Cellular Activities of 20K- and 22K-hGH Do Not Necessarily Correlate with Their Binding Affinities for Rat GH Receptor

Repetitive Stimulation of the Pituitary with Growth-Hormone-Releasing Hormone Alters the Proportion of 22 and 20 Kilodalton Human-Growth Hormone Released

Background/Aims. 20 Kilodalton-hGH (20 K-hGH) is the second most abundant pituitary GH variant after 22 K-hGH. In the steady state the proportion of 20 : 22 K-hGH appears constant; does this proportion change with repetitive somatotroph stimulation? Methods. Forty adult males were randomised to receive a GHRH(1–29)NH₂ bolus (0.5 μg/kg (n = 20) or 1.0 μg/kg (n = 20)), preceded or followed by a saline bolus, 1 week apart. Four to six weeks later, 10 subjects received 0.5 μg/kg GHRH(1–29)NH₂ at 0, 60, 120, and 180 minutes. Clearance rate of 22 and 20 K-hGH was measured in 10 subjects. Results. Total amount/proportion of 22 K-hGH/20 K-hGH secreted was similar for both GHRH(1–29)NH₂ doses. Repetitive stimulation reduced the amount of 22 K-hGH released whereas the amount of 20 K-hGH did not change significantly leading to an increase in the proportion of 20 K-hGH (P = .05). Half-life of 20 and 22 K-hGH were not significantly different (P = .55). Conclusions. Repetitive stimulation of the somatotroph may alter the proportion of GH variant released.

Growth hormone isoforms

Human growth hormone (GH) is a heterogeneous protein hormone consisting of several isoforms. The sources of this heterogeneity reside at the level of the genome, mRNA splicing, post-translational modification and metabolism. The GH gene cluster on chromosome 17q contains 2 GH genes (GH1 or GH-N and GH2 or GH-V) in addition to 2(-3) genes encoding the related chorionic somatomammotropin. Alternative mRNA splicing of the GH1 transcript yields two products: 22K-GH (the principal pituitary GH form) and 20K-GH. Post-translationally modified GH forms include N(alpha)-acylated, deamidated and glycosylated monomeric GH forms, as well as both non-covalent and disulfide-linked oligomers up to at least pentameric GH. GH fragments generated in the course of peripheral metabolism may be measured in immunoassays for GH. The GH-N gene is expressed in the pituitary, the GH-V gene in the placenta. Secretion of pituitary GH forms is pulsatile under control from the hypothalamus, whereas secretion of placental GH-V is tonic and rises progressively in maternal blood during the 2nd and 3rd trimester. Pituitary GH forms are co-secreted during a secretory pulse; no isoform-specific stimuli have been identified. There are minor differences in somatogenic and metabolic bioactivity among the GH isoforms, depending on species and assay system used. Both 20K-GH and GH-V have poor lactogenic activity. Oligomeric GH forms have variably diminished bioactivity compared to monomeric forms. GH isoforms cross-react in most immunoassays, but assays specific for 22K-GH, 20K-GH and GH-V have been developed. The metabolic clearance of 20K-GH and GH oligomers is delayed compared to that of 22K-GH. The heterogeneous mixture of GH isoforms in blood is further complicated by the presence of two GH-binding proteins, which form complexes with GH; isoform proportions also vary depending on the lag time from a secretory pulse because of different half-lives. GH forms excreted in the urine reflect monomeric GH isoforms in blood, but constitute only a minute fraction of the GH production rate. The heterogeneity of GH is one important reason for the notorious disparity among assay results. It also presents an opportunity for distinguishing endogenous from exogenous GH.

RNA-MEDIATED NEUROMUSCULAR DISORDERS

Myotonic dystrophy type 1 (DM1) is caused by a CTG expansion mutation located in the 3' untranslated portion of the dystrophica myotonin protein kinase gene. The identification and characterization of RNA-binding proteins that interact with expanded CUG repeats and the discovery that a similar transcribed but untranslated CCTG expansion in an intron causes myotonic dystrophy type 2 (DM2) have uncovered a new type of mechanism in which microsatellite expansion mutations cause disease through an RNA gain-of-function mechanism. This review discusses RNA pathogenesis in DM1 and DM2 and evidence that similar mechanisms may play a role in a growing number of dominant noncoding expansion disorders, including fragile X tremor ataxia syndrome (FXTAS), spinocerebellar ataxia type 8 (SCA8), SCA10, SCA12, and Huntington's disease-like 2 (HDL2).

Circulating non-22 kDa growth hormone isoforms after a repeated GHRH stimulus in normal subjects

The aim of this study was to evaluate the proportion of non-22 kDa GH isoforms in relation to total GH concentration after a repeated GHRH stimulus in healthy subjects. We studied 25 normal volunteers (12 males and 13 females, mean age 13.1 years, range 6-35), who received two GHRH bolus (1.5 mug/kg body weight, i.v.) administered separately by an interval of 120 minutes. The proportion of non-22 kDa GH was determined by the 22 kDa GH exclusion assay (GHEA), which is based on immunomagnetic extraction of monomeric and dimeric 22 kDa GH from serum, and quantitation of non-22 kDa GH isoforms using a polyclonal GH assay. Samples were collected at baseline and at 15-30 min intervals up to 240 min for total GH concentration. Non-22 kDa GH isoforms were measured in samples where peak GH after GHRH was observed. Total GH peaked after the first GHRH bolus in all subjects (median 37.2 ng/ml; range: 10.4-94.6). According to GH response to the second GHRH stimulus, the study group was divided in "non-responders" (n=7; 28%), with GH peak levels lower than 10 ng/ml (median GH: 8.7 ng/ml; range 7.3-9.6) and "responders" (n=18; 72%), who showed a GH response greater than 10 ng/ml (median 17 ng/ml; range 10.1-47.0). The median proportion of non-22 kDa GH on the peak of GH secretion after the first GHRH administration was similar in both groups ("responders" median: 8.6%, range 7-10.9%; "non-responders" median: 8.7%, range 6.7-10.3%), independently of the type of response after the second GHRH. In contrast, the median proportion of non-22 kDa GH was greater at time of GH peak after the second GHRH bolus in the "non-responders" (median 11.4%; range 9.1-14.3%) in comparison with the "responders" (median 9.1%; range 6.7-11.9%; p=0.003). A significant negative correlation between the total GH secreted and the percentage of non-22 kDa isoforms was seen in the "non-responders" (p=0.003). These differences in GH response to repeated GHRH stimulation and in the pattern of GH isoforms at GH peak among subjects might be due to distinct recovery patterns of somatrotrophic function and/or differences in metabolic clearance of GH isoforms.