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Satué K, Fazio E, Velasco-Martinez MG, La Fauci D, Barbiera G, Medica P, Cravana C. Can the reduced GH, IGF-1, and ovarian steroids concentrations be considered as suspected biomarkers of age-associated functional deficit in mares? Theriogenology 2024; 228:75-80. [PMID: 39098123 DOI: 10.1016/j.theriogenology.2024.08.001] [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: 02/23/2024] [Revised: 07/29/2024] [Accepted: 08/01/2024] [Indexed: 08/06/2024]
Abstract
In humans' and experimental animals' components of the somatotropic axis, such as growth hormone (GH) and insulin-like growth factor 1 (IGF-1) concentrations, decrease with advancing age. Although there is evidence regarding IGF-1, the effect of age on GH in mares, as well as the relationships between both parameters, have not yet been elucidated. On the other hand, although GH and IGF-1 are related to follicular development, it is unknown if they could be correlated with the circulating concentrations of ovarian steroids in mares, as occurs in other species. The hypothesis of this study was that both GH and IGF-1 could experience physiological changes with advancing age also in mares, and that both GH/IGF-1 could be correlated with oestradiol-17β (E2) and progesterone (P4), as recorded for other species. Hence, the objective of this study was to evaluate the concentrations of GH, IGF-1, E2, and P4 in mares, according to the different ages. Blood samples were drawn from 56 healthy cyclic Spanish Purebred mares belonging to four different age groups: 6-9 years, 10-13 years, 14-16 years and >16 years. Mares aged 6-9 years and 10-13 years showed higher GH concentrations (P < 0.05) than mares of 14-16 and >16 years; and mares aged 14-16 showed higher GH concentrations (P < 0.05) than >16 years (P < 0.05). Mares aged >16 years showed lower IGF-1 concentrations (P < 0.05) than mares of 6-9, 10-13 and 14-16 years (P < 0.05). The concentrations of E2 and P4 showed no significant differences among different age groups. Both GH and IGF-1 were not correlated with each other or with E2 and P4. The concentrations of E2 and P4 did not change with age. Advancing age leads to a decrease in the activity of the somatotropic axis in physiological cyclic mares, represented by a significant GH reduction, which, however, was ascribed for IGF-1 exclusively to mares over 16 years of age, without alterations in steroid hormone patterns.
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Affiliation(s)
- Katiuska Satué
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, CEU-Cardenal Herrera University, Tirant lo Blanc, 7, Alfara del Patriarca, 46115, Valencia, Spain.
| | - Esterina Fazio
- Department of Veterinary Sciences, Veterinary Physiology Unit, Polo Universitario Annunziata, Via Palatucci 13, 98168, Messina, Italy
| | - Maria Gemma Velasco-Martinez
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, CEU-Cardenal Herrera University, Tirant lo Blanc, 7, Alfara del Patriarca, 46115, Valencia, Spain
| | - Deborah La Fauci
- Department of Veterinary Sciences, Veterinary Physiology Unit, Polo Universitario Annunziata, Via Palatucci 13, 98168, Messina, Italy
| | - Giuliana Barbiera
- Pharmaceutical and Chemical Technician, 98168, Messina, Messina, Italy
| | - Pietro Medica
- Department of Veterinary Sciences, Veterinary Physiology Unit, Polo Universitario Annunziata, Via Palatucci 13, 98168, Messina, Italy
| | - Cristina Cravana
- Department of Veterinary Sciences, Veterinary Physiology Unit, Polo Universitario Annunziata, Via Palatucci 13, 98168, Messina, Italy
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Cheng Z, Li J, Chen Z, Ren W. Role of bisphosphonates in osteoporosis caused by adult growth hormone deficiency. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2024; 49:839-847. [PMID: 39311779 PMCID: PMC11420967 DOI: 10.11817/j.issn.1672-7347.2024.230469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/26/2024]
Abstract
In recent years, growth hormone and insulin-like growth factors have become key regulators of bone metabolism and remodeling, crucial for maintaining healthy bone mass throughout life. Studies have shown that adult growth hormone deficiency leads to alterations in bone remodeling, significantly affecting bone microarchitecture and increasing fracture risk. Although recombinant human growth hormone replacement therapy can mitigate these adverse effects, improving bone density, and reduce fracture risk, its effectiveness in treating osteoporosis, especially in adults with established growth hormone deficiency, seems limited. Bisphosphonates inhibit bone resorption by targeting farnesyl pyrophosphate synthase in osteoclasts, and clinical trials have confirmed their efficacy in improving osteoporosis. Therefore, for adult growth hormone deficiency patients with osteoporosis, the use of bisphosphonates alongside growth hormone replacement therapy is recommended.
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Affiliation(s)
- Zhiling Cheng
- Department of Endocrinology, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400011.
| | - Jie Li
- Department of Endocrinology, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400011
| | - Zhongpei Chen
- Department of Endocrinology, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400011
| | - Wei Ren
- Department of Endocrinology, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
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List EO, Basu R, Berryman DE, Duran-Ortiz S, Martos-Moreno GÁ, Kopchick JJ. Common and uncommon mouse models of growth hormone deficiency. Endocr Rev 2024:bnae017. [PMID: 38853618 DOI: 10.1210/endrev/bnae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/22/2024] [Accepted: 05/31/2024] [Indexed: 06/11/2024]
Abstract
Mouse models of growth hormone deficiency (GHD) have provided important tools for uncovering the various actions of GH. Nearly 100 years of research using these mouse lines has greatly enhanced our knowledge of the GH/IGF-1 axis. Some of the shared phenotypes of the five "common" mouse models of GHD include reduced body size, delayed sexual maturation, decreased fertility, reduced muscle mass, increased adiposity, and enhanced insulin sensitivity. Since these common mouse lines outlive their normal-sized littermates - and have protection from age-associated disease - they have become important fixtures in the aging field. On the other hand, the twelve "uncommon" mouse models of GHD described herein have tremendously divergent health outcomes ranging from beneficial aging phenotypes (similar to those described for the common models) to extremely detrimental features (such as improper development of the CNS, numerous sensory organ defects, and embryonic lethality). Moreover, advancements in next generation sequencing technologies have led to the identification of an expanding array of genes that are recognized as causative agents to numerous rare syndromes with concomitant GHD. Accordingly, this review provides researchers with a comprehensive up-to-date collection of the common and uncommon mouse models of GHD that have been used to study various aspects of physiology and metabolism associated with multiple forms of GHD. For each mouse line presented, the closest comparable human syndromes are discussed providing important parallels to the clinic.
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Affiliation(s)
- Edward O List
- Edison Biotechnology Institute, Ohio University, Athens Ohio, 45701, United States
- Department of Specialty Medicine, Heritage College of Osteopathic Medicine, Athens Ohio
| | - Reetobrata Basu
- Edison Biotechnology Institute, Ohio University, Athens Ohio, 45701, United States
| | - Darlene E Berryman
- Edison Biotechnology Institute, Ohio University, Athens Ohio, 45701, United States
- Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Athens Ohio
| | - Silvana Duran-Ortiz
- Edison Biotechnology Institute, Ohio University, Athens Ohio, 45701, United States
| | - Gabriel Á Martos-Moreno
- Department of Endocrinology & Pediatrics, Hospital Infantil Universitario Niño Jesús, IIS La Princesa & Universidad Autónoma de Madrid. CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - John J Kopchick
- Edison Biotechnology Institute, Ohio University, Athens Ohio, 45701, United States
- Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Athens Ohio
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Barros-Oliveira CS, de Jesus MJM, Campos VC, Salvatori R, de Souza Araújo AA, Neto RFS, Bartke A, Batista VO, Schneider A, Villar-Gouy KR, Masternak MM, Leal ÂC, Santos LB, Oliveira CRP, Santos EG, Oliveira Simões DA, de Santana Silva B, Aguiar-Oliveira MH. Skin assessment in congenital untreated isolated GH deficiency. Endocrine 2024; 84:1116-1124. [PMID: 38703329 DOI: 10.1007/s12020-024-03840-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/16/2024] [Indexed: 05/06/2024]
Abstract
PURPOSE The separation between the inside and outside through the skin was fundamental for the evolution of prevertebrates, which grow through extrapituitary circuits, to vertebrates, which grow through the somatotrophic axis, namely pituitary growth hormone (GH). and circulating IGF1.Individuals with untreated isolated growth hormone (GH) deficiency (IGHD) due to a mutation in the GH-releasing hormone receptor (GHRH) gene, residing in Itabaianinha, Brazil, are vulnerable to skin cancer and have reduced sweating. However other aspects of their skin physiology are still unknown. Our objectives were to evaluate the number of skin cancers, skin aging, and functional aspects of the skin in this IGHD cohort. METHODS Twenty-six IGHD individuals and 26 controls matched by age, sex, ethnicity, and occupation were submitted to a biochemical, dermatological and a functional skin assessment by the Multi Probe Adapter Cutometer® MPA 580. RESULTS There was no difference in the number of skin cancers and in the degrees of photodamage between the groups. The melanin content in the forearm was similar between the groups but was lower in the buttocks (p = 0.005), as well as skin resistance (p < 0.0001) and elasticity (p = 0.003), lower in the IGHD. There was no difference in hydration and sebum content between the two groups. CONCLUSION IGHD is apparently associated with a neutral profile in terms of skin cancer and photodamage, with similar melanin on the forearm and lower buttocks, lower skin resistance and elasticity, with hydration and sebum similar to controls.
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Affiliation(s)
- Cynthia S Barros-Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
| | - Maria Joseli Melo de Jesus
- Pharmaceutical Testing Laboratory, Department of Pharmacy, Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, 49100000, Aracaju, Sergipe, Brazil
| | - Viviane C Campos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, 21287, USA
| | - Adriano Antunes de Souza Araújo
- Pharmaceutical Testing Laboratory, Department of Pharmacy, Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, 49100000, Aracaju, Sergipe, Brazil
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
| | | | - Andrzej Bartke
- Southern Illinois University School of Medicine, Department of Internal Medicine, 801 N. Rutledge, P.O. Box 19628, Springfield, Illinois, 62702, USA
| | - Vanderlan O Batista
- Division of Psychiatry, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
| | - Augusto Schneider
- Faculty of Nutrition, Federal University of Pelotas, Pelotas, 96010-610, Brazil
| | - Keila R Villar-Gouy
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
| | - Michal M Masternak
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, 32826 FL, USA
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, 60-512, Poland
| | - Ângela C Leal
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
| | - Lucas B Santos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
| | - Elenilde G Santos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
| | - Davi A Oliveira Simões
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
| | - Bruno de Santana Silva
- Division of Dermatology, Department of Medicine, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
| | - Manuel H Aguiar-Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil.
