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Raman S, Grimberg A, Waguespack SG, Miller BS, Sklar CA, Meacham LR, Patterson BC. Risk of Neoplasia in Pediatric Patients Receiving Growth Hormone Therapy--A Report From the Pediatric Endocrine Society Drug and Therapeutics Committee. J Clin Endocrinol Metab 2015; 100:2192-203. [PMID: 25839904 PMCID: PMC5393518 DOI: 10.1210/jc.2015-1002] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
CONTEXT GH and IGF-1 have been shown to affect tumor growth in vitro and in some animal models. This report summarizes the available evidence on whether GH therapy in childhood is associated with an increased risk of neoplasia during treatment or after treatment is completed. EVIDENCE ACQUISITION A PubMed search conducted through February 2014 retrieved original articles written in English addressing GH therapy and neoplasia risk. Subsequent searches were done to include additional relevant publications. EVIDENCE SYNTHESIS In children without prior cancer or known risk factors for developing cancer, the clinical evidence does not affirm an association between GH therapy during childhood and neoplasia. GH therapy has not been reported to increase the risk for neoplasia in this population, although most of these data are derived from postmarketing surveillance studies lacking rigorous controls. In patients who are at higher risk for developing cancer, current evidence is insufficient to conclude whether or not GH further increases cancer risk. GH treatment of pediatric cancer survivors does not appear to increase the risk of recurrence but may increase their risk for subsequent primary neoplasms. CONCLUSIONS In children without known risk factors for malignancy, GH therapy can be safely administered without concerns about an increased risk for neoplasia. GH use in children with medical diagnoses predisposing them to the development of malignancies should be critically analyzed on an individual basis, and if chosen, appropriate surveillance for malignancies should be undertaken. GH can be used to treat GH-deficient childhood cancer survivors who are in remission with the understanding that GH therapy may increase their risk for second neoplasms.
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Affiliation(s)
- Sripriya Raman
- Division of Pediatric Endocrinology (S.R.), Children's Mercy Hospital, University of Missouri, Kansas City, Missouri 64111; University of Kansas Medical Center (S.R.), Kansas City, Kansas 66160; Department of Pediatrics (A.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Division of Endocrinology and Diabetes (A.G.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; Department of Endocrine Neoplasia and Hormonal Disorders (S.G.W.), University of Texas MD Anderson Cancer Center, Houston, Texas 77030; Division of Endocrinology (B.S.M.), Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota 55455; Memorial Sloan Kettering Cancer Center (C.A.S.), New York, New York 10065; and Emory University/Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta (L.R.M., B.C.P.), Atlanta, Georgia 30322
| | - Adda Grimberg
- Division of Pediatric Endocrinology (S.R.), Children's Mercy Hospital, University of Missouri, Kansas City, Missouri 64111; University of Kansas Medical Center (S.R.), Kansas City, Kansas 66160; Department of Pediatrics (A.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Division of Endocrinology and Diabetes (A.G.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; Department of Endocrine Neoplasia and Hormonal Disorders (S.G.W.), University of Texas MD Anderson Cancer Center, Houston, Texas 77030; Division of Endocrinology (B.S.M.), Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota 55455; Memorial Sloan Kettering Cancer Center (C.A.S.), New York, New York 10065; and Emory University/Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta (L.R.M., B.C.P.), Atlanta, Georgia 30322
| | - Steven G Waguespack
- Division of Pediatric Endocrinology (S.R.), Children's Mercy Hospital, University of Missouri, Kansas City, Missouri 64111; University of Kansas Medical Center (S.R.), Kansas City, Kansas 66160; Department of Pediatrics (A.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Division of Endocrinology and Diabetes (A.G.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; Department of Endocrine Neoplasia and Hormonal Disorders (S.G.W.), University of Texas MD Anderson Cancer Center, Houston, Texas 77030; Division of Endocrinology (B.S.M.), Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota 55455; Memorial Sloan Kettering Cancer Center (C.A.S.), New York, New York 10065; and Emory University/Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta (L.R.M., B.C.P.), Atlanta, Georgia 30322
| | - Bradley S Miller
- Division of Pediatric Endocrinology (S.R.), Children's Mercy Hospital, University of Missouri, Kansas City, Missouri 64111; University of Kansas Medical Center (S.R.), Kansas City, Kansas 66160; Department of Pediatrics (A.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Division of Endocrinology and Diabetes (A.G.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; Department of Endocrine Neoplasia and Hormonal Disorders (S.G.W.), University of Texas MD Anderson Cancer Center, Houston, Texas 77030; Division of Endocrinology (B.S.M.), Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota 55455; Memorial Sloan Kettering Cancer Center (C.A.S.), New York, New York 10065; and Emory University/Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta (L.R.M., B.C.P.), Atlanta, Georgia 30322
| | - Charles A Sklar
- Division of Pediatric Endocrinology (S.R.), Children's Mercy Hospital, University of Missouri, Kansas City, Missouri 64111; University of Kansas Medical Center (S.R.), Kansas City, Kansas 66160; Department of Pediatrics (A.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Division of Endocrinology and Diabetes (A.G.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; Department of Endocrine Neoplasia and Hormonal Disorders (S.G.W.), University of Texas MD Anderson Cancer Center, Houston, Texas 77030; Division of Endocrinology (B.S.M.), Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota 55455; Memorial Sloan Kettering Cancer Center (C.A.S.), New York, New York 10065; and Emory University/Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta (L.R.M., B.C.P.), Atlanta, Georgia 30322
