogs, and pegvisomant. Specifically, mutations in dopamine receptors, somatostatin receptors, growth hormone receptors, and metabolic pathways involved in growth hormone action; polymorphisms in the insulin-like growth factor and the insulin-like growth factor binding proteins; and polymorphisms in other genes that may determine differences in the frequency of developing adverse events.
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Affiliation(s)
- Ana M Ramos-Leví
- Department of Endocrinology and Nutrition, Hospital Universitario la Princesa, Instituto de Investigación Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Ignacio Bernabeu
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela, Servicio Gallego de Salud (SERGAS); Universidad de Santiago de Compostela, La Coruña, Spain
| | - Miguel Sampedro-Núñez
- Department of Endocrinology and Nutrition, Hospital Universitario la Princesa, Instituto de Investigación Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Mónica Marazuela
- Department of Endocrinology and Nutrition, Hospital Universitario la Princesa, Instituto de Investigación Princesa, Universidad Autónoma de Madrid, Madrid, Spain.
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Valsesia A, Chatelain P, Stevens A, Peterkova VA, Belgorosky A, Maghnie M, Antoniazzi F, Koledova E, Wojcik J, Farmer P, Destenaves B, Clayton P. GH deficiency status combined with GH receptor polymorphism affects response to GH in children. Eur J Endocrinol 2015; 173:777-89. [PMID: 26340968 PMCID: PMC4623334 DOI: 10.1530/eje-15-0474] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 09/04/2015] [Indexed: 12/17/2022]
Abstract
Meta-analysis has shown a modest improvement in first-year growth response to recombinant human GH (r-hGH) for carriers of the exon 3-deleted GH receptor (GHRd3) polymorphism but with significant interstudy variability. The associations between GHRd3 and growth response to r-hGH over 3 years in relation to severity of GH deficiency (GHD) were investigated in patients from 14 countries. Treatment-naïve pre-pubertal children with GHD were enrolled from the PREDICT studies (NCT00256126 and NCT00699855), categorized by peak GH level (peak GH) during provocation test: ≤4 μg/l (severe GHD; n=45) and >4 to <10 μg/l mild GHD; n=49) and genotyped for the GHRd3 polymorphism (full length (fl/fl, fl/d3, d3/d3). Gene expression (GE) profiles were characterized at baseline. Changes in growth (height (cm) and SDS) over 3 years were measured. There was a dichotomous influence of GHRd3 polymorphism on response to r-hGH, dependent on peak GH level. GH peak level (higher vs lower) and GHRd3 (fl/fl vs d3 carriers) combined status was associated with height change over 3 years (P<0.05). GHRd3 carriers with lower peak GH had lower growth than subjects with fl/fl (median difference after 3 years -3.3 cm; -0.3 SDS). Conversely, GHRd3 carriers with higher peak GH had better growth (+2.7 cm; +0.2 SDS). Similar patterns were observed for GH-dependent biomarkers. GE profiles were significantly different between the groups, indicating that the interaction between GH status and GHRd3 carriage can be identified at a transcriptomic level. This study demonstrates that responses to r-hGH depend on the interaction between GHD severity and GHRd3 carriage.
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Affiliation(s)
- Armand Valsesia
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
| | - Pierre Chatelain
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
| | - Adam Stevens
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
| | - Valentina A Peterkova
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
| | - Alicia Belgorosky
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
| | - Mohamad Maghnie
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
| | - Franco Antoniazzi
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
| | - Ekaterina Koledova
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
| | - Jerome Wojcik
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
| | - Pierre Farmer
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
| | - Benoit Destenaves
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
| | - Peter Clayton
- Merck Serono SAGeneva, SwitzerlandDépartement de PédiatrieHôpital Mère-Enfant, Université Claude Bernard, Lyon, FranceFederal State Institution 'Endocrinology Scientific Center of Russian Medical Technology'Moscow, RussiaEndocrine ServiceHospital de Pediatría Garrahan, Ciudad Autónoma de Buenos Aires, Buenos Aires, ArgentinaIRCCS Istituto Giannina Gaslini di GenovaClinica Pediatrica, Università di Genova, Genova, ItalyPediatra d.U. Azienda Ospedaliera Universitaria IntegrataUniversità di Verona, Verona, ItalyManchester Academic Health Sciences CentreRoyal Manchester Children's Hospital, 5th Floor, Oxford Road, Manchester M13 9WL, UK
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27
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Franck SE, van der Lely AJ, Delhanty PJD, Jørgensen JOL, Neggers SJCMM. Pegvisomant in combination with long-acting somatostatin analogues in acromegaly: the role of the GH receptor deletion of exon 3. Eur J Endocrinol 2015; 173:553-61. [PMID: 26243033 DOI: 10.1530/eje-15-0519] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 08/03/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Doses of the GH receptor (GHR) antagonist pegvisomant (PEGV) that normalize insulin-like growth factor 1 (IGF1) levels vary widely among acromegaly patients. Predictors for PEGV response are baseline IGF1 levels, sex, body weight and previous radiotherapy. A GHR polymorphism lacking exon 3 (d3-GHR) is frequent in the general population. The influence of d3-GHR on PEGV responsiveness in acromegaly is unclear. OBJECTIVE To assess the influence of d3-GHR on IGF1 levels and PEGV responsiveness in acromegaly patients using combined PEGV and long-acting somatostatin receptor ligand (LA-SRIF) treatment. DESIGN Data were collected at the Rotterdam Pituitary Centre between 2004 and 2013. Patients with elevated IGF1 levels (>1.2 upper limit of normal; n=112) and over 6 months of high-dose LA-SRIF treatment were co-treated with PEGV. GHR genotype was assessed using genomic DNA in 104 patients. RESULTS D3-GHR was observed in 51 (49.0%) of the patients (7.7% homozygous, 41.3% heterozygous) and was in Hardy-Weinberg equilibrium (P=0.859). Baseline characteristics were similar in d3-GHR and full-length (fl)-GHR genotypes. During PEGV/LA-SRIF treatment IGF1 levels were not different between d3-carriers and non-carriers. Similarly, no difference in PEGV dose required to normalize IGF1 (P=0.337) or PEGV serum levels (P=0.433) was observed between the two groups. However, adenoma size decreased significantly (>20% of largest diameter) in 25.6% of the fl-GHR genotype but only in 7.5% of d3-carriers (P=0.034, OR: 4.6 (CI: 1.1-18.9)). CONCLUSIONS GHR genotype does not predict the IGF1 normalizing dose of PEGV in acromegaly patients using combination PEGV/LA-SRIF treatment. However, fewer d3-carriers showed significant reductions in adenoma size.