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Yuan R, Hascup E, Hascup K, Bartke A. Relationships among Development, Growth, Body Size, Reproduction, Aging, and Longevity - Trade-Offs and Pace-Of-Life. BIOCHEMISTRY. BIOKHIMIIA 2023; 88:1692-1703. [PMID: 38105191 PMCID: PMC10792675 DOI: 10.1134/s0006297923110020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 12/19/2023]
Abstract
Relationships of growth, metabolism, reproduction, and body size to the biological process of aging and longevity have been studied for decades and various unifying "theories of aging" have been proposed to account for the observed associations. In general, fast development, early sexual maturation leading to early reproductive effort, as well as production of many offspring, have been linked to shorter lifespans. The relationship of adult body size to longevity includes a remarkable contrast between the positive correlation in comparisons between different species and the negative correlation seen in comparisons of individuals within the same species. We now propose that longevity and presumably also the rate of aging are related to the "pace-of-life." A slow pace-of-life including slow growth, late sexual maturation, and a small number of offspring, predicts slow aging and long life. The fast pace of life (rapid growth, early sexual maturation, and major reproductive effort) is associated with faster aging and shorter life, presumably due to underlying trade-offs. The proposed relationships between the pace-of-life and longevity apply to both inter- and intra-species comparisons as well as to dietary, genetic, and pharmacological interventions that extend life and to evidence for early life programming of the trajectory of aging. Although available evidence suggests the causality of at least some of these associations, much further work will be needed to verify this interpretation and to identify mechanisms that are responsible.
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Affiliation(s)
- Rong Yuan
- Southern Illinois University School of Medicine, Department of Internal Medicine, Springfield, IL 19628, USA.
| | - Erin Hascup
- Southern Illinois University School of Medicine, Department of Medical, Microbial, Cellular Immunology and Biology, Springfield, IL 19628, USA.
| | - Kevin Hascup
- Southern Illinois University School of Medicine, Department of Medical, Microbial, Cellular Immunology and Biology, Springfield, IL 19628, USA.
- Department of Neurology, Dale and Deborah Smith Center for Alzheimer's Research and Treatment, Neuroscience Institute, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Andrzej Bartke
- Southern Illinois University School of Medicine, Department of Internal Medicine, Springfield, IL 19628, USA.
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6
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Petrashen AP, Lin Y, Kun B, Kreiling JA. A cluster of X-linked miRNAs are de-repressed with age in mouse liver and target growth hormone signaling. FRONTIERS IN AGING 2023; 4:1261121. [PMID: 37881503 PMCID: PMC10594992 DOI: 10.3389/fragi.2023.1261121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/28/2023] [Indexed: 10/27/2023]
Abstract
Growth hormone (GH) signaling influences lifespan in a wide variety of mammalian species. We previously reported that a cluster of miRNAs located on the X-chromosome are de-repressed with age in male mouse liver, and a subset, the mir-465 family, can directly attenuate expression of the growth hormone receptor (GHR) in vitro leading to a reduction in GH signaling. Here we show that this cluster of miRNAs is also upregulated in the liver with age in females, and that calorie restriction and the Ames dwarf genotype, both known to delay aging, attenuate the upregulation of the miRNA cluster. Upregulation of mir-465 in vivo leads to a reduction in GHR mRNA in the liver and an attenuation of GH signaling, indicated by a reduction in GHR, IGF-1, IGFBP3, and ALS mRNA expression. There is a corresponding reduction in IGF-1 protein levels in the liver and plasma. These results suggest that the age-associated upregulation of the X-chromosomal cluster of miRNAs could influence lifespan.
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Affiliation(s)
| | | | | | - Jill A. Kreiling
- Department of Molecular Biology, Cell Biology and Biochemistry, Center for the Biology of Aging, Brown University, Providence, RI, United States
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7
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Hahm JH, Seo HD, Jung CH, Ahn J. Longevity through diet restriction and immunity. BMB Rep 2023; 56:537-544. [PMID: 37482753 PMCID: PMC10618078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023] Open
Abstract
The share of the population that is aging is growing rapidly. In an aging society, technologies and interventions that delay the aging process are of great interest. Dietary restriction (DR) is the most reproducible and effective nutritional intervention tested to date for delaying the aging process and prolonging the health span in animal models. Preventive effects of DR on age-related diseases have also been reported in human. In addition, highly conserved signaling pathways from small animal models to human mediate the effects of DR. Recent evidence has shown that the immune system is closely related to the effects of DR, and functions as a major mechanism of DR in healthy aging. This review discusses the effects of DR in delaying aging and preventing age-related diseases in animal, including human, and introduces the molecular mechanisms that mediate these effects. In addition, it reports scientific findings on the relationship between the immune system and DRinduced longevity. The review highlights the role of immunity as a potential mediator of the effects of DR on longevity, and provides insights into healthy aging in human. [BMB Reports 2023; 56(10): 537-544].
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Affiliation(s)
- Jeong-Hoon Hahm
- Aging and Metabolism Research Group, Korea Food Research Institute, Wanju 55365, Korea
| | - Hyo-Deok Seo
- Aging and Metabolism Research Group, Korea Food Research Institute, Wanju 55365, Korea
| | - Chang Hwa Jung
- Aging and Metabolism Research Group, Korea Food Research Institute, Wanju 55365, Korea
- Department of Food Biotechnology, University of Science and Technology, Daejeon 34113, Korea
| | - Jiyun Ahn
- Aging and Metabolism Research Group, Korea Food Research Institute, Wanju 55365, Korea
- Department of Food Biotechnology, University of Science and Technology, Daejeon 34113, Korea
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8
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Santos HT, Silva-Albuquerque VM, Salvatori R, Melo EV, Oliveira-Santos AA, Oliveira CRP, Campos VC, Barros-Oliveira CS, Menezes NV, Santos EG, Pereira FA, Santana NO, Batista VO, Villar-Gouy KR, Oliveira-Neto LA, Aguiar-Oliveira MH. Function and form of the shoulder in congenital and untreated growth hormone deficiency. Endocrine 2023; 81:547-554. [PMID: 37198380 DOI: 10.1007/s12020-023-03391-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/27/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVES The shoulder is the most mobile joint in the entire human body. During arm elevation, it requires the integrity of a set of muscles, bones, and tendons. Individuals with short stature often need to raise their arms above the shoulder girdle and may have functional restriction or shoulder injuries. The impact of isolated GH deficiency (IGHD) on joints remains not well defined. The purpose of this work is to evaluate the function and structure of the shoulder in short-statured adult individuals with untreated IGHD due to the same homozygous mutation in the GHRH receptor gene. METHODS A cross-sectional study (evidence 3) was carried out in 20 GH-naive IGHD subjects and 20 age-matched controls. They completed the disabilities of the arm, shoulder, and hand (DASH) questionnaire and shoulder ultrasound (US). Thickness of the anterior, medial, and posterior portions of the supraspinatus tendon and of subacromial space was measured, and the number of individuals with tendinosis or tearing of the supraspinatus tendon was registered. RESULTS DASH score was similar between IGHD and controls, but IGHD subjects complained less of symptoms (p = 0.002). The number of individual with tears was higher in the controls (p = 0.02). As expected, the absolute US measurements were lower in IGHD, but the magnitude of the reduction was most pronounced in the thickness of the anterior portion of the supraspinatus tendon. CONCLUSION Adults with lifetime IGHD do not have functional shoulder restrictions, complain less of problems in performing upper extremity activities, and have fewer tendinous injuries than controls.
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Affiliation(s)
- Hertz T Santos
- Division of Orthopedics, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Victor M Silva-Albuquerque
- Ultrasound Division, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine Baltimore, Baltimore, Maryland, 21287, USA
| | - Enaldo V Melo
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Alécia A Oliveira-Santos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Viviane C Campos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Cynthia S Barros-Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Nelmo V Menezes
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Elenilde G Santos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Francisco A Pereira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Nathalie O Santana
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Vanderlan O Batista
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Keila R Villar-Gouy
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Luiz A Oliveira-Neto
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Manuel H Aguiar-Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil.
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9
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Hage C, Salvatori R. Growth Hormone and Aging. Endocrinol Metab Clin North Am 2023; 52:245-257. [PMID: 36948778 DOI: 10.1016/j.ecl.2022.10.003] [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] [Indexed: 11/18/2022]
Abstract
Growth hormone (GH) secretion declines with aging (somatopause). One of the most controversial issues in aging is GH treatment of older adults without evidence of pituitary pathology. Although some clinicians have proposed reversing the GH decline in the older population, most information comes from not placebo-controlled studies. Although most animal studies reported an association between decreased GH levels (or GH resistance) and increased lifespan, human models have shown contradictory reports on the consequences of GH deficiency (GHD) on longevity. Currently, GH treatment in adults is only indicated for individuals with childhood-onset GHD transitioning to adulthood or new-onset GHD due to hypothalamic or pituitary pathologic processes.
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Affiliation(s)
- Camille Hage
- Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, 1830 east Monument street #333 Baltimore, MD 21287, USA
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, 1830 east Monument street #333 Baltimore, MD 21287, USA.
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10
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Garmes HM, Castillo AR, Monte Alegre S, de Souza AL, Atala YB, Zantut-Wittmann DE. Childhood-Onset GH Deficiency versus Adult-Onset GH Deficiency: Relevant Differences Regarding Insulin Sensitivity. Metabolites 2022; 12:metabo12121251. [PMID: 36557289 PMCID: PMC9782045 DOI: 10.3390/metabo12121251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
The results of the studies on the pattern of insulin sensitivity (IS) are contradictory in patients with GH deficiency (GHD); however, the interference of the GHD onset stage, childhood or adulthood in the IS has not been assessed by euglycemic hyperinsulinemic clamp (EHC), a gold-standard method for the assessment of insulin sensitivity. In a prospective cross-sectional study, we assessed IS and body composition in 17 adults with hypopituitarism without GH replacement, ten with childhood-onset (COGHD) and seven with adulthood-onset (AOGHD) and compared them to paired control groups. COGHD presented higher IS (p = 0.0395) and a similar percentage of fat mass (PFM) to AOGHD. COGHD showed higher IS than the control group (0.0235), despite a higher PFM (0.0022). No differences were found between AODGH and the control group. In AOGHD and the control group, IS was negatively correlated with PFM (rs: −0.8214, p = 0.0234 and rs: −0.3639, p < 0.0344), while this correlation was not observed with COGHD (rs: −0.1152, p = 0.7514). Despite the higher PFM, patients with COGHD were more sensitive to insulin than paired healthy individuals, while patients with AOGHD showed similar IS compared to controls. The lack of GH early in life could modify the metabolic characteristics of tissues related to the glucose metabolism, inducing beneficial effects on IS that persist into adulthood. Thus, the glycometabolic findings in patients with COGHD seems to be not applicable to AOGHD.