| | - Lillian R Meacham
- Division of Pediatric Endocrinology (S.R.), Children's Mercy Hospital, University of Missouri, Kansas City, Missouri 64111; University of Kansas Medical Center (S.R.), Kansas City, Kansas 66160; Department of Pediatrics (A.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Division of Endocrinology and Diabetes (A.G.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; Department of Endocrine Neoplasia and Hormonal Disorders (S.G.W.), University of Texas MD Anderson Cancer Center, Houston, Texas 77030; Division of Endocrinology (B.S.M.), Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota 55455; Memorial Sloan Kettering Cancer Center (C.A.S.), New York, New York 10065; and Emory University/Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta (L.R.M., B.C.P.), Atlanta, Georgia 30322
| | - Briana C Patterson
- Division of Pediatric Endocrinology (S.R.), Children's Mercy Hospital, University of Missouri, Kansas City, Missouri 64111; University of Kansas Medical Center (S.R.), Kansas City, Kansas 66160; Department of Pediatrics (A.G.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Division of Endocrinology and Diabetes (A.G.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; Department of Endocrine Neoplasia and Hormonal Disorders (S.G.W.), University of Texas MD Anderson Cancer Center, Houston, Texas 77030; Division of Endocrinology (B.S.M.), Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota 55455; Memorial Sloan Kettering Cancer Center (C.A.S.), New York, New York 10065; and Emory University/Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta (L.R.M., B.C.P.), Atlanta, Georgia 30322
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Reddy SY, Rasmussen NA, Fourie NH, Berger RS, Martino AC, Gill J, Longchamps R, Wang XM, Heitkemper MM, Henderson WA. Sleep quality, BDNF genotype and gene expression in individuals with chronic abdominal pain. BMC Med Genomics 2014; 7:61. [PMID: 25358868 PMCID: PMC4226913 DOI: 10.1186/s12920-014-0061-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 10/09/2014] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Sleep quality and genetics may contribute to the etiology of gastrointestinal (GI) symptoms. Individuals with impaired sleep often have a number of associated symptoms including chronic abdominal pain (CAP). The current study examined the interactions of brain-derived neurotrophic factor (BDNF) genotype with sleep quality in persons with CAP and healthy controls. In addition, associations among sleep quality, BDNF genotype, and gene expression were explored in the participants. METHODS Data were collected on 59 participants (46% male, 61% White, 26.9 ± 6.6 years; CAP (n=19) and healthy controls (n=40)). Participants with CAP reported poorer sleep quality compared to healthy controls. BDNF genotype, categorized as Val/Val homozygotes versus the Met carriers. RESULTS Microarray analysis found twenty-four differentially expressed genes by a two-fold magnitude in participants with poor sleep quality compared to good sleep quality, and seven differentially expressed genes comparing CAP to healthy control. Three specific genes in the pain group overlap with sleep quality, including insulin-like growth factor 1 (IGF1), spermatogenesis associated serine-rich 2-like (SPATS2L), and immunoglobulin heavy constant gamma 1 or mu (IGHG1/// IGHM). BDNF was shown to have an interaction effect with GI and sleep symptoms. CONCLUSIONS Participants with CAP reported poor sleep quality compared to healthy controls. The role of the BDNF Met allele on differential gene expression was not distinct as main factor, but impacted interactions with sleep quality and CAP. Down-regulation of IGF1, SPATS2L, and IGHG1 expression may be related to the etiology of poor sleep quality and CAP. TRIAL REGISTRATION Clinicaltrial.gov # NCT00824941.
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Affiliation(s)
- Swarnalatha Y Reddy
- />Division of Intramural Research, National Institute of Nursing of Research, National Institutes of Health, Department of Health and Human Resources, 10 Center Drive, Building 10, 2-1341, Bethesda, MD 20892 USA
| | - Nat A Rasmussen
- />Division of Intramural Research, National Institute of Nursing of Research, National Institutes of Health, Department of Health and Human Resources, 10 Center Drive, Building 10, 2-1341, Bethesda, MD 20892 USA
| | - Nicolaas H Fourie
- />Division of Intramural Research, National Institute of Nursing of Research, National Institutes of Health, Department of Health and Human Resources, 10 Center Drive, Building 10, 2-1341, Bethesda, MD 20892 USA
| | - Rebecca S Berger
- />Division of Intramural Research, National Institute of Nursing of Research, National Institutes of Health, Department of Health and Human Resources, 10 Center Drive, Building 10, 2-1341, Bethesda, MD 20892 USA
| | - Angela C Martino
- />Division of Intramural Research, National Institute of Nursing of Research, National Institutes of Health, Department of Health and Human Resources, 10 Center Drive, Building 10, 2-1341, Bethesda, MD 20892 USA
| | - Jessica Gill
- />Division of Intramural Research, National Institute of Nursing of Research, National Institutes of Health, Department of Health and Human Resources, 10 Center Drive, Building 10, 2-1341, Bethesda, MD 20892 USA
| | - Ryan Longchamps
- />Division of Intramural Research, National Institute of Nursing of Research, National Institutes of Health, Department of Health and Human Resources, 10 Center Drive, Building 10, 2-1341, Bethesda, MD 20892 USA
| | - Xiao Min Wang
- />Division of Intramural Research, National Institute of Nursing of Research, National Institutes of Health, Department of Health and Human Resources, 10 Center Drive, Building 10, 2-1341, Bethesda, MD 20892 USA
| | | | - Wendy A Henderson
- />Division of Intramural Research, National Institute of Nursing of Research, National Institutes of Health, Department of Health and Human Resources, 10 Center Drive, Building 10, 2-1341, Bethesda, MD 20892 USA
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