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Affiliation(s)
- S E Franck
- Department of Internal MedicineEndocrinology Section, Pituitary Center Rotterdam, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The NetherlandsDepartment of Internal MedicineEndocrinology Section, Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
| | - A J van der Lely
- Department of Internal MedicineEndocrinology Section, Pituitary Center Rotterdam, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The NetherlandsDepartment of Internal MedicineEndocrinology Section, Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
| | - P J D Delhanty
- Department of Internal MedicineEndocrinology Section, Pituitary Center Rotterdam, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The NetherlandsDepartment of Internal MedicineEndocrinology Section, Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
| | - J O L Jørgensen
- Department of Internal MedicineEndocrinology Section, Pituitary Center Rotterdam, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The NetherlandsDepartment of Internal MedicineEndocrinology Section, Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
| | - S J C M M Neggers
- Department of Internal MedicineEndocrinology Section, Pituitary Center Rotterdam, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The NetherlandsDepartment of Internal MedicineEndocrinology Section, Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
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Jallad RS, Trarbach EB, Duarte FH, Jorge AAL, Bronstein MD. Influence of growth hormone receptor (GHR) exon 3 and -202A/C IGFBP-3 genetic polymorphisms on clinical and biochemical features and therapeutic outcome of patients with acromegaly. Pituitary 2015; 18:666-73. [PMID: 25552351 DOI: 10.1007/s11102-014-0629-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The association of GHR-exon 3 and -202 A/C IGFBP3 polymorphisms with clinical presentation, biochemical measurements and response to therapies in acromegaly have been suggested. OBJECTIVE To evaluate the presence of these polymorphisms in acromegaly and their influence on clinical and laboratorial characteristics of patients at diagnosis and after treatment in a large cohort of acromegalic patients. PATIENTS AND METHODS This is a cross-sectional study developed in a single tertiary reference center. Clinical data were obtained from the medical records of 186 acromegalic patients (116 women, age range 21-88 years). GH and IGF1 levels and GHR-exon 3 and -202 A/C IGFBP3 polymorphisms were evaluated in the same hospital. RESULTS At diagnosis, serum GH concentrations were lower in patients with GHR-d3 genotype than those with GHR-fl, whereas an association of lower IGFBP3 levels with d3 allele was observed only after neurosurgical or medical treatments. However, these associations were not confirmed in posterior statistical analysis. CONCLUSION Our results suggest that GHR-exon 3 and -202 A/C IGFBP3 polymorphisms did not show any consistent association on clinical and laboratorial features of acromegalic patients even after treatment.
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Affiliation(s)
- Raquel S Jallad
- Neuroendocrine Unit, Hospital das Clinicas, University of São Paulo Medical School, Av Dr Eneas de Carvalho Aguiar, 155, PAMB, 8 andar, São Paulo, SP, CEP: 05403-010, Brazil,
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Schilbach K, Bidlingmaier M. Growth hormone binding protein - physiological and analytical aspects. Best Pract Res Clin Endocrinol Metab 2015; 29:671-83. [PMID: 26522453 DOI: 10.1016/j.beem.2015.06.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A significant proportion of total circulating growth hormone (GH) is bound to a high affinity growth hormone binding protein (GHBP). Several low affinity binding proteins have also been described. Significant differences between species exist with respect to origin and regulation of GHBP, but generally it resembles the extracellular domain of the GH receptor. Concentrations are associated with GH status, body composition and other factors. Although the clinical relevance of GHBP is not fully understood it is suggested that concentrations indirectly reflect GH receptor status. This is supported by cases of Laron's syndrome where a molecular defect in the extracellular domain of the GH receptor is associated with low or unmeasurable GHBP concentrations. Methods to measure GHBP have evolved from chromatographic, activity based procedures to direct immunoassays. In clinical practice, measurement of GHBP can be helpful to differentiate between GH deficiency and GH insensitivity, particularly if GHBP is absent.
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Affiliation(s)
- Katharina Schilbach
- Endocrine Laboratory, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336, Munich, Germany.
| | - Martin Bidlingmaier
- Endocrine Laboratory, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336, Munich, Germany.
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Park HY, Hwang IR, Seo JB, Kim SW, Seo HA, Lee IK, Kim JG. Association between the Growth Hormone Receptor Exon 3 Polymorphism and Metabolic Factors in Korean Patients with Acromegaly. Endocrinol Metab (Seoul) 2015; 30:312-7. [PMID: 25559716 PMCID: PMC4595356 DOI: 10.3803/enm.2015.30.3.312] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 09/22/2014] [Accepted: 10/17/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This study investigated the association between the frequency of growth hormone receptor (GHR) exon 3 polymorphism (exon 3 deletion; d3-GHR) and metabolic factors in patients with acromegaly in Korea. METHODS DNA was extracted from the peripheral blood of 30 unrelated patients with acromegaly. GHR genotypes were evaluated by polymerase chain reaction and correlated with demographic data and laboratory parameters. RESULTS No patient had the d3/d3 genotype, while four (13.3%) had the d3/fl genotype, and 26 (86.7%) had the fl/fl genotype. Body mass index (BMI) in patients with the d3/fl genotype was significantly higher than in those with the fl/fl genotype (P=0.001). Age, gender, blood pressure, insulin-like growth factor-1, growth hormone, fasting plasma glucose, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol levels showed no significant differences between the two genotypes. CONCLUSION The d3-GHR polymorphism may be associated with high BMI but not with other demographic characteristics or laboratory parameters.
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Affiliation(s)
- Hye Yoon Park
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - In Ryang Hwang
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jung Bum Seo
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Su Won Kim
- Department of Biomedical Laboratory Science, Kyungwon University, Gumi, Korea
| | - Hyun Ae Seo
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - In Kyu Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jung Guk Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
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Pelekanos RA, Sardesai VS, Dekker Nitert M, Callaway LK, Fisk NM, Jeffery PL. Rapid method for growth hormone receptor exon 3 delete (GHRd3) SNP genotyping from archival human placental samples. Endocrine 2015; 49:643-52. [PMID: 26067082 DOI: 10.1007/s12020-015-0647-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 06/01/2015] [Indexed: 12/15/2022]
Abstract
Analysis of archival samples from cohorts of pregnant women may be key to discovering prognosticators of stillbirth and pregnancy/perinatal complications. Growth hormone (GH) and its receptor (GHR) are pivotal in feto-placental development and pregnancy maintenance. We report a rapid, optimized method for genotyping the GHR full-length versus exon 3-deleted isoform (GHRd3). TaqMan single nucleotide polymorphism (SNP) genotyping proved superior to standard multiplex polymerase chain reaction (PCR) in allele detection and GHR genotyping from archived samples, including those with poor genomic deoxyribonucleic acid quality/quantity such as formalin fixed, paraffin embedded, blood, and serum. Furthermore, this assay is suitable for high through put 96 or 384-well plate quantitative PCR machines with automated genotype calling software. The TaqMan genotyping assay can increase the data obtained from precious archival human samples.