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Affiliation(s)
- Heraldo Mendes Garmes
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas 13083-852, SP, Brazil
- Correspondence:
| | - Alejandro Rosell Castillo
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas 13083-852, SP, Brazil
| | - Sarah Monte Alegre
- Internal Medicine Division, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas 13083-852, SP, Brazil
| | - Aglecio Luiz de Souza
- Internal Medicine Division, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas 13083-852, SP, Brazil
| | - Yeelen Ballesteros Atala
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas 13083-852, SP, Brazil
| | - Denise Engelbrecht Zantut-Wittmann
- Endocrinology Division, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas 13083-852, SP, Brazil
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Aguiar-Oliveira MH, Salvatori R. The state of Sergipe contribution to GH research: from Souza Leite to Itabaianinha syndrome. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:919-928. [PMID: 36394485 PMCID: PMC10118753 DOI: 10.20945/2359-3997000000567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In the late 19th century, José Dantas de Souza Leite, a physician born in Sergipe, published the first detailed clinical description of acromegaly under the guidance of the French neurologist Pierre Marie. In 2014, the Brazilian Society of Endocrinology and Metabolism created the "José Dantas de Souza Leite Award", which is granted every two years to a Brazilian researcher who has contributed to the development of endocrinology. In 2022, the award was given to another physician from Sergipe, Manuel Hermínio de Aguiar Oliveira, from the Federal University of Sergipe for the description of "Itabaianinha syndrome" in a cohort of individuals with isolated GH deficiency due to a homozygous inactivating mutation in the GH-releasing hormone receptor gene. This research, which was carried out over almost 30 years, was performed in partnership with Roberto Salvatori from Johns Hopkins University and in collaboration with other researchers around the world. This review article tells the story of Souza Leite, some milestones in the history of GH, and summarizes the description of Itabaianinha syndrome.
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12
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Fazekas-Pongor V, Péterfi A, Major D, Szarvas Z, Fekete M, Tabak AG, Csiszar A, Sonntag WE, Austad SN, Ungvari ZI. Decreased lifespan in female "Munchkin" actors from the cast of the 1939 film version of The Wizard of Oz does not support the hypothesis linking hypopituitary dwarfism to longevity. GeroScience 2022; 44:2527-2539. [PMID: 36334178 PMCID: PMC9768075 DOI: 10.1007/s11357-022-00680-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/21/2022] [Indexed: 11/08/2022] Open
Abstract
In laboratory mice, pituitary dwarfism caused by genetic reduction or elimination of the activity of growth hormone (GH) significantly extends lifespan. The effects of congenital pituitary dwarfism on human longevity are not well documented. To analyse the effects of untreated pituitary dwarfism on human lifespan, the longevity of a diverse group of widely known little people, the 124 adults who played "Munchkins" in the 1939 movie The Wizard of Oz was investigated. Survival of "Munchkin" actors with those of controls defined as cast members of The Wizard of Oz and those of other contemporary Academy Award winning Hollywood movies was compared. According to the Kaplan-Meier survival curves, survival of female and male "Munchkin" actors was shorter than cast controls and Hollywood controls of respective sexes. Cox regression analyses showed that female "Munchkin" actors had significantly higher risk ratios compared to both female cast controls (RR, 1.70; 95% CI, 1.05 to 2.77) and female Hollywood controls (RR, 1.52; 95% CI, 1.03 to 2.24). Similar trends were also discernible for men, albeit point estimates were not significant. The lack of lifespan extension in "Munchkin" actors does not support the hypothesis that hereditary GH deficiency regulates longevity in humans.
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Affiliation(s)
| | - Anna Péterfi
- Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Dávid Major
- Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Zsófia Szarvas
- Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Monika Fekete
- Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Adam G Tabak
- Department of Public Health, Semmelweis University, Budapest, Hungary
- Department of Epidemiology and Public Health, University College London, London, UK
- Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Anna Csiszar
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, 975 NE 10th Street, BRC 1313, Oklahoma City, OK, 731042, USA
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 731042, USA
- Peggy and Charles Stephenson Cancer Center, Oklahoma City, OK, 73104, USA
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Departments of Translational Medicine and Public Health, Semmelweis University, Budapest, Hungary
| | - William E Sonntag
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, 975 NE 10th Street, BRC 1313, Oklahoma City, OK, 731042, USA
| | - Steven N Austad
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Zoltan I Ungvari
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, 975 NE 10th Street, BRC 1313, Oklahoma City, OK, 731042, USA.
- Vascular Cognitive Impairment and Neurodegeneration Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 731042, USA.
- Peggy and Charles Stephenson Cancer Center, Oklahoma City, OK, 73104, USA.
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Departments of Translational Medicine and Public Health, Semmelweis University, Budapest, Hungary.
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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13
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Menezes NV, Barros-Oliveira CS, Salvatori R, Gois VC, Marinho CG, Oliveira CRP, Campos VC, Oliveira-Santos AA, Santos-Júnior HT, Santos EG, Melo EV, Faro ACN, Oliveira NV, Gumes-Felix HM, Melo GB, Aguiar-Oliveira MH. Quantitative measures of the vascular and neural components of the retina in adult individuals with congenital and untreated growth hormone deficiency. Int J Retina Vitreous 2022; 8:72. [PMID: 36183116 PMCID: PMC9526970 DOI: 10.1186/s40942-022-00408-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Background The somatotrophic axis, including hypothalamic growth hormone (GH)-releasing hormone (GHRH), pituitary GH and circulating IGF-I, is critical for body size. However, the local production of GH/IGF-I (and IGF-II) and other peptides is relevant for other body functions, such as vascular, brain, and retinal function. The consequences of GH deficiency (GHD) on the retinal structure are still unclear, possibly reflecting the heterogeneity of patients and the different types of assessment in previous publications. Our purpose was to assess quantitative measures of the vascular and neural components of the retina in subjects with severe congenital isolated GHD (IGHD). Methods A cross-sectional study was carried out in 25 adult IGHD subjects and 25 age- and gender-matched controls. Interview, physical examination, laboratory data, optical coherence tomography (OCT) and OCT angiography (OCTA) were performed. Results OCT revealed no difference in the areas of the nerve fiber layer average, nor in the areas of superior, inferior, or nasal quadrants, between the two groups. However, areas of the temporal quadrant (p = 0.041), the optical disc (p = 0.042), the cup (p < 0.0001), as well as the cup/disc ratio (p < 0.0001), were higher in IGHD subjects than controls. The rim area was smaller (p = 0.002), although still normal. In OCTA, there was no difference in the minimum foveal thickness, central fovea, foveal avascular zone, and retinal density in any assessed area. Conclusions In conclusion, congenital IGHD does not affect quantitative measures of the vascular and neural retina, and it is associated with increased optical disc in this genetically homogeneous cohort.
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Affiliation(s)
- Nelmo V Menezes
- Division of Ophthalmology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Cynthia S Barros-Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, University Hospital, Street Claudio Batista s/n, Aracaju, SE, 49060-100, Brazil
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Vinicius C Gois
- Retinal Specialist, Hospital de Olhos Rolemberg Gois, Aracaju, Sergipe, 49010-390, Brazil
| | - Cindi G Marinho
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, University Hospital, Street Claudio Batista s/n, Aracaju, SE, 49060-100, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, University Hospital, Street Claudio Batista s/n, Aracaju, SE, 49060-100, Brazil
| | - Viviane C Campos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, University Hospital, Street Claudio Batista s/n, Aracaju, SE, 49060-100, Brazil
| | - Alécia A Oliveira-Santos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, University Hospital, Street Claudio Batista s/n, Aracaju, SE, 49060-100, Brazil
| | - Hertz T Santos-Júnior
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, University Hospital, Street Claudio Batista s/n, Aracaju, SE, 49060-100, Brazil
| | - Elenilde G Santos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, University Hospital, Street Claudio Batista s/n, Aracaju, SE, 49060-100, Brazil
| | - Enaldo V Melo
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, University Hospital, Street Claudio Batista s/n, Aracaju, SE, 49060-100, Brazil
| | - Augusto C N Faro
- Division of Ophthalmology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Neima V Oliveira
- Division of Ophthalmology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Hérika M Gumes-Felix
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, University Hospital, Street Claudio Batista s/n, Aracaju, SE, 49060-100, Brazil
| | | | - Manuel H Aguiar-Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, University Hospital, Street Claudio Batista s/n, Aracaju, SE, 49060-100, Brazil.
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Huang Z, Xiao L, Xiao Y, Chen C. The Modulatory Role of Growth Hormone in Inflammation and Macrophage Activation. Endocrinology 2022; 163:6607489. [PMID: 35695371 DOI: 10.1210/endocr/bqac088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Indexed: 11/19/2022]
Abstract
Inflammation is a body's response to remove harmful stimuli and heal tissue damage, which is involved in various physiology and pathophysiology conditions. If dysregulated, inflammation may lead to significant negative impacts. Growth hormone (GH) has been shown responsible for not only body growth but also critical in the modulation of inflammation. In this review, we summarize the current clinical and animal studies about the complex and critical role of GH in inflammation. Briefly, GH excess or deficiency may lead to pathological inflammatory status. In inflammatory diseases, GH may serve as an inflammatory modulator to control the disease progression and promote disease resolution. The detailed mechanisms and signaling pathways of GH on inflammation, with a focus on the modulation of macrophage polarization, are carefully discussed with potential direction for future investigations.
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Affiliation(s)
- Zhengxiang Huang
- School of Biomedical Sciences, University of Queensland, St Lucia, QLD 4072, Australia
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, QUT, Brisbane, QLD 4000, Australia
- The Australia-China Centre for Tissue Engineering and Regenerative Medicine (ACCTERM), QUT, Brisbane, QLD 4000, Australia
| | - Lan Xiao
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, QUT, Brisbane, QLD 4000, Australia
- The Australia-China Centre for Tissue Engineering and Regenerative Medicine (ACCTERM), QUT, Brisbane, QLD 4000, Australia
| | - Yin Xiao
- School of Mechanical, Medical, and Process Engineering, Queensland University of Technology (QUT), Brisbane, QLD 4000, Australia
- Centre for Biomedical Technologies, QUT, Brisbane, QLD 4000, Australia
- The Australia-China Centre for Tissue Engineering and Regenerative Medicine (ACCTERM), QUT, Brisbane, QLD 4000, Australia
| | - Chen Chen
- School of Biomedical Sciences, University of Queensland, St Lucia, QLD 4072, Australia
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15
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Oliveira-Neto LA, Nascimento JKF, Salvatori R, Oliveira-Santos AA, Girão RS, Silva EV, Santos ALM, Cunha MM, Bittencourt MAV, Rodrigues GT, Andrade BMR, Oliveira AHA, Valença EHO, Aguiar-Oliveira MH. Growth of teeth and bones in adult subjects with congenital untreated isolated growth hormone deficiency. Growth Horm IGF Res 2022; 65:101469. [PMID: 35696752 DOI: 10.1016/j.ghir.2022.101469] [Citation(s) in RCA: 1] [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: 03/04/2022] [Revised: 04/14/2022] [Accepted: 05/15/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To understand the growth of teeth and mandibular and maxillary bones in subjects with isolated growth hormone deficiency (IGHD). MATERIAL AND METHODS Mesiodistal tooth width of 28 maxillary and mandibular dental models of 14 adult IGHD subjects (9 men) were digitalized and compared to 40 models of 20 normal-statured controls (11 men). The mean SDS of the maxillary and mandibular teeth were compared with height, cephalic perimeter, total anterior facial height, total maxillary and mandibular length, and maxillary and mandibular arches. RESULTS All average mesiodistal dimensions in absolute values of the 14 dental pairs were reduced in the IGHD group. Eight of 28 (28.6%) mesiodistal dimensions in IGHD subjects of both sexes had an average SDS below -2, thirteen of them (46.4%) had mean SDS between -1 and - 2, and seven of them (25.0%) had SDS above -1. The highest SDS values were the upper lateral incisor (-0.32 in women), and the upper canine (-0.91 in men). The lowest SDS values were the 2nd upper molar (-3.51 in men), and the 2nd upper premolar (-2.64 in women). The ascending order of the mean SDS was height, total maxillary length, total mandibular length, total anterior height of the face, cephalic perimeter, the maxillary arches width, the mesiodistal width of the mandibular teeth, the mesiodistal width of the maxillary teeth and the mandibular arches width. CONCLUSIONS Reduction in mesiodistal width is present in untreated IGHD adults with magnitude of tooth size reduction being lower than height, cephalic perimeter, total anterior facial height, and most jaw measurements. IGHD abolishes the sexual dimorphism in mesiodistal dental measures.
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Affiliation(s)
- Luiz A Oliveira-Neto
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Jéssica K F Nascimento
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Roberto Salvatori
- Division of Endocrinology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Alécia A Oliveira-Santos
- Division of Nutrition, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Rafaela S Girão
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Evânio V Silva
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - André L M Santos
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Matheus M Cunha
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Gustavo T Rodrigues
- Postgraduate Program in Dentistry School of Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Bruna M R Andrade
- Division of Speech Therapy, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Alaíde H A Oliveira
- School of Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Eugênia H O Valença
- Division of Speech therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Manuel H Aguiar-Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, 49060-100 Aracaju, Sergipe, Brazil.
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16
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de Andrade BMR, Valença EHO, Salvatori R, Oliveira LA, Souza AHO, Oliveira AHA, Oliveira MCP, Melo EV, de Carvalho S, Sales NJ, Monteiro GC, de Lima JM, Annunziato MFH, Mannis GDB, de A Souza LE, Goes YD, Carvalho TS, de Farias C, Dos Santos MP, Cardoso GPF, Pereira Sousa CS, Santana JR, Sales EA, d'Avila JS, Aguiar-Oliveira MH. Art and science: impact of semioccluded vocal tract exercises and choral singing on quality of life in subjects with congenital GH deficiency. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:198-205. [PMID: 35315986 PMCID: PMC9832885 DOI: 10.20945/2359-3997000000449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective Currently, not much is known about the interactions between voice and growth hormone (GH). We have described large kindred with isolated GH deficiency (IGHD) due to a GHRH receptor mutation, resulting in severe short stature and high-pitched voice. These IGHD individuals have little interest in GH treatment, as they consider themselves "short long-lived people", rather than patients. Interestingly, they report normal general quality of life, but they rate their Voice-Related Quality of Life (V-RQOL) as low. Here, we assessed the social and auditory-perceptual impacts of artistic-intervention voice therapy with semioccluded vocal tract exercises (SOVTE) and choral singing, on their voices. Methods Seventeen GH-naïve adult IGHD individuals were enrolled in a single-arm interventional pre-post study with 13 weekly sessions of choir singing over 90 days. Outcome measures were V-RQOL scores, self-assessment of voice, and auditory-perceptual analysis (GRBAS scale, G: grade of the severity of dysphonia; R: roughness; B: breathiness; A: asthenia; and S: strain). Results Marked improvements in total (p = 0.0001), physical (p = 0.0002), and socioemotional (p = 0.0001) V-RQOL scores and in self-assessment of voice (p = 0.004) were found. The general grades of vocal deviation (p = 0.0001), roughness (p = 0.0001), breathiness (p = 0.0001) and strain (p = 0.0001) exhibited accentuated reductions. Conclusion Voice therapy with semioccluded vocal tract exercises and choral training improved social impact and perceptual voice assessments in IGHD subjects and markedly improved their voice-related quality of life. This is particularly important in a setting where GH replacement therapy is not widely accepted.
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Affiliation(s)
- Bruna M R de Andrade
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Eugenia H O Valença
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Roberto Salvatori
- Division of Endocrinology, Department of Medicine, The Johns Hopkins University School of Medicine Baltimore (Maryland), United States
| | - Luiz A Oliveira
- Divisão de Odontologia, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Anita H O Souza
- Divisão de Endocrinologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Alaíde H A Oliveira
- Divisão de Odontologia, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Mario C P Oliveira
- Departamento de Comunicação Social, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Enaldo V Melo
- Divisão de Odontologia, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Susana de Carvalho
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Neuza J Sales
- Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | | | | | | | | | - Lucas E de A Souza
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Yasmin D Goes
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Thayza S Carvalho
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Celiane de Farias
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Michela P Dos Santos
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Gabriela P F Cardoso
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Carla S Pereira Sousa
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Julia Rodrigues Santana
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Ester Almeida Sales
- Departamento de Fonoaudiologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Jeferson Sampaio d'Avila
- Divisão de Otorrinolaringologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil
| | - Manuel H Aguiar-Oliveira
- Divisão de Endocrinologia, Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe, Aracaju, SE, Brasil,
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17
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Brown-Borg HM. Growth hormone, not IGF-1 is the key longevity regulator in mammals. J Gerontol A Biol Sci Med Sci 2022; 77:1719-1723. [PMID: 35436323 PMCID: PMC9434454 DOI: 10.1093/gerona/glac092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Holly M Brown-Borg
- Department of Biomedical Sciences, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND
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18
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Girão RS, Aguiar-Oliveira MH, Andrade BMR, Bittencourt MAV, Salvatori R, Silva EV, Santos ALM, Cunha MM, Takeshita WM, Oliveira AHA, Valença EHO, Oliveira-Santos AA, Oliveira-Neto LA. Dental arches in inherited severe isolated growth hormone deficiency. Growth Horm IGF Res 2022; 62:101444. [PMID: 35151933 DOI: 10.1016/j.ghir.2022.101444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/06/2022] [Accepted: 01/12/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The growth of the dental arches depends on GH and insulin-like growth factor type 1 (IGF1), but the consequences of GH deficiency (GHD) on their growth are still unclear, probably due to the acquired etiology of GHD in most described series, often associated with additional pituitary deficits (thyrotrophic, corticotrophic and gonadotrophic hormones), and imperfections of related replacement therapies, which may affect the dental arch growth. To avoid these limitations, we took advantage of a unique cohort of subjects with isolated GH deficiency (IGHD) due the same mutation in the GH releasing hormone receptor gene, living with very low serum GH and low to undetectable circulating IGF1 levels. Our purpose was to analyze the dimensions of maxillary and mandibular dental arches. METHODS 22 adult IGHD (15 untreated and 7 previously partially treated with GH) and 33 controls were enrolled in a cross-sectional study using the Ortho Insight 3D and MeshMixer software, RESULTS: In untreated IGHD subjects all maxillary arch measures were smaller than controls, while among mandibular arches, only the mandibular canine width and the mandibular arch length were reduced. In partially GH treated subjects only the palate depth, the maxillary canine width, the maxillary and mandibular arch lengths remained smaller than controls. CONCLUSIONS IGHD reduces the growth of maxillary arch to a greater degree than the mandibular arch, suggesting different control of superior and inferior dental arches. GH treatment increases some of these measures.
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Affiliation(s)
- Rafaela S Girão
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Manuel H Aguiar-Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
| | - Bruna M R Andrade
- Division of Speech therapy, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Roberto Salvatori
- Division of Endocrinology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Evânio V Silva
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - André L M Santos
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Matheus M Cunha
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Wilton M Takeshita
- Postgraduate Program in Dentistry School of Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Alaíde H A Oliveira
- School of Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Eugênia H O Valença
- Division of Speech therapy, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Alécia A Oliveira-Santos
- Division of Nutrition, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Luiz A Oliveira-Neto
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil
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19
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Pekic S, Stojanovic M, Popovic V. Pituitary tumors and the risk of other malignancies: is the relationship coincidental or causal? ENDOCRINE ONCOLOGY (BRISTOL, ENGLAND) 2022; 2:R1-R13. [PMID: 37435457 PMCID: PMC10259320 DOI: 10.1530/eo-21-0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/21/2021] [Indexed: 07/13/2023]
Abstract
Pituitary adenomas are benign neoplasms of the pituitary. The most prevalent are prolactinomas and non-functioning pituitary adenomas, followed by growth hormone- and ACTH-secreting adenomas. Most pituitary adenomas seem to be sporadic and their persistent growth is very atypical. No molecular markers predict their behavior. The occurrence of pituitary adenomas and malignancies in the same patient can be either pure coincidence or caused by shared underlying genetic susceptibility involved in tumorigenesis. Detailed family history on cancers/tumors in the first, second and third generation of family members on each side of the family has been reported in a few studies. They found an association of pituitary tumors with positive family history for breast, lung and colorectal cancer. We have reported that in about 50% of patients with pituitary adenomas, an association with positive family history for cancer has been found independent of secretory phenotype (acromegaly, prolactinoma, Cushing's disease or non-functioning pituitary adenomas). We also found earlier onset of pituitary tumors (younger age at diagnosis of pituitary tumors) in patients with a strong family history of cancer. In our recent unpublished series of 1300 patients with pituitary adenomas, 6.8% of patients were diagnosed with malignancy. The latency period between the diagnosis of pituitary adenoma and cancer was variable, and in 33% of patients, it was longer than 5 years. Besides the inherited trophic mechanisms (shared underlying genetic variants), the potential influence of shared complex epigenetic influences (environmental and behavioral factors - obesity, smoking, alcohol intake and insulin resistance) is discussed. Further studies are needed to better understand if patients with pituitary adenomas are at increased risk for cancer.
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Affiliation(s)
- Sandra Pekic
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center Belgrade, Belgrade, Serbia
| | - Marko Stojanovic
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center Belgrade, Belgrade, Serbia
| | - Vera Popovic
- School of Medicine, University of Belgrade, Belgrade, Serbia
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20
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Barros PR, Costa TJ, Akamine EH, Tostes RC. Vascular Aging in Rodent Models: Contrasting Mechanisms Driving the Female and Male Vascular Senescence. FRONTIERS IN AGING 2021; 2:727604. [PMID: 35821995 PMCID: PMC9261394 DOI: 10.3389/fragi.2021.727604] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 08/25/2021] [Indexed: 12/12/2022]
Abstract
Increasing scientific interest has been directed to sex as a biological and decisive factor on several diseases. Several different mechanisms orchestrate vascular function, as well as vascular dysfunction in cardiovascular and metabolic diseases in males and females. Certain vascular sex differences are present throughout life, while others are more evident before the menopause, suggesting two important and correlated drivers: genetic and hormonal factors. With the increasing life expectancy and aging population, studies on aging-related diseases and aging-related physiological changes have steeply grown and, with them, the use of aging animal models. Mouse and rat models of aging, the most studied laboratory animals in aging research, exhibit sex differences in many systems and physiological functions, as well as sex differences in the aging process and aging-associated cardiovascular changes. In the present review, we introduce the most common aging and senescence-accelerated animal models and emphasize that sex is a biological variable that should be considered in aging studies. Sex differences in the cardiovascular system, with a focus on sex differences in aging-associated vascular alterations (endothelial dysfunction, remodeling and oxidative and inflammatory processes) in these animal models are reviewed and discussed.
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Affiliation(s)
- Paula R. Barros
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Tiago J. Costa
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Eliana H. Akamine
- Department of Pharmacology, Institute of Biomedical Science, University of São Paulo, São Paulo, Brazil
- *Correspondence: Rita C. Tostes, ; Eliana H. Akamine,
| | - Rita C. Tostes
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- *Correspondence: Rita C. Tostes, ; Eliana H. Akamine,
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21
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Saccon TD, Schneider A, Marinho CG, Nunes ADC, Noureddine S, Dhahbi J, Nunez Lopez YO, LeMunyan G, Salvatori R, Oliveira CRP, Oliveira‐Santos AA, Musi N, Bartke A, Aguiar‐Oliveira MH, Masternak MM. Circulating microRNA profile in humans and mice with congenital GH deficiency. Aging Cell 2021; 20:e13420. [PMID: 34118183 PMCID: PMC8282278 DOI: 10.1111/acel.13420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 05/10/2021] [Accepted: 05/26/2021] [Indexed: 12/13/2022] Open
Abstract
Reduced inflammation, increased insulin sensitivity, and protection against cancer are shared between humans and mice with GH/IGF1 deficiency. Beyond hormone levels, miRNAs are important regulators of metabolic changes associated with healthy aging. We hypothesized that GH deficiency in humans alters the abundance of circulating miRNAs and that a subset of those miRNAs may overlap with those found in GH-deficient mice. In this study, subjects with untreated congenital isolated GH deficiency (IGHD; n = 23) and control subjects matched by age and sex (n = 23) were recruited and serum was collected for miRNA sequencing. Serum miRNAs from young (6 month) and old (22 month) Ames dwarf (df/df) mice with GH deficiency and their WT littermates (n = 5/age/genotype group) were used for comparison. We observed 14 miRNAs regulated with a genotype by age effect and 19 miRNAs regulated with a genotype effect independent of age in serum of IGHD subjects. These regulated miRNAs are known for targeting pathways associated with longevity such as mTOR, insulin signaling, and FoxO. The aging function was overrepresented in IGHD individuals, mediated by hsa-miR-31, hsa-miR-146b, hsa-miR-30e, hsa-miR-100, hsa-miR-181b-2, hsa-miR-195, and hsa-miR-181b-1, which target the FoxO and mTOR pathways. Intriguingly, miR-181b-5p, miR-361-3p, miR-144-3p, and miR-155-5p were commonly regulated in the serum of humans and GH-deficient mice. In vitro assays confirmed target genes for the main up-regulated miRNAs, suggesting miRNAs regulated in IGHD individuals can regulate the expression of age-related genes. These findings indicate that systemic miRNAs regulated in IGHD individuals target pathways involved in aging in both humans and mice.
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Affiliation(s)
- Tatiana D. Saccon
- Centro de Desenvolvimento Tecnológico Universidade Federal de Pelotas Pelotas Brazil
- Burnett School of Biomedical Sciences College of Medicine University of Central Florida Orlando FL USA
| | - Augusto Schneider
- Faculdade de Nutrição Universidade Federal de Pelotas Pelotas Brazil
| | - Cindi G. Marinho
- Division of Endocrinology Health Sciences Graduate Program Federal University of Sergipe Aracaju Brazil
| | - Allancer D. C. Nunes
- Burnett School of Biomedical Sciences College of Medicine University of Central Florida Orlando FL USA
| | - Sarah Noureddine
- Burnett School of Biomedical Sciences College of Medicine University of Central Florida Orlando FL USA
| | - Joseph Dhahbi
- Department of Medical Education School of Medicine California University of Science & Medicine San Bernardino CA USA
| | - Yury O. Nunez Lopez
- Advent Health Translational Research Institute for Metabolism and Diabetes Orlando FL USA
| | - Gage LeMunyan
- Department of Medical Education School of Medicine California University of Science & Medicine San Bernardino CA USA
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism Department of Medicine The Johns Hopkins University School of Medicine Baltimore MD USA
| | - Carla R. P. Oliveira
- Division of Endocrinology Health Sciences Graduate Program Federal University of Sergipe Aracaju Brazil
| | - Alécia A. Oliveira‐Santos
- Division of Endocrinology Health Sciences Graduate Program Federal University of Sergipe Aracaju Brazil
| | - Nicolas Musi
- Barshop Institute for Longevity and Aging Studies Center for Healthy Aging University of Texas Health Sciences Center at San Antonio and South Texas Veterans Health Care System San Antonio TX USA
- San Antonio Geriatric Research Education and Clinical Center South Texas Veterans Health Care System San Antonio TX USA
| | - Andrzej Bartke
- Department of Internal Medicine Southern Illinois University School of Medicine Springfield IL USA
| | - Manuel H. Aguiar‐Oliveira
- Division of Endocrinology Health Sciences Graduate Program Federal University of Sergipe Aracaju Brazil
| | - Michal M. Masternak
- Burnett School of Biomedical Sciences College of Medicine University of Central Florida Orlando FL USA
- Department of Head and Neck Surgery Poznan University of Medical Sciences Poznan Poland
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22
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Oliveira-Santos AA, Salvatori R, Bueno AC, Nogueira MC, Campos VC, Melo MA, Oliveira CRP, Barros-Oliveira CS, Marinho CG, Damascena NP, Santos EG, Melo EV, de Paula FJA, de Castro M, Aguiar-Oliveira MH. Reduced fibroblast growth factor 21 and β-Klotho secretion in untreated congenital isolated GH deficiency. Endocrine 2021; 73:160-165. [PMID: 33770382 DOI: 10.1007/s12020-021-02700-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
PURPOSES Increasing evidence suggests that the FGF-Klotho endocrine system and the somatotropic system (pituitary and extra-pituitary GH) may have important metabolic and immune relationships, thus contributing to the pathophysiology of aging-related disorders, including diabetes, atherosclerosis, and cancer. The status of these interactions in isolated GH deficiency (IGHD) is unknown. The objective of this study was to assess the response of both FGF21 and β-Klotho levels to a standard meal in a homogeneous group of adults with congenital untreated IGHD due to a homozygous mutation in the GHRH receptor gene. METHODS In a cross-sectional study, we measured the levels of FGF21 and β-Klotho, before and 30, 60, 120, and 180 min after a standardized test meal in 20 (11 males) IGHD and 20 (11 males) age-matched controls. Areas under the curves (AUC) of FGF21 and β-Klotho were calculated. RESULTS Baseline levels of FGF21 were similar, but baseline levels of β-Klotho were lower in IGHD subjects. The IGHD individuals exhibited lower AUC for FGF21 and β-Klotho levels than control subjects. There was a positive correlation between IGF1 and β-Klotho levels in the pooled groups. No correlation was found between IGF1 and FGF21 levels. CONCLUSIONS Subjects with lifetime, untreated IGHD exhibit reduced FGF21 and β-Klotho levels response to a mixed meal. This difference may have consequences on metabolism and aging.
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Affiliation(s)
- Alécia A Oliveira-Santos
- Postgraduate Nucleus in Health Science, Federal University of Sergipe, 49060-100, Aracaju, Brazil
| | - Roberto Salvatori
- Division of Endocrinology and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | - Ana C Bueno
- Department of Internal Medicine, The Ribeirao Preto Medical School, University of São Paulo, 14049-900, Ribeirao Preto, SP, Brazil
| | - Monica C Nogueira
- Department of Internal Medicine, The Ribeirao Preto Medical School, University of São Paulo, 14049-900, Ribeirao Preto, SP, Brazil
| | - Viviane C Campos
- Postgraduate Nucleus in Health Science, Federal University of Sergipe, 49060-100, Aracaju, Brazil
| | - Manuela A Melo
- Postgraduate Nucleus in Health Science, Federal University of Sergipe, 49060-100, Aracaju, Brazil
| | - Carla R P Oliveira
- Postgraduate Nucleus in Health Science, Federal University of Sergipe, 49060-100, Aracaju, Brazil
| | | | - Cindi G Marinho
- Postgraduate Nucleus in Health Science, Federal University of Sergipe, 49060-100, Aracaju, Brazil
| | - Nayra P Damascena
- Postgraduate Nucleus in Health Science, Federal University of Sergipe, 49060-100, Aracaju, Brazil
| | - Elenilde G Santos
- Postgraduate Nucleus in Health Science, Federal University of Sergipe, 49060-100, Aracaju, Brazil
| | - Enaldo V Melo
- Postgraduate Nucleus in Health Science, Federal University of Sergipe, 49060-100, Aracaju, Brazil
| | - Francisco J A de Paula
- Department of Internal Medicine, The Ribeirao Preto Medical School, University of São Paulo, 14049-900, Ribeirao Preto, SP, Brazil
| | - Margaret de Castro
- Department of Internal Medicine, The Ribeirao Preto Medical School, University of São Paulo, 14049-900, Ribeirao Preto, SP, Brazil
| | - Manuel H Aguiar-Oliveira
- Postgraduate Nucleus in Health Science, Federal University of Sergipe, 49060-100, Aracaju, Brazil
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23
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Melo MA, Borges LP, Salvatori R, Souza DRV, Santos-Júnior HT, de R Neto JM, Campos VC, Santos AA, Oliveira CRP, da Invenção GB, Batista VO, Matos ILS, Barros-Oliveira CS, Dos Santos KA, Santos EG, Souza NAA, Melo EV, Borges PC, Santos SEFS, de Oliveira BM, Oliveira-Santos AA, de Jesus AR, Aguiar-Oliveira MH. Individuals with isolated congenital GH deficiency due to a GHRH receptor gene mutation appear to cope better with SARS-CoV-2 infection than controls. Endocrine 2021; 72:349-355. [PMID: 33860882 PMCID: PMC8050633 DOI: 10.1007/s12020-021-02728-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/05/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Several interactions exist between the GH/IGF axis and the immune system, including effects on innate immunity and humoral and cellular response. Acquired GH deficiency (GHD) has been recently proposed as a risk factor for severity of COVID-19 infections. However, acquired GHD is often associated to other factors, including pituitary tumors, surgery, radiotherapy, and additional pituitary hormones deficits and their replacements, which, together, may hinder an accurate analysis of the relationship between GHD and COVID-19. Therefore, we decided to assess the seroprevalence of SARS-CoV-2 antibodies and the frequency of symptomatic cases of COVID-19 in adults subjects with untreated isolated GHD (IGHD) due to a homozygous null mutation in the GHRH receptor gene. METHODS A cross-sectional study was carried out in 27 adult IGHD subjects and 27 age- and gender-matched local controls. Interview, physical examination, bio-impedance, hematological and SARS-CoV-2 IgM and IgG antibodies were analyzed. RESULTS There was no difference in the prevalence of positivity of anti-SARS-CoV-2 IgM and IgG antibodies between the two groups. Conversely, no IGHD individual had a previous clinical diagnosis of COVID-19 infection, while 6 control subjects did (p = 0.023). CONCLUSION The production of anti-SARS-CoV-2 antibodies was similar between IGHD subjects due to a GHRH receptor gene mutation and controls, but the evolution to symptomatic stages of the infection and the frequency of confirmed cases was lower in IGHD subjects than in GH sufficient individuals.