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Affiliation(s)
- Rebecca A Pelekanos
- Experimental Fetal Medicine Group, UQ Centre for Clinical Research, The University of Queensland, Herston, QLD, 4029, Australia,
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Puig Domingo M. Treatment of acromegaly in the era of personalized and predictive medicine. Clin Endocrinol (Oxf) 2015; 83:3-14. [PMID: 25640882 DOI: 10.1111/cen.12731] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 07/21/2014] [Accepted: 01/26/2015] [Indexed: 12/16/2022]
Abstract
Acromegaly is a chronic disorder usually diagnosed late in the disease evolution. Such delayed diagnosis, together with the inability to achieve the treatment goals of normalizing biochemical disease markers and controlling tumour mass may result in substantial morbidity and mortality. Somatostatin analogues (SSA) are accepted as first-line medical therapy or as second-line therapy in patients undergoing unsuccessful surgery and are considered a cornerstone in the treatment of acromegaly. However, because a high percentage of patients experience SSA medical treatment failure, the identification of biomarkers associated with a successful or unsuccessful response to all classes of medical therapy would help in the choice of treatment and potentially allow for a quicker normalization of biochemical parameters. The current treatment algorithms for acromegaly are based upon a "trial-and-error" approach with additional treatment options provided when disease is not controlled. In many other diseases, therapeutic algorithms have been evolving towards personalized treatment with the medication that best matches individual disease characteristics, using biomarkers that identify therapeutic response. Additionally, a personalized approach to complementary treatment of comorbidities present in the acromegalic patient is also required. This review will discuss the development of a potential treatment algorithm for acromegaly addressing the biochemical control of the disease as well of its associated comorbidities, under a personalized approach based upon markers of prognostic and predictive significance, such as tumour size, MRI adenoma signal, GH value after acute octreotide test, granular adenoma pattern, Ki-67, somatostatin receptor phenotype, aryl hydrocarbon-interacting protein expression, gsp mutations, RAF kinase activity, E-cadherin and beta-arrestin-1.
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Fernandez-Rodriguez E, Casanueva FF, Bernabeu I. Update on prognostic factors in acromegaly: Is a risk score possible? Pituitary 2015; 18:431-40. [PMID: 24858722 DOI: 10.1007/s11102-014-0574-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Certain clinical conditions and markers have recently been demonstrated to modify the natural history of acromegaly in affected patients. Thus, some clinical, histological, radiological and molecular factors are associated with more aggressive pituitary tumors that have higher biochemical activity, higher tumor volumes and decreased tumoral and biochemical responses to current therapies. However, these factors do not seem to have an equal influence on the prognosis of patients with acromegaly. We present a review of the factors that influence the clinical course of patients with acromegaly and propose a risk value for each factor that will allow prognostic scoring for affected patients by considering a combination of these factors.
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Affiliation(s)
- E Fernandez-Rodriguez
- Endocrinology Division, Servicio Gallego de Salud (SERGAS), Complejo Hospitalario Universitario de Santiago de Compostela, 15706, Santiago de Compostela, La Coruña, Spain
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Cinar N, Dagdelen S, Yorgun H, Canpolat U, Kabakçı G, Erbas T. The clinical and cardiometabolic effects of d3-growth hormone receptor polymorphism in acromegaly. Pituitary 2015; 18:116-25. [PMID: 24706164 DOI: 10.1007/s11102-014-0564-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Exon 3-deleted GH receptor variant (d3-GHR) is associated with increased responsiveness to exogenous GH. The aim of this study was to determine the effect of d3-GHR polymorphism on the GH/IGF-1 relationship, clinical parameters, and comorbidity in acromegalic patients. METHODS The study included 118 acromegalic patients (61 female and 57 male; mean age: 50.3 ± 12.2 years) and 108 healthy controls (94 female and 14 male: mean age: 41.1 ± 11.1 years). The prevalence of GHR genotypes was evaluated via PCR. RESULTS In all, 71 (60.2%) patients had the fl/fl-GHR genotype, 40 (33.9%) were heterozygous for the fl/d3-GHR genotype, and 7 (5.9%) were homozygous for the d3/d3-GHR genotype. The prevalence of fl/fl-GHR, fl/d3-GHR, and d3/d3-GHR genotypes in the control group was 57.4, 29.6, and 13.0%, respectively-similar prevalences as in the patient group. Patients that were heterozygous and homozygous for the d3 allele were subgrouped (d3-GHR subgroup), and were compared to those with the fl/fl-GHR genotype (fl/fl-GHR subgroup). Anthropometric measures, features of pituitary adenoma, and baseline GH and IGF-1 levels were similar in both subgroups. The prevalence of coronary artery disease, hypertension, hyperlipidemia, type 2 diabetes mellitus, and multinodular goiter did not differ between patient subgroups. In total, 24 (20.3%) of the patients had cancer and the prevalence of cancer was similar in the d3-GHR (14.9%) and fl/fl-GHR (23.9%) subgroups (P = 0.23). More of the acromegalic patients that were d3 carriers had discordant GH and IGF-1 levels at baseline and post surgery, but the difference was not significant. A significant correlation between basal GH and IGF-1 levels was observed only in the patients with the fl/fl-GHR genotype (R(2) = 0.227, P < 0.001). CONCLUSION The d3-GHR variant genotype did not have an effect on clinical features or comorbidity in acromegalic patients, but it might play a role in GH/IGF-1 level discordance in acromegaly.
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Affiliation(s)
- Nese Cinar
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Sihhiye, 06100, Ankara, Turkey,
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35
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Glad CAM, Carlsson LMS, Melander O, Almgren P, Sjöström L, Nilsson S, Larsson I, Svensson PA, Johannsson G. The GH receptor exon 3 deleted/full-length polymorphism is associated with central adiposity in the general population. Eur J Endocrinol 2015; 172:123-8. [PMID: 25391539 DOI: 10.1530/eje-14-0723] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To test the hypothesis that the GH receptor (GHR) exon 3 deleted (d3)/full-length (fl) polymorphism influences anthropometry and body composition in the general population. DESIGN AND SETTING The Swedish Obese Subjects (SOS) reference study is a cross-sectional population-based study, randomly selected from a population registry. A subgroup of the population-based Malmö Diet and Cancer study (MDC-CC) was used as a replication cohort. METHODS The SOS reference study comprises 1135 subjects (46.2% men), with an average age of 49.5 years. The MDC-CC includes 5451 successfully genotyped subjects (41.5% men), with an average age of 57.5 years. GHR d3/fl genotypes were determined using TagSNP rs6873545. Linear regression analyses were used to test for genotype-phenotype associations. RESULTS In the SOS reference study, subjects homozygous for the d3-GHR weighed ∼4 kg more (P=0.011), and had larger waist-to-hip ratio (WHR, P=0.036), larger waist circumference (P=0.016), and more fat-free mass estimated from total body potassium (P=0.026) than grouped fl/d3 and fl/fl subjects (d3-recessive genetic model). The association with WHR was replicated in the MDC-CC (P=0.002), but not those with other anthropometric traits. CONCLUSIONS In this population-based study, the GHR d3/fl polymorphism was found to be of functional relevance and associated with central adiposity, such that subjects homozygous for the d3-GHR showed an increased abdominal obesity.
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Affiliation(s)
- Camilla A M Glad
- Departments of EndocrinologyMolecular and Clinical MedicineInstitute of Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Vita Stråket 15, SE-413 45 Gothenburg, SwedenDepartment of Clinical SciencesLund University, Malmö, SwedenDepartment of Mathematical StatisticsChalmers University of Technology, Gothenburg, SwedenDepartment of EndocrinologyDiabetology and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lena M S Carlsson
- Departments of EndocrinologyMolecular and Clinical MedicineInstitute of Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Vita Stråket 15, SE-413 45 Gothenburg, SwedenDepartment of Clinical SciencesLund University, Malmö, SwedenDepartment of Mathematical StatisticsChalmers University of Technology, Gothenburg, SwedenDepartment of EndocrinologyDiabetology and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Olle Melander
- Departments of EndocrinologyMolecular and Clinical MedicineInstitute of Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Vita Stråket 15, SE-413 45 Gothenburg, SwedenDepartment of Clinical SciencesLund University, Malmö, SwedenDepartment of Mathematical StatisticsChalmers University of Technology, Gothenburg, SwedenDepartment of EndocrinologyDiabetology and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Peter Almgren
- Departments of EndocrinologyMolecular and Clinical MedicineInstitute of Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Vita Stråket 15, SE-413 45 Gothenburg, SwedenDepartment of Clinical SciencesLund University, Malmö, SwedenDepartment of Mathematical StatisticsChalmers University of Technology, Gothenburg, SwedenDepartment of EndocrinologyDiabetology and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars Sjöström
- Departments of EndocrinologyMolecular and Clinical MedicineInstitute of Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Vita Stråket 15, SE-413 45 Gothenburg, SwedenDepartment of Clinical SciencesLund University, Malmö, SwedenDepartment of Mathematical StatisticsChalmers University of Technology, Gothenburg, SwedenDepartment of EndocrinologyDiabetology and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Staffan Nilsson
- Departments of EndocrinologyMolecular and Clinical MedicineInstitute of Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Vita Stråket 15, SE-413 45 Gothenburg, SwedenDepartment of Clinical SciencesLund University, Malmö, SwedenDepartment of Mathematical StatisticsChalmers University of Technology, Gothenburg, SwedenDepartment of EndocrinologyDiabetology and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingrid Larsson
- Departments of EndocrinologyMolecular and Clinical MedicineInstitute of Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Vita Stråket 15, SE-413 45 Gothenburg, SwedenDepartment of Clinical SciencesLund University, Malmö, SwedenDepartment of Mathematical StatisticsChalmers University of Technology, Gothenburg, SwedenDepartment of EndocrinologyDiabetology and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Per-Arne Svensson
- Departments of EndocrinologyMolecular and Clinical MedicineInstitute of Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Vita Stråket 15, SE-413 45 Gothenburg, SwedenDepartment of Clinical SciencesLund University, Malmö, SwedenDepartment of Mathematical StatisticsChalmers University of Technology, Gothenburg, SwedenDepartment of EndocrinologyDiabetology and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gudmundur Johannsson
- Departments of EndocrinologyMolecular and Clinical MedicineInstitute of Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Vita Stråket 15, SE-413 45 Gothenburg, SwedenDepartment of Clinical SciencesLund University, Malmö, SwedenDepartment of Mathematical StatisticsChalmers University of Technology, Gothenburg, SwedenDepartment of EndocrinologyDiabetology and Metabolism, Sahlgrenska University Hospital, Gothenburg, Sweden
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Martins CS, Fernandes-Rosa FL, Espineira AR, de Souza RM, de Castro M, Barbieri MA, Bettiol H, Jorge AL, Antonini SR. The growth hormone receptor exon 3 polymorphism is not associated with height or metabolic traits in healthy young adults. Growth Horm IGF Res 2014; 24:123-129. [PMID: 24893921 DOI: 10.1016/j.ghir.2014.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 03/20/2014] [Accepted: 04/03/2014] [Indexed: 12/16/2022]
Abstract
CONTEXT The GHR polymorphisms contribution to the interindividual variability in prenatal and postnatal growth as well as to metabolic traits is controversial. OBJECTIVE The aim of this study is to analyze the association of the GHRfl/d3 polymorphism with prenatal and postnatal growth and metabolic outcomes in adult life and to compare the genotype distribution in different populations. DESIGN 385 community healthy subjects followed from birth to adult life (23-25years old) were grouped according to birth size: small-SGA (n=130, 62 males), appropriate-AGA (n=162, 75 males) and large for gestational age-LGA (n=93, 48 males). GHRfl/d3 genotype distribution and its potential association with anthropometric (at birth, childhood and adult life) and metabolic features (in adult life) were analyzed and compared with data obtained from a systematic review of GHRfl/d3 association studies (31 articles). RESULTS The frequency of the GHR d3/d3 genotype was lower in the LGA (χ2 p=0.01); SGA and AGA subjects exhibited an increased chance of the d3/d3 genotype (OR=3.58; 95%CI: 1.55; 8.24) and (OR=2.39; 95%CI: 1.02; 5.62), respectively. Despite the different prevalence among different birth size groups, in adults, GHRfl/d3 genotype was not associated with height, plasma IGF1 levels or metabolic phenotype and cardiovascular risk. GHRfl/d3 genotype distributions in AGA, SGA and LGA groups were comparable with those found in subjects of European origin but not with those of Asian ancestry. CONCLUSIONS The GHRd3 genotype was negatively associated with birth size but it was not associated with adult height or weight, plasma IGF1, metabolic phenotype or any marker of increased cardiovascular risk in young adults.
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Affiliation(s)
- Clarissa S Martins
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Fabio L Fernandes-Rosa
- Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Aniette R Espineira
- Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Roberto Molina de Souza
- Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Margaret de Castro
- Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Marco A Barbieri
- Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Heloisa Bettiol
- Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Alexander L Jorge
- Department of Endocrinology, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Sonir R Antonini
- Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
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Mormando M, Nasto LA, Bianchi A, Mazziotti G, Giampietro A, Pola E, Pontecorvi A, Giustina A, De Marinis L. GH receptor isoforms and skeletal fragility in acromegaly. Eur J Endocrinol 2014; 171:237-45. [PMID: 24866575 DOI: 10.1530/eje-14-0205] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Acromegaly is associated with an increased prevalence of vertebral fractures (VFs) in close relationship with GH hypersecretion. Two isoforms of the GH receptor (GHR) have been identified; the two isoforms differ or not by the expression of the protein fragment encoded by exon 3 of the GHR gene. Deletion of the exon 3 may influence the functional properties of the GHR and affect fracture risk in acromegalic patients. DESIGN A cross-sectional study was designed to investigate the association between the d3-GHR isoform and the prevalence of VFs in patients with acromegaly. METHODS In this study, 109 acromegalic patients were included (M/F, 48/61): 73 with controlled/cured acromegaly and 36 with active disease. GHR genotype was assessed in each patient. All patients were evaluated for VFs and bone mineral density at lumbar spine and hip. Serum IGF1 levels and bone metabolism markers were measured. A multivariate analysis was performed to establish risk factors for VFs in our population. RESULTS d3-GHR carriers showed an increased prevalence of VFs when compared with patients expressing full-length GHR (35/55 vs 12/54; P<0.001). The association between GHR deletion and VFs was demonstrated both in patients with active disease and in those with controlled/cured disease. Out of 35 patients who were prospectively evaluated, 13 (37.1%) developed incident VFs. The incidence of VFs was significantly higher in patients for whom the GHR gene has been deleted when compared with those harboring the fl gene (P=0.04). In multivariate analysis, male sex (odds ratio (OR), 3.250; P=0.041), IGF1 levels (OR, 1.183; P=0.031), length of active diseases (OR, 1.038; P=0.001), and d3-GHR genotype (OR, 3.060; P=0.015) were all confirmed as risk factors of VFs in our population. CONCLUSIONS This study suggests for the first time that exon 3 deletion of GHR may predispose patients with active and controlled acromegaly to a higher risk of VFs.
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Affiliation(s)
- Marilda Mormando
- Pituitary UnitDepartment of EndocrinologyDivision of Spine SurgeryDepartment of Orthopaedics and Traumatology, Catholic University School of Medicine, 'A. Gemelli' University Hospital, l.go Agostino Gemelli 8, 00168 Rome, ItalyChair of EndocrinologyUniversity of Brescia, 25125 Brescia, Italy
| | - Luigi A Nasto
- Pituitary UnitDepartment of EndocrinologyDivision of Spine SurgeryDepartment of Orthopaedics and Traumatology, Catholic University School of Medicine, 'A. Gemelli' University Hospital, l.go Agostino Gemelli 8, 00168 Rome, ItalyChair of EndocrinologyUniversity of Brescia, 25125 Brescia, Italy
| | - Antonio Bianchi
- Pituitary UnitDepartment of EndocrinologyDivision of Spine SurgeryDepartment of Orthopaedics and Traumatology, Catholic University School of Medicine, 'A. Gemelli' University Hospital, l.go Agostino Gemelli 8, 00168 Rome, ItalyChair of EndocrinologyUniversity of Brescia, 25125 Brescia, Italy
| | - Gherardo Mazziotti
- Pituitary UnitDepartment of EndocrinologyDivision of Spine SurgeryDepartment of Orthopaedics and Traumatology, Catholic University School of Medicine, 'A. Gemelli' University Hospital, l.go Agostino Gemelli 8, 00168 Rome, ItalyChair of EndocrinologyUniversity of Brescia, 25125 Brescia, Italy
| | - Antonella Giampietro
- Pituitary UnitDepartment of EndocrinologyDivision of Spine SurgeryDepartment of Orthopaedics and Traumatology, Catholic University School of Medicine, 'A. Gemelli' University Hospital, l.go Agostino Gemelli 8, 00168 Rome, ItalyChair of EndocrinologyUniversity of Brescia, 25125 Brescia, Italy
| | - Enrico Pola
- Pituitary UnitDepartment of EndocrinologyDivision of Spine SurgeryDepartment of Orthopaedics and Traumatology, Catholic University School of Medicine, 'A. Gemelli' University Hospital, l.go Agostino Gemelli 8, 00168 Rome, ItalyChair of EndocrinologyUniversity of Brescia, 25125 Brescia, Italy
| | - Alfredo Pontecorvi
- Pituitary UnitDepartment of EndocrinologyDivision of Spine SurgeryDepartment of Orthopaedics and Traumatology, Catholic University School of Medicine, 'A. Gemelli' University Hospital, l.go Agostino Gemelli 8, 00168 Rome, ItalyChair of EndocrinologyUniversity of Brescia, 25125 Brescia, Italy
| | - Andrea Giustina
- Pituitary UnitDepartment of EndocrinologyDivision of Spine SurgeryDepartment of Orthopaedics and Traumatology, Catholic University School of Medicine, 'A. Gemelli' University Hospital, l.go Agostino Gemelli 8, 00168 Rome, ItalyChair of EndocrinologyUniversity of Brescia, 25125 Brescia, Italy
| | - Laura De Marinis
- Pituitary UnitDepartment of EndocrinologyDivision of Spine SurgeryDepartment of Orthopaedics and Traumatology, Catholic University School of Medicine, 'A. Gemelli' University Hospital, l.go Agostino Gemelli 8, 00168 Rome, ItalyChair of EndocrinologyUniversity of Brescia, 25125 Brescia, Italy
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Alatzoglou KS, Webb EA, Le Tissier P, Dattani MT. Isolated growth hormone deficiency (GHD) in childhood and adolescence: recent advances. Endocr Rev 2014; 35:376-432. [PMID: 24450934 DOI: 10.1210/er.2013-1067] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The diagnosis of GH deficiency (GHD) in childhood is a multistep process involving clinical history, examination with detailed auxology, biochemical testing, and pituitary imaging, with an increasing contribution from genetics in patients with congenital GHD. Our increasing understanding of the factors involved in the development of somatotropes and the dynamic function of the somatotrope network may explain, at least in part, the development and progression of childhood GHD in different age groups. With respect to the genetic etiology of isolated GHD (IGHD), mutations in known genes such as those encoding GH (GH1), GHRH receptor (GHRHR), or transcription factors involved in pituitary development, are identified in a relatively small percentage of patients suggesting the involvement of other, yet unidentified, factors. Genome-wide association studies point toward an increasing number of genes involved in the control of growth, but their role in the etiology of IGHD remains unknown. Despite the many years of research in the area of GHD, there are still controversies on the etiology, diagnosis, and management of IGHD in children. Recent data suggest that childhood IGHD may have a wider impact on the health and neurodevelopment of children, but it is yet unknown to what extent treatment with recombinant human GH can reverse this effect. Finally, the safety of recombinant human GH is currently the subject of much debate and research, and it is clear that long-term controlled studies are needed to clarify the consequences of childhood IGHD and the long-term safety of its treatment.
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Affiliation(s)
- Kyriaki S Alatzoglou
- Developmental Endocrinology Research Group (K.S.A., E.A.W., M.T.D.), Clinical and Molecular Genetics Unit, and Birth Defects Research Centre (P.L.T.), UCL Institute of Child Health, London WC1N 1EH, United Kingdom; and Faculty of Life Sciences (P.L.T.), University of Manchester, Manchester M13 9PT, United Kingdom
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Rethmeyer JA, Tan X, Manzardo A, Schroeder SR, Butler MG. Comparison of biological specimens and DNA collection methods for PCR amplification and microarray analysis. Clin Chem Lab Med 2014; 51:e79-83. [PMID: 23241593 DOI: 10.1515/cclm-2012-0429] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 11/07/2012] [Indexed: 11/15/2022]
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Andreassen M, Jensen RB, Jørgensen N, Juul A. Association between GH receptor polymorphism (exon 3 deletion), serum IGF1, semen quality, and reproductive hormone levels in 838 healthy young men. Eur J Endocrinol 2014; 170:555-63. [PMID: 24412931 DOI: 10.1530/eje-13-0729] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION GH activity may be involved in male reproductive function. A common genetic polymorphism in the gene encoding the GH receptor (GHR) results in deletion of the entire exon 3 sequence (GHRd3 isoform). The short GHRd3/d3 isoform seems more sensitive compared with full-length receptors (GHRfl/fl). AIM TO INVESTIGATE THE ASSOCIATIONS BETWEEN GH ACTIVITY, EVALUATED BY EXON 3 GHR POLYMORPHISM, AND SERUM IGF1 VS REPRODUCTIVE HORMONES, SEMEN QUALITY, AND PRE- AND POSTNATAL GROWTH IN HEALTHY YOUNG MALES (N=838, MEAN AGE: 19.4 years). RESULTS Compared with GHRfl/fl homozygous individuals (n=467) GHRd3/d3 homozygous individuals (n=69) tended to have larger semen volume (3.2 (2.4-4.3) vs 3.6 (2.6-4.7) ml, P=0.053) and higher serum inhibin-B levels (208 pg/ml (158-257) vs 227 pg/ml (185-264), P=0.050). Semen quality, levels of gonadotropins, testosterone, estradiol, sex hormone-binding globulin, and IGF1 were not associated with GHRd3 genotype. A twofold increase in serum IGF1 was associated with a 13% (4-23) increase in calculated free testosterone (P=0.004). By contrast IGF1 was inversely associated with serum inhibin-B (P=0.027), but showed no associations to semen quality. GHR genotype and serum IGF1 were not associated with size at birth or final height. CONCLUSIONS GHRd3 polymorphism seemed only to have a weak influence on male reproductive function of borderline significance. The sensitive GHRd3/d3 genotype may slightly increase testicular function, as evaluated by semen volume and levels of inhibin-B, but does not seem to influence Leydig cell steroidogenesis. GHR genotype did not influence pre- and postnatal growth.
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Affiliation(s)
- M Andreassen
- Department of Growth and Reproduction GR, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Rigshospitalet Section 5064, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
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Marques FA, Lins TC, Lima RM, Fonseca RMC, de França NM, de Oliveira RJ, de Oliveira Cardoso MT, Pereira RW, Pogue R. The exon 3 polymorphism of the growth hormone receptor is a severity-related factor for osteoporosis. Endocrine 2014; 45:487-96. [PMID: 23812803 DOI: 10.1007/s12020-013-0004-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 06/08/2013] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to investigate the association between the GHR exon 3 fl/d3 polymorphism and body composition traits in Brazilian cohorts of normal post-menarche adolescent girls and in post-menopausal women with and without osteoporosis. First, multiplex PCR and quantitative PCR (TaqMan) were used with 105 DNA samples from the general Brazilian population to validate the SNP rs6873545 as a surrogate marker for the GHR polymorphism. Subsequently, genotyping was carried out to evaluate associations for this polymorphism in 136 post-menarche adolescents and 175 post-menopausal women, who were evaluated for body composition traits such as bone mineral density and fat-free mass. Statistical analysis used an independent sample t test, one-way ANOVA test and post hoc Tukey HSD test. Significant values were assumed by p < 0.05. Genotyping indicated complete linkage disequilibrium between the GHR polymorphism and the SNP alleles (r(2) = 1.0). Adolescents and healthy post-menopausal women showed no genotype associations for body composition traits or osteoporosis. However, a lower total body bone mineral density was observed in fl/fl post-menopausal women with osteoporosis (p = 0.0004). These results suggest that the SNP rs6873545 can be used as a surrogate for the GHR fl/d3 polymorphism due to linkage disequilibrium in the Brazilian population and that the fl/fl genotype is a severity-related risk factor for osteoporosis, but did not appear to be associated with disease status.
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Affiliation(s)
- Felipe Albuquerque Marques
- Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916, Asa Norte, Brasília, DF, 70790-160, Brazil,
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Giavoli C, Profka E, Sala E, Filopanti M, Barbieri AM, Bergamaschi S, Ferrante E, Arosio M, Ambrosi B, Lania AG, Spada A, Beck-Peccoz P. Impact of IGF(CA)19 gene polymorphism on the metabolic response to GH therapy in adult GH-deficient patients. Eur J Endocrinol 2014; 170:273-81. [PMID: 24217936 DOI: 10.1530/eje-13-0600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE A polymorphism in the promoter region of the IGF1 gene has been linked to serum IGF1 levels, risk of diabetes, and cardiovascular diseases with conflicting results. The aim of this study was to investigate the impact of this polymorphism on the short-term (1 year, n=98) and long-term (5 years, n=50) metabolic response to recombinant human GH (rhGH) in GH-deficient (GHD) adults. DESIGN AND METHODS Prospective study on GHD adults. Different genotypes were studied by microsatellite method. According to the most frequent 192 bp allele (19 cytosine-adenosine-repeats), subjects were divided into homozygous (19/19), heterozygous (19/X), and noncarriers (X/X). RESULTS Basal characteristics of patients as well as their response to rhGH in terms of decrease in body fat percentage and increase in IGF1 levels were not different in the three genotype-groups. Conversely, after 1-year rhGH, a significant worsening of insulin sensitivity (i.e. increase in fasting glucose levels and homeostasis model assessment of insulin resistance) and a significant improvement in lipid profile (i.e. reduction in total cholesterol and LDL-cholesterol) were recorded only in homozygous subjects. In the long-term, insulin sensitivity was restored in all the patients, while a significant improvement in lipid profile was observed in homozygous and heterozygous subjects, but not in noncarrier subjects. No difference in rhGH dose among groups was recorded throughout the study. CONCLUSIONS In GHD adults, the presence of the WT allele in the IGF1 gene promoter may enhance sensitivity to either negative or positive metabolic changes induced by rhGH.
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Affiliation(s)
- C Giavoli
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Prodam F, Savastio S, Genoni G, Babu D, Giordano M, Ricotti R, Aimaretti G, Bona G, Bellone S. Effects of growth hormone (GH) therapy withdrawal on glucose metabolism in not confirmed GH deficient adolescents at final height. PLoS One 2014; 9:e87157. [PMID: 24498035 PMCID: PMC3907518 DOI: 10.1371/journal.pone.0087157] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 12/18/2013] [Indexed: 11/18/2022] Open
Abstract
CONTEXT OBJECTIVE Growth hormone deficiency (GHD) is associated with insulin resistance and diabetes, in particular after treatment in children and adults with pre-existing metabolic risk factors. Our aims were. i) to evaluate the effect on glucose metabolism of rhGH treatment and withdrawal in not confirmed GHD adolescents at the achievement of adult height; ii) to investigate the impact of GH receptor gene genomic deletion of exon 3 (d3GHR). DESIGN SETTING We performed a longitudinal study (1 year) in a tertiary care center. METHODS 23 GHD adolescent were followed in the last year of rhGH treatment (T0), 6 (T6) and 12 (T12) months after rhGH withdrawal with fasting and post-OGTT evaluations. 40 healthy adolescents were used as controls. HOMA-IR, HOMA%β, insulinogenic (INS) and disposition (DI) indexes were calculated. GHR genotypes were determined by multiplex PCR. RESULTS In the group as a whole, fasting insulin (p<0.05), HOMA-IR (p<0.05), insulin and glucose levels during OGTT (p<0.01) progressively decreased from T0 to T12 becoming similar to controls. During rhGH, a compensatory insulin secretion with a stable DI was recorded, and, then, HOMAβ and INS decreased at T6 and T12 (p<0.05). By evaluating the GHR genotype, nDel GHD showed a decrease from T0 to T12 in HOMA-IR, HOMAβ, INS (p<0.05) and DI. Del GHD showed a gradual increase in DI (p<0.05) and INS with a stable HOMA-IR and higher HDL-cholesterol (p<0.01). CONCLUSIONS In not confirmed GHD adolescents the fasting deterioration in glucose homeostasis during rhGH is efficaciously coupled with a compensatory insulin secretion and activity at OGTT. The presence of at least one d3GHR allele is associated with lower glucose levels and higher HOMA-β and DI after rhGH withdrawal. Screening for the d3GHR in the pediatric age may help physicians to follow and phenotype GHD patients also by a metabolic point of view.
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Affiliation(s)
- Flavia Prodam
- Division of Pediatrics, Department of Health Sciences, University of “Piemonte Orientale Amedeo Avogadro”, Novara, Italy
- Endocrinology, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Novara, Italy
- I.C.O.S. (Interdisciplinary Center for Obesity Study), Novara, Italy
- * E-mail:
| | - Silvia Savastio
- Division of Pediatrics, Department of Health Sciences, University of “Piemonte Orientale Amedeo Avogadro”, Novara, Italy
| | - Giulia Genoni
- Division of Pediatrics, Department of Health Sciences, University of “Piemonte Orientale Amedeo Avogadro”, Novara, Italy
| | - Deepak Babu
- Laboratory of Human Genetics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Mara Giordano
- I.C.O.S. (Interdisciplinary Center for Obesity Study), Novara, Italy
- Laboratory of Human Genetics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Roberta Ricotti
- Division of Pediatrics, Department of Health Sciences, University of “Piemonte Orientale Amedeo Avogadro”, Novara, Italy
| | - Gianluca Aimaretti
- Endocrinology, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Novara, Italy
| | - Gianni Bona
- Division of Pediatrics, Department of Health Sciences, University of “Piemonte Orientale Amedeo Avogadro”, Novara, Italy
- I.C.O.S. (Interdisciplinary Center for Obesity Study), Novara, Italy
| | - Simonetta Bellone
- Division of Pediatrics, Department of Health Sciences, University of “Piemonte Orientale Amedeo Avogadro”, Novara, Italy
- Endocrinology, Department of Clinical and Experimental Medicine, University of Piemonte Orientale, Novara, Italy
- I.C.O.S. (Interdisciplinary Center for Obesity Study), Novara, Italy
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Ballerini MG, Domené HM, Scaglia P, Martínez A, Keselman A, Jasper HG, Ropelato MG. Association of serum components of the GH-IGFs-IGFBPs system with GHR-exon 3 polymorphism in normal and idiopathic short stature children. Growth Horm IGF Res 2013; 23:229-236. [PMID: 23999134 DOI: 10.1016/j.ghir.2013.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 07/30/2013] [Accepted: 08/13/2013] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the possible association of circulating components of GH-IGFs-IGFBPs system with the GHR-exon 3 genotype in normal and idiopathic short stature (ISS) children. DESIGN Descriptive, cross-sectional study in normal and ISS children. SUBJECTS AND METHODS 192 normal and 81 ISS children (age: 5-17 years) were included. Serum IGF-I, IGFBP3, ALS and GHBP levels were measured. GHR-exon 3 polymorphism (GHRd3) was analyzed by multiplex PCR assay. Normal and ISS children were divided according to GHR-exon 3 genotype: homozygous for the full-length GHR isoform (GHRfl) and carriers of one or two copies of the GHRd3 allele. RESULTS GHRd3 genotype distribution (fl:fl/fl:d3/d3:d3,%) in normal (60:34:6) and ISS (64:32:4) was similar and reached Hardy-Weinberg equilibrium. ISS children had significantly reduced levels of GHBP and GH-dependent factors as compared to controls (p<0.0001). Within the normal group, homozygous carriers of the GHRfl allele had significantly higher GHBP serum levels than those with one or two copies of the GHRd3 allele (Mean ± SEM; GHRfl: 3.2 ± 0.2 vs GHRd3: 2.7 ± 0.2 nmol/L, p = 0.04). No other significant association with GHR exon 3 polymorphism was found in either the normal or the ISS groups. CONCLUSIONS GHR exon 3 polymorphism is distributed similarly in normal and ISS children, however only normal homozygous children for GHRfl allele showed higher GHBP levels. The lack of association between GHBP and GHR polymorphism in ISS children might be related to the heterogeneity of this group, where potential defects in GH receptor action may result in partial GH insensitivity.
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Affiliation(s)
- María Gabriela Ballerini
- División de Endocrinología, Centro de Investigaciones Endocrinológicas (CEDIE-CONICET), Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina.
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Castell AL, Sadoul JL, Bouvattier C. L’axe GH-IGF-I dans la croissance. ANNALES D'ENDOCRINOLOGIE 2013; 74 Suppl 1:S33-41. [DOI: 10.1016/s0003-4266(13)70019-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Kohler S, Tschopp O, Sze L, Neidert M, Bernays RL, Spanaus KS, Wiesli P, Schmid C. Monitoring for potential residual disease activity by serum insulin-like growth factor 1 and soluble Klotho in patients with acromegaly after pituitary surgery: is there an impact of the genomic deletion of exon 3 in the growth hormone receptor (d3-GHR) gene on "safe" GH cut-off values? Gen Comp Endocrinol 2013; 188:282-7. [PMID: 23648743 DOI: 10.1016/j.ygcen.2013.04.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 04/16/2013] [Accepted: 04/19/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND Acromegaly is an illness usually defined by excessively high growth hormone (GH) and insulin like growth factor 1 (IGF-1) levels, the latter mainly reflecting GH action on the liver. IGF-1, also known as somatomedin C, mediates several actions of GH. The diagnosis and management of acromegaly is relatively straight forward, but long-term follow-up of patients can be difficult, as elevated IGF-1 levels can occur in the presence of apparently normalised GH levels and late recurrence of acromegaly may arise despite previous suppression on oral glucose tolerance testing. Data suggest this applies especially to patients in whom the GH receptor lacks exon 3. In such patients, GH may not always be a useful marker of disease, and traditional GH cut-offs may be misleading. Recent data suggest that soluble Klotho (sKlotho), besides and in addition to IGF-1, may help monitor the activity of GH-producing adenomas (presumably reflecting GH action on the kidneys) and may be a useful supplementary tool. METHODS GHR genotyping was performed in 112 patients with acromegaly. IGF-1 and sKlotho levels were measured in the sera of patients before and after transsphenoidal surgery, with emphasis on patients judged inconclusively cured by surgery or with small residual tumour masses shortly after surgery. Patients were assessed for recurrence of acromegaly with GH levels (random or nadir during an oGTT). RESULTS Of the 48 patients who underwent surgery between 2000 and 2009 and who had well-documented longer term follow-up at our institution, 29 had no biochemical evidence of residual disease activity after transsphenoidal surgery (marked reduction in IGF-1 and sKlotho levels, GH suppressible to <1 ng/ml) and were classified as in remission. 2 of these patients developed recurrent symptoms of acromegaly during follow-up with increasing levels of IGF-1 and sKlotho, and both patients were carriers of the d3-GHR genotype. CONCLUSIONS Acromegalic patients with the d3-GHR polymorphism might be - for a given low postsurgical GH level - at higher risk for recurrence and may require a lower GH nadir during oGTT to be classified as in remission. Soluble Klotho could be useful in the follow-up of acromegalic patients. The question arises whether sKlotho not only reflects the activity of GH-secreting pituitary adenomas but whether Klotho (ectodomain clipping?) could also mediate selected actions of GH.
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Affiliation(s)
- S Kohler
- Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital Zurich, Rämistrasse 100, CH-8091 Zurich, Switzerland
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Claessen KMJA, Kloppenburg M, Kroon HM, Bijsterbosch J, Pereira AM, Romijn JA, van der Straaten T, Nelissen RGHH, Hofman A, Uitterlinden AG, Duijnisveld BJ, Lakenberg N, Beekman M, van Meurs JB, Slagboom PE, Biermasz NR, Meulenbelt I. Relationship between the functional exon 3 deleted growth hormone receptor polymorphism and symptomatic osteoarthritis in women. Ann Rheum Dis 2013; 73:433-6. [DOI: 10.1136/annrheumdis-2012-202713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Butler MG, Roberts J, Hayes J, Tan X, Manzardo AM. Growth hormone receptor (GHR) gene polymorphism and Prader-Willi syndrome. Am J Med Genet A 2013; 161A:1647-53. [PMID: 23696513 DOI: 10.1002/ajmg.a.35980] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 03/24/2013] [Indexed: 02/03/2023]
Abstract
Prader-Willi syndrome (PWS) is a genomic imprinting disorder due to loss of paternally expressed genes in the 15q11-q13 region and characterized by hypotonia, a poor suck, failure to thrive, hypogonadism/hypogenitalism, growth hormone deficiency, learning, and behavioral problems and hyperphagia leading to early childhood obesity. Growth hormone acts as a ligand for the growth hormone receptor (GHR) coded by a gene polymorphic for an exon-3 deletion (d3) seen in about 50% of Caucasians and associated with an increased response to growth hormone (GH) therapy. We examined 69 individuals with PWS (average age ± SD = 20.1 ± 12.8 year). The GHR allele distribution in our PWS subjects was similar to reported data in the literature with no gender or PWS genetic subtype differences. A negative correlation was found with age for height standard deviational scores and a positive correlation with age for weight and BMI for non-GH treated PWS subjects. Adjusting for effects of age and gender, individuals with PWS and the d3/d3 allele showed a significant increase in BMI compared with those having the full length (fl) allele. In addition, 12 infants and children with PWS were examined when growth and GH data were available before and during GH treatment. A significant increase in growth rate (1.7 times) was noted in the presence of the d3 allele (fl/fl = 0.87 cm/month; fl/d3 or d3/d3 = 1.5 cm/month; P < 0.05). The presence of the d3 allele and its impact on growth and medical care of individuals with PWS while on GH therapy should be further investigated.
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Affiliation(s)
- Merlin G Butler
- Department of Psychiatry and Behavioral Sciences, Kansas University Medical Center, Kansas City, KS 66160, USA.
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Wan J, Atzmon G, Hwang D, Barzlai N, Kratzsch J, Cohen P. Growth hormone receptor (GHR) exon 3 polymorphism status detection by dual-enzyme-linked immunosorbent assay (ELISA). J Clin Endocrinol Metab 2013; 98:E77-81. [PMID: 23162096 PMCID: PMC3537082 DOI: 10.1210/jc.2012-2375] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT GH receptor (GHR) exon 3-deleted/full-length (d3/fl) polymorphism has been proposed to affect the responsiveness to GH therapy. Conventional multiplex PCR genotyping method for this polymorphism detection requires DNA samples, which may be difficult to obtain due to ethical and procedural issues and may limit further studies into the role of this polymorphism in health and disease. OBJECTIVE The objective of the study was to develop a simple genotyping-alternative method for GHRd3 identification by directly measuring serum levels of total GH binding protein (tGHBP) and exon 3-positive GHBP[(E3(+)GHBP] by immunoassay and thereby assess the GHRd3 status. DESIGN The GHRd3 genotype was determined by PCR, and tGHBP and E3(+)GHBP levels were measured in serum of 88 healthy adults. MAIN OUTCOME MEASURES The GHRd3 chemotype by ELISA was compared with the genotype by conventional PCR. RESULTS The concordance rate of GHR exon 3 status identification between PCR genotyping and ELISA chemotyping was shown to be 100%. There were negligible detectable serum levels of E3(+)GHBP in d3/d3 subjects. The ratio of serum levels E3(+)GHBP vs. tGHBP in fl/fl and d3/fl subjects was (mean ± SD) 96.6 ± 5.1 and 57.1 ± 8.4%, respectively (P < 0.0001). Interestingly, we observed that d3/d3 subjects had significantly lower serum levels of tGHBP compared with fl/fl and d3/fl genotypes. CONCLUSIONS This dual ELISA against tGHBP and E3(+)GHBP can be used as an alternative method for determining GHRd3 polymorphism status. The implications of differences in serum levels of tGHBP among different genotypes and responsiveness to GH therapy need to be further investigated.
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Affiliation(s)
- JunXiang Wan
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, 3715 McClintock Avenue, Los Angeles, California 90089-0191, USA
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The role of GHR and IGF1 genes in the genetic determination of African pygmies' short stature. Eur J Hum Genet 2012; 21:653-8. [PMID: 23047741 DOI: 10.1038/ejhg.2012.223] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
African pygmies are at the lower extreme of human variation in adult stature and many evolutionary hypotheses have been proposed to explain this phenotype. We showed in a recent study that the difference in average stature of about 10 cm observed between contemporary pygmies and neighboring non-pygmies has a genetic component. Nevertheless, the genetic basis of African pygmies' short stature remains unknown. Using a candidate-gene approach, we show that intronic polymorphisms in GH receptor (GHR) and insulin-like growth factor 1 (IGF1) genes present outlying values of the genetic distance between Baka pygmies and their non-pygmy Nzimé neighbors. We further show that GHR and IGF1 genes have experienced divergent natural selection pressures between pygmies and non-pygmies throughout evolution. In addition, these SNPs are associated with stature in a sample composed of 60 pygmies and 30 non-pygmies and this association remains significant when correcting for population structure for the GHR locus. We conclude that the GHR and IGF1 genes may have a role in African pygmies' short stature. The use of phenotypically contrasted populations is a promising strategy to identify new variants associated with complex traits in humans.
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