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Affiliation(s)
- Manuela A Melo
- Division of Endocrinology, Health Sciences Graduate Program, Aracaju, Brazil
| | | | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | | | | | - José M de R Neto
- Laboratory of Biochemistry and Clinical Immunology, Aracaju, Brazil
| | - Viviane C Campos
- Division of Endocrinology, Health Sciences Graduate Program, Aracaju, Brazil
| | - Aryanne A Santos
- Laboratory of Biochemistry and Clinical Immunology, Aracaju, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Aracaju, Brazil
| | | | - Vanderlan O Batista
- Division of Endocrinology, Health Sciences Graduate Program, Aracaju, Brazil
| | - Igor L S Matos
- Laboratory of Biochemistry and Clinical Immunology, Aracaju, Brazil
| | | | | | - Elenilde G Santos
- Division of Endocrinology, Health Sciences Graduate Program, Aracaju, Brazil
| | | | - Enaldo V Melo
- Division of Endocrinology, Health Sciences Graduate Program, Aracaju, Brazil
| | - Pamela C Borges
- Laboratory of Biochemistry and Clinical Immunology, Aracaju, Brazil
| | - Saulo E F S Santos
- Division of Endocrinology, Health Sciences Graduate Program, Aracaju, Brazil
| | | | | | - Amélia R de Jesus
- Division of Immunology, Health Sciences Graduate Program Federal University of Sergipe, Aracaju, 49060-100, Sergipe, Brazil
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24
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Icyuz M, Zhang F, Fitch MP, Joyner MR, Challa AK, Sun LY. Physiological and metabolic characteristics of novel double-mutant female mice with targeted disruption of both growth hormone-releasing hormone and growth hormone receptor. Aging Cell 2021; 20:e13339. [PMID: 33755309 PMCID: PMC8045953 DOI: 10.1111/acel.13339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/27/2020] [Accepted: 01/12/2021] [Indexed: 12/19/2022] Open
Abstract
Mice with disruptions of growth hormone-releasing hormone (GHRH) or growth hormone receptor (GHR) exhibit similar phenotypes of prolonged lifespan and delayed age-related diseases. However, these two models respond differently to calorie restriction indicating that they might carry different and/or independent mechanisms for improved longevity and healthspan. In order to elucidate these mechanisms, we generated GHRH and GHR double-knockout mice (D-KO). In the present study, we focused specifically on the characteristics of female D-KO mice. The D-KO mice have reduced body weight and enhanced insulin sensitivity compared to wild-type (WT) controls. Growth retardation in D-KO mice is accompanied by decreased GH expression in pituitary, decreased circulating IGF-1, increased high-molecular-weight (HMW) adiponectin, and leptin hormones compared to WT controls. Generalized linear model-based regression analysis, which controls for body weight differences between D-KO and WT groups, shows that D-KO mice have decreased lean mass, bone mineral density, and bone mineral content, but increased adiposity. Indirect calorimetry markers including oxygen consumption, carbon dioxide production, and energy expenditure were significantly lower in D-KO mice relative to the controls. In comparison with WT mice, the D-KO mice displayed reduced respiratory exchange ratio (RER) values only during the light cycle, suggesting a circadian-related metabolic shift toward fat utilization. Interestingly, to date survival data suggest extended lifespan in D-KO female mice.
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Affiliation(s)
- Mert Icyuz
- Department of Biology University of Alabama at Birmingham Birmingham Alabama USA
| | - Fang Zhang
- Department of Biology University of Alabama at Birmingham Birmingham Alabama USA
| | - Michael P. Fitch
- Department of Biology University of Alabama at Birmingham Birmingham Alabama USA
| | - Matthew R. Joyner
- Department of Biology University of Alabama at Birmingham Birmingham Alabama USA
| | - Anil K. Challa
- Department of Biology University of Alabama at Birmingham Birmingham Alabama USA
| | - Liou Y. Sun
- Department of Biology University of Alabama at Birmingham Birmingham Alabama USA
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25
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Biscotto IP, Costa Hong VA, Batista RL, Mendonca BB, Arnhold IJP, Bortolotto LA, Carvalho LRS. Vasculometabolic effects in patients with congenital growth hormone deficiency with and without GH replacement therapy during adulthood. Pituitary 2021; 24:216-228. [PMID: 33098037 DOI: 10.1007/s11102-020-01099-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/17/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluated the metabolic profiles and vascular properties in congenital growth hormone (GH) deficiency (GHD) and its replacement in adults. PATIENTS AND METHODS Cross-sectional study conducted in a single tertiary center for pituitary diseases. Eighty-one adult subjects were divided into three groups: (1) 29 GHD patients with daily subcutaneous GH replacement therapy (GHRT) during adulthood; (2) 20 GHD patients without GHRT during adulthood and (3) 32 controls. Only patients with adequate adherence to others pituitary hormone deficiencies were included. Anthropometric parameters, body composition by dual-energy X-ray absorptiometry, metabolic profiles and vascular properties (carotid intima media thickness, pulse wave velocity and flow-mediated dilation) were compared among the groups. RESULTS Waist-to-height ratio (WHR), body fat percentages and fat mass index (FMI) were lower in patients with GHRT than patients without GHRT during adulthood (0.49 ± 0.06 vs. 0.53 ± 0.06 p = 0.026, 30 ± 10 vs. 40 ± 11 p = 0.003 and 7.3 ± 4 vs. 10 ± 3.5 p = 0.041, respectively). In addition, association between longer GHRT and lower body fat percentage was observed (r = - 0.326, p = 0.04). We found higher triglyceride (113.5 ± 62 vs. 78 ± 36, p = 0.025) and lower HDL cholesterol (51 ± 17 vs. 66 ± 23, p = 0.029) levels in patients without GHRT during adulthood in comparison to controls. No statistical differences were observed for vascular properties among the groups. CONCLUSIONS No differences in vascular properties were observed in congenital GHD adult patients with or without GHRT despite patients without GHRT had an unfavorable body composition. GHRT currently remains an individualized decision in adults with GHD and these findings bring new insight into the treatment and follow-up of these patients.
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Affiliation(s)
- Isabela Peixoto Biscotto
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM42, Disciplina de Endocrinologia, Departamento de Clínica Médica do Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-000, Brazil.
| | - Valéria Aparecida Costa Hong
- Unidade de Hipertensão, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, Sao Paulo, Brazil
| | - Rafael Loch Batista
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM42, Disciplina de Endocrinologia, Departamento de Clínica Médica do Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-000, Brazil
| | - Berenice Bilharinho Mendonca
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM42, Disciplina de Endocrinologia, Departamento de Clínica Médica do Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-000, Brazil
| | - Ivo Jorge Prado Arnhold
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM42, Disciplina de Endocrinologia, Departamento de Clínica Médica do Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-000, Brazil
| | - Luiz Aparecido Bortolotto
- Unidade de Hipertensão, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, Sao Paulo, Brazil
| | - Luciani Renata Silveira Carvalho
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM42, Disciplina de Endocrinologia, Departamento de Clínica Médica do Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, SP, 05403-000, Brazil.
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26
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Aguiar-Oliveira MH, Salvatori R. Disruption of the GHRH receptor and its impact on children and adults: The Itabaianinha syndrome. Rev Endocr Metab Disord 2021; 22:81-89. [PMID: 32935264 DOI: 10.1007/s11154-020-09591-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2020] [Indexed: 12/22/2022]
Abstract
Since 1994, we have been studying an extended kindred with 105 subjects (over 8 generations) residing in Itabaianinha County, in the Brazilian state of Sergipe, who have severe isolated GH deficiency (IGHD) due to a homozygous inactivating mutation (c.57 + 1G > A) in the GH releasing hormone (GHRH) receptor (GHRHR) gene. Most of these individuals have never received GH replacement therapy. They have low GH, and very low and often undetectable levels of serum IGF-I. Their principal physical findings are proportionate short stature, doll facies, high-pitched-voice, central obesity, wrinkled skin, and youthful hair with delayed pigmentation, and virtual absence of graying. The newborns from this cohort are of normal size, indicating that GH is not needed for intra-uterine growth. However, these IGHD individuals exhibit a myriad of phenotypic changes throughout the body, with a greater number of beneficial than harmful consequences. This GHRH signal disruption syndrome has been a valuable model to study the GH roles in body size and function. This reviews summarized the findings we have reported on this cohort.
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Affiliation(s)
- Manuel H Aguiar-Oliveira
- Division of Endocrinology, University Hospital, Federal University of Sergipe, Rua Claudio Batista s/n, Aracaju, Sergipe, 49060-100, Brazil.
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine Baltimore, Baltimore, MD, 21287, USA
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27
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Marinho CG, Melo HA, Salvatori R, Nunes MAP, Oliveira CRP, Campos VC, Barros-Oliveira CS, Oliveira-Santos AA, Menezes NV, Santos-Júnior HT, Santos EG, Melo MA, Oliveira JLM, Melo EV, Aguiar-Oliveira MH. Cerebral vasoreactivity, a surrogate marker of cerebrovascular disease, is not impaired in subjects with lifetime, untreated, congenital isolated GH deficiency. Endocrine 2020; 70:388-395. [PMID: 32656695 DOI: 10.1007/s12020-020-02415-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/04/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Cerebrovascular disease (CeVD) is a major cause of death and disability. The role of the GH/IGF-I axis on CeVD risk is controversial. Patients with GH deficiency (GHD) in the setting of hypopituitarism often exhibit CeVD predisposing factors, like low nitric oxide generation, endothelial dysfunction, increased visceral fat mass, increased levels of LDL cholesterol, and increased intima-media thickness, a surrogate marker of atherosclerosis. However, several confounders such as the primary hypothalamic-pituitary lesion, hormonal replacement therapies, consequences of surgery and radiotherapy, may influence this relationship. Therefore, we decided to assess cerebral vasoreactivity, a surrogate marker of CeVD, in adult subjects with untreated isolated GHD (IGHD) due to the same homozygous null mutation in the GHRH receptor gene. METHODS A cross-sectional study was carried out in 25 adult IGHD subjects and 25 age- and gender-matched controls. Interview, physical examination, laboratory data, intima-media thickness measurement, and transcranial Doppler were performed. The intracranial hemodynamics (mean flow velocity, pulsatility and resistance indexes) were measured, and the response to the vasodilatory stimulus by breath-holding maneuver (breath-holding index) was calculated. RESULTS IGHD and control groups were similar in Framingham risk score and intima-media thickness. Similarly, there was no difference in mean flow velocity, pulsatility, resistance, and breath-holding index. CONCLUSIONS Lifetime, untreated IGHD does not cause impaired cerebral vasoreactivity.
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Affiliation(s)
- Cindi G Marinho
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Hyder A Melo
- Service of Transcranial Doppler, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | - Marco A P Nunes
- Division of Angiology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Viviane C Campos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Cynthia S Barros-Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Alécia A Oliveira-Santos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Nelmo V Menezes
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Hertz T Santos-Júnior
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Elenilde G Santos
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Manuela A Melo
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Joselina L M Oliveira
- Division of Cardiology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Enaldo V Melo
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
| | - Manuel H Aguiar-Oliveira
- Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil
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Doknic M, Gasic V, Stojanovic M, Pavlovic S, Marinkovic S, Miljic D, Pekic S, Manojlovic-Gacic E, Damjanovic D, Soldatovic I, Petakov M. Hypopituitarism in five PROP1 mutation siblings: long-lasting natural course and the effects of growth hormone replacement introduction in middle adulthood. Pituitary 2020; 23:400-408. [PMID: 32415500 DOI: 10.1007/s11102-020-01049-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Twenty years after the first description of combined hypopituitarism (CPHD) caused by PROP1 mutations, the phenotype of affected subjects is still challenging for clinicians. These patients suffer from pituitary hormone deficits ranging from IGHD to panhypopituitarism. ACTH deficiency usually develops later in life. Pituitary size is variable. PROP1 mutation is the most frequent in familial congenital hypopituitarism (CH). Reports on initiation of hormonal replacement including growth hormone (GH) in adults with CH are scarce. We identified 5 adult siblings with CPHD due to PROP1 mutation (301-302delAG), aged 36-51 years (4 females), never treated for hormone deficiencies. They presented with short stature (SD from - 3.7 to - 4.7), infantile sexual characteristic, moderate abdominal obesity and low bone mineral density in 3 of them. Complete hypopituituitarism was confirmed in three siblings, while two remaining demonstrated GH, TSH, FSH and LH deficiencies. Required hormonal replacement including rhGH was initiated in all patients. After several months necessity for hydrocortisone replacement developed in all patients. After 2 years of continual replacement therapy, BMD and body composition (measured by DXA-dual X-ray absorptiometry) improved in all subjects, most prominently in two younger females and the male sibling. Besides rhGH therapy, these three patients have received sex hormones contributing to the favorable effect. The male sibling was diagnosed with brain glioblastoma two years following complete hormonal replacement. This report provides important experience regarding hormonal replacement, particularly rhGH treatment, in adults with long-term untreated CH. Beneficial effect of such therapy are widely acknowledged, yet these subjects could be susceptible to certain risks of hormonal treatment initiated in adulthood. Careful and continual clinical follow-up is thus strongly advised.
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Affiliation(s)
- Mirjana Doknic
- Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Dr Subotic 13, 11000, Belgrade, Serbia.
- Faculty of Medicine, University Belgrade, Belgrade, Serbia.
| | - Vladimir Gasic
- Institute of Molecular Genetics and Genetic Engineering, University Belgrade, Belgrade, Serbia
| | - Marko Stojanovic
- Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Dr Subotic 13, 11000, Belgrade, Serbia
- Faculty of Medicine, University Belgrade, Belgrade, Serbia
| | - Sonja Pavlovic
- Institute of Molecular Genetics and Genetic Engineering, University Belgrade, Belgrade, Serbia
| | - Snezana Marinkovic
- Special Hospital for Thyroid Gland and Metabolism Diseases, Zlatibor, Serbia
| | - Dragana Miljic
- Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Dr Subotic 13, 11000, Belgrade, Serbia
- Faculty of Medicine, University Belgrade, Belgrade, Serbia
| | - Sandra Pekic
- Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Dr Subotic 13, 11000, Belgrade, Serbia
- Faculty of Medicine, University Belgrade, Belgrade, Serbia
| | | | - Dusan Damjanovic
- Center for Radiology Imaging - Magnetic Resonance and Gamma Knife, Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University Belgrade, Belgrade, Serbia
| | - Ivan Soldatovic
- Institute of Medical Statistics and Informatics, Belgrade, Serbia
- Faculty of Medicine, University Belgrade, Belgrade, Serbia
| | - Milan Petakov
- Neuroendocrine Department, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Dr Subotic 13, 11000, Belgrade, Serbia
- Faculty of Medicine, University Belgrade, Belgrade, Serbia
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29
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He X, Barkan AL. Growth hormone therapy in adults with growth hormone deficiency: a critical assessment of the literature. Pituitary 2020; 23:294-306. [PMID: 32060708 DOI: 10.1007/s11102-020-01031-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Growth hormone (GH) therapy has been studied as treatment for clinical manifestations of adult-onset growth hormone deficiency (AO-GHD), including cardiovascular risk, bone health, and quality of life. Patients with AO-GHD typically also have significant history of pituitary pathology and hypopituitarism, which raises the question of what proportion of their clinical presentation can be attributed to GHD alone. Currently, much of the existing data for GH therapy in AO-GHD come from uncontrolled retrospective studies and observational protocols. These considerations require careful reassessment of the role of GH as a therapeutic agent in adult patients with hypopituitarism. METHODS We contrast results from placebo-controlled trials with those from uncontrolled and retrospective studies for GH replacement in patients with hypopituitarism. We also examine the evidence for the manifestations of AO-GHD being attributed to GHD alone, as well as the data on adults with congenital, life-long untreated isolated GHD. RESULTS The evidence for increased morbidity and mortality in hypopituitary patients with GHD, and for the benefits of GH therapy, are conflicting. There remains the possibility that the described clinical manifestations of AO-GHD may not be due to GHD alone, but may also be related to underlying pituitary pathology, treatment history and suboptimal hormone replacement. CONCLUSIONS In the setting of inconsistent data on the benefits of GH therapy, treatment of AO-GHD remains an individualized decision. There is a need for more randomized, placebo-controlled studies to evaluate the long-term outcomes of GH therapy in adults with hypopituitarism.
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Affiliation(s)
- Xin He
- Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan, Domino's Farms, Lobby G, Suite 1500, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48106, USA
| | - Ariel L Barkan
- Division of Metabolism, Endocrinology & Diabetes, Department of Internal Medicine, University of Michigan, Domino's Farms, Lobby G, Suite 1500, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48106, USA.
- Department of Neurosurgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA.
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30
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Norling AM, Gerstenecker AT, Buford TW, Khan B, Oparil S, Lazar RM. The role of exercise in the reversal of IGF-1 deficiencies in microvascular rarefaction and hypertension. GeroScience 2019; 42:141-158. [PMID: 31808026 DOI: 10.1007/s11357-019-00139-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 11/19/2019] [Indexed: 12/18/2022] Open
Abstract
Hypertension has been linked with peripheral and central reductions in vascular density, and with devastating effects on brain function. However, the underlying mechanisms in the relationship between blood pressure and cognitive impairment have yet to be fully elucidated. Here, we review compelling evidence from two lines of inquiry: one that links microvascular rarefaction with insulin-like growth factor 1 (IGF-1) deficiencies, and another which posits that vascular dysfunction precedes hypertension. Based on the findings from experimental and clinical studies, we propose that these lines of evidence converge, and suggest that age-related declines in IGF-1 concentrations precede microvascular rarefaction, initiate an increase in vascular resistance, and therefore are causally linked to onset of hypertension. Physical exercise provides a relevant model for supporting our premise, given the well-established effects of exercise in attenuating vascular dysfunction, hypertension, IGF-1 deficiency, and cognitive decline. We highlight here the role of exercise-induced increases in blood flow in improving vascular integrity and enhancing angiogenesis via the actions of IGF-1, resulting in reversal of rarefaction and hypertension, and enhancement of cerebral blood flow and cognition.
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Affiliation(s)
- Amani M Norling
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.,The UAB Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Alabama, AL, 35294, USA
| | - Adam T Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.,The UAB Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Alabama, AL, 35294, USA
| | - Thomas W Buford
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Bilal Khan
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Suzanne Oparil
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Ronald M Lazar
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA. .,The UAB Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Alabama, AL, 35294, USA.
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31
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Barrios MR, Campos VC, Peres NTA, de Oliveira LL, Cazzaniga RA, Santos MB, Aires MB, Silva RLL, Barreto A, Goto H, Almeida RP, Salvatori R, Aguiar-Oliveira MH, Jesus AMR. Macrophages From Subjects With Isolated GH/IGF-I Deficiency Due to a GHRH Receptor Gene Mutation Are Less Prone to Infection by Leishmania amazonensis. Front Cell Infect Microbiol 2019; 9:311. [PMID: 31544067 PMCID: PMC6730494 DOI: 10.3389/fcimb.2019.00311] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 08/16/2019] [Indexed: 01/06/2023] Open
Abstract
Isolated growth hormone (GH) deficiency (IGHD) affects approximately 1 in 4,000 to 1 in 10,000 individuals worldwide. We have previously described a large cohort of subjects with IGHD due to a homozygous mutation in the GH releasing hormone (GHRH) receptor gene. These subjects exhibit throughout the life very low levels of GH and its principal mediator, the Insulin Growth Factor-I (IGF-I). The facilitating role of IGF-I in the infection of mouse macrophages by different Leishmania strains is well-known. Nevertheless, the role of IGF-I in Leishmania infection of human macrophages has not been studied. This study aimed to evaluate the behavior of Leishmania infection in vitro in macrophages from untreated IGHD subjects. To this end, blood samples were collected from 14 IGHD individuals and 14 age and sex-matched healthy controls. Monocytes were isolated and derived into macrophages and infected with a strain of Leishmania amazonensis. In addition, IGF-I was added to culture medium to evaluate its effect on the infection. Cytokines were measured in the culture supernatants. We found that macrophages from IGHD subjects were less prone to Leishmania infection compared to GH sufficient controls. Both inflammatory and anti-inflammatory cytokines increase only in the supernatants of the control macrophages. Addition of IGF-I to the culture medium increased infection rates. In conclusion, we demonstrated that IGF-I is crucial for Leishmania infection of human macrophages.
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Affiliation(s)
- Mônica R Barrios
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - Viviane C Campos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Brazil
| | - Nalu T A Peres
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe, Aracaju, Brazil.,Department of Microbiology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Laís L de Oliveira
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - Rodrigo A Cazzaniga
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - Márcio B Santos
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - Murilo B Aires
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - Ricardo L L Silva
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - Aline Barreto
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - Hiro Goto
- Laboratório de Soroepidemiologia e Imunobiologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil.,Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Roque P Almeida
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Amélia M R Jesus
- Division of Immunology and Molecular Biology Laboratory, Federal University of Sergipe, Aracaju, Brazil
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32
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Oliveira-Santos AA, Salvatori R, Nogueira MC, Bueno AC, Barros-Oliveira CS, Leal ÂCGB, Marinho CG, Damascena NP, Oliveira DA, Melo MA, Oliveira CRP, da Costa FO, Dos Santos JSS, Santos PFC, Campos VC, Santos EG, Melo EV, Barbosa MLA, Rocha IES, de Castro M, Aguiar-Oliveira MH. Enteroendocrine Connections in Congenital Isolated GH Deficiency Due to a GHRH Receptor Gene Mutation. J Clin Endocrinol Metab 2019; 104:2777-2784. [PMID: 30860584 DOI: 10.1210/jc.2019-00094] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/06/2019] [Indexed: 12/25/2022]
Abstract
CONTEXT GH and IGF-1 are crucial for attainment of normal body size and regulation of food intake, nutrient storage, and insulin sensitivity. Enteroendocrine connections exist between the GH-IGF-1 axis and insulin, ghrelin, and glucagon-like peptide 1 (GLP-1). The status of these connections in GH deficiency (GHD) is unknown. OBJECTIVE To study the enteroendocrine connections before and after a standard meal test in a homogeneous population of adults with congenital untreated isolated GHD (IGHD) due to a mutation in the GHRH receptor gene. DESIGN In a cross-sectional study of 20 individuals with IGHD and 20 control subjects, we measured glucose, insulin, ghrelin, and GLP-1 before and 30, 60, 120, and 180 minutes after a standardized test meal. Homeostasis model assessment index of insulin resistance (HOMA-IR) and homeostasis model assessment (HOMA)-β were calculated. Participants scored feelings of hunger, fullness, and prospective food consumption on a visual analog scale. MAIN OUTCOME MEASURES Area under the curve (AUC) values of glucose, insulin, ghrelin, GLP-1, hunger, fullness, and prospective food consumption. RESULTS Fasting HOMA-IR and HOMA-β were lower in individuals with IGHD than in control subjects (P = 0.002 and P = 0.023, respectively). AUC was higher for hunger (P < 0.0001), glucose (P = 0.0157), ghrelin (P < 0.0001), and GLP-1 (P < 0.0001) and smaller for fullness (P < 0.0001) in individuals with IGHD compared with control subjects. There was no difference in AUC for prospective food consumption or insulin. CONCLUSIONS Untreated IGHD is associated with increased GLP-1 secretion and reduced postprandial ghrelin and hunger attenuation in response to a mixed meal. These enteroendocrine connections can result in a favorable outcome in terms of environmental adaptation and guaranteeing appropriate food intake and can confer metabolic benefits.
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Affiliation(s)
| | - Roberto Salvatori
- Division of Endocrinology and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Monica C Nogueira
- Department of Internal Medicine, The Ribeirao Preto Medical School, University of São Paulo Ribeirão Preto, São Paulo, Brazil
| | - Ana C Bueno
- Department of Internal Medicine, The Ribeirao Preto Medical School, University of São Paulo Ribeirão Preto, São Paulo, Brazil
| | | | - Ângela C G B Leal
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Cindi G Marinho
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Nayra P Damascena
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Djane A Oliveira
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Manuela A Melo
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Flavia O da Costa
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Paula F C Santos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Viviane C Campos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Elenilde G Santos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Enaldo V Melo
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | | | - Ivina E S Rocha
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Margaret de Castro
- Department of Internal Medicine, The Ribeirao Preto Medical School, University of São Paulo Ribeirão Preto, São Paulo, Brazil
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33
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Reinheimer DM, Andrade BMR, Nascimento JKF, Fonte JBM, Araújo IMP, Martins-Filho PRS, Salvatori R, Valença EHO, Oliveira AHA, Aguiar-Oliveira MH, Oliveira-Neto LA. Formant Frequencies, Cephalometric Measures, and Pharyngeal Airway Width in Adults With Congenital, Isolated, and Untreated Growth Hormone Deficiency. J Voice 2019; 35:61-68. [PMID: 31147205 DOI: 10.1016/j.jvoice.2019.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/23/2019] [Accepted: 04/29/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Adult subjects with isolated growth hormone deficiency (IGHD) due to a mutation in the growth hormone releasing hormone receptor gene exhibit higher values formant frequencies. In normal subjects, a significant negative association between the formant frequencies and the reduction of linear craniofacial measurements, especially of maxilla and mandible, has been reported. This suggests smaller pharyngeal width, despite low prevalence of obstructive sleep apnea syndrome. Here we evaluate their pharyngeal airway width, its correlation with vowel formant frequencies, and the correlation between them and the craniofacial measures. SUBJECTS AND METHODS A two-step protocol was performed. In the first case-control experiment, aimed to assess the pharyngeal width, we compared nine adult IGHD and 36 normal statured controls. Both upper and lower pharyngeal widths were measured. The second step (assessment of pharyngeal width) was performed only in the IGHD group. RESULTS Upper and lower pharyngeal widths were similar in IGHD and controls. In IGHD subjects, the lower pharyngeal width exhibited a negative correlation with F1 [a] and a positive correlation with mandibular length. There were negative correlations between F1 and F2 with linear and positive correlations with the angular measures. CONCLUSIONS Pharyngeal airway width is not reduced in adults with congenital, untreated lifetime IGHD, contributing to the low prevalence of obstructive sleep apnea syndrome. The formant frequencies relate more with cephalometric measurements than with the pharyngeal airway width. These findings exemplify the consequences of lifetime IGHD on osseous and nonosseous growth.
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Affiliation(s)
- Daniele M Reinheimer
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - Bruna M R Andrade
- Division of Speech Therapy, Federal University of Sergipe, Aracaju, Brazil
| | | | - Juliana B M Fonte
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - Isabella M P Araújo
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | | | - Roberto Salvatori
- Division of Endocrinology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Alaíde H A Oliveira
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | | | - Luiz A Oliveira-Neto
- Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
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34
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Santana-Ribeiro AA, Moreira-Brasileiro GA, Aguiar-Oliveira MH, Salvatori R, Carvalho VO, Alvim-Pereira CK, Araújo-Daniel CR, Reis-Costa JG, Andrade-Guimarães AL, Oliveira-Santos AA, Vieira ER, Gois-Junior MB. Walking and postural balance in adults with severe short stature due to isolated GH deficiency. Endocr Connect 2019; 8:416-424. [PMID: 30865930 PMCID: PMC6454299 DOI: 10.1530/ec-19-0103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/13/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Walking and postural balance are extremely important to obtain food and to work. Both are critical for quality of life and ability to survive. While walking reflects musculoskeletal and cardiopulmonary systems, postural balance depends on body size, muscle tone, visual, vestibular and nervous systems. Since GH and IGF-I act on all these systems, we decided to study those parameters in a cohort of individuals with severe short stature due to untreated isolated GH deficiency (IGHD) caused by a mutation in the GHRH receptor gene. These IGHD subjects, despite reduction in muscle mass, are very active and have normal longevity. METHODS In a cross-sectional study, we assessed walking (by a 6-min walk test), postural balance (by force platform) and fall risk (by the 'Timed Up and Go' test) in 31 IGHD and 40 matched health controls. RESULTS The percentage of the walked distance measured in relation to the predicted one was similar in groups, but higher in IGHD, when corrected by the leg length. Absolute postural balance data showed similar velocity of unipodal support in the two groups, and better values, with open and closed eyes and unipodal support, in IGHD, but these differences became non-significant when corrected for height and lower-limb length. The time in 'Timed Up and Go' test was higher in IGHD cohort, but still below the cut-off value for fall risk. CONCLUSION IGHD subjects exhibit satisfactory walking and postural balance, without increase in fall risk.
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Affiliation(s)
- Ananda A Santana-Ribeiro
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, Sergipe, Brazil
| | - Giulliani A Moreira-Brasileiro
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | - Manuel H Aguiar-Oliveira
- Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, Brazil
- Correspondence should be addressed to M H Aguiar-Oliveira:
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vitor O Carvalho
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | - Claudia K Alvim-Pereira
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, Sergipe, Brazil
| | - Carlos R Araújo-Daniel
- Department of Statistic and Actuarial Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Júlia G Reis-Costa
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, Sergipe, Brazil
| | - Alana L Andrade-Guimarães
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | | | - Edgar R Vieira
- Department of Physical Therapy and Neuroscience, Wertheims’ College of Nursing and Health Science, Florida International University, Miami, Florida, USA
| | - Miburge B Gois-Junior
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
- Department of Physical Therapy and Neuroscience, Wertheims’ College of Nursing and Health Science, Florida International University, Miami, Florida, USA
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35
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Aguiar-Oliveira MH, Bartke A. Growth Hormone Deficiency: Health and Longevity. Endocr Rev 2019; 40:575-601. [PMID: 30576428 PMCID: PMC6416709 DOI: 10.1210/er.2018-00216] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 12/07/2018] [Indexed: 12/13/2022]
Abstract
The important role of GH in the control of mammalian longevity was first deduced from extended longevity of mice with genetic GH deficiency (GHD) or GH resistance. Mice with isolated GHD (IGHD) due to GHRH or GHRH receptor mutations, combined deficiency of GH, prolactin, and TSH, or global deletion of GH receptors live longer than do their normal siblings. They also exhibit multiple features of delayed and/or slower aging, accompanied by extension of healthspan. The unexpected, remarkable longevity benefit of severe endocrine defects in these animals presumably represents evolutionarily conserved trade-offs among aging, growth, maturation, fecundity, and the underlying anabolic processes. Importantly, the negative association of GH signaling with longevity extends to other mammalian species, apparently including humans. Data obtained in humans with IGHD type 1B, owing to a mutation of the GHRH receptor gene, in the Itabaianinha County, Brazil, provide a unique opportunity to study the impact of severe reduction in GH signaling on age-related characteristics, health, and functionality. Individuals with IGHD are characterized by proportional short stature, doll facies, high-pitched voices, and central obesity. They have delayed puberty but are fertile and generally healthy. Moreover, these IGHD individuals are partially protected from cancer and some of the common effects of aging and can attain extreme longevity, 103 years of age in one case. We think that low, but detectable, residual GH secretion combined with life-long reduction of circulating IGF-1 and with some tissue levels of IGF-1 and/or IGF-2 preserved may account for the normal longevity and apparent extension of healthspan in these individuals.
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Affiliation(s)
| | - Andrzej Bartke
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois
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Andrade-Guimarães AL, Aguiar-Oliveira MH, Salvatori R, Carvalho VO, Alvim-Pereira F, Daniel CRA, Brasileiro GAM, Santana-Ribeiro AA, Santos-Carvalho HA, Oliveira CRP, Vieira ER, Gois-Junior MB. Adult individuals with congenital, untreated, severe isolated growth hormone deficiency have satisfactory muscular function. Endocrine 2019; 63:112-119. [PMID: 30251164 DOI: 10.1007/s12020-018-1763-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 09/11/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE While growth hormone (GH) and the insulin-like growth factor type I (IGF-I) are known to exert synergistic actions on muscle anabolism, the consequences of prolonged GH deficiency (GHD) on muscle function have not been well defined. We have previously described a large cohort of subjects with isolated GHD (IGHD) caused by a mutation in the GH-releasing hormone receptor gene, with low serum levels of GH and IGF-I. The aim of this study was to assess muscular function in these IGHD subjects. METHODS A total of 31 GH-naïve IGHD (16 males) and 40 control (20 males) subjects, matched by age and degree of daily physical activity, were enrolled. Fat free mass was measured by bioelectrical impedance; muscle strength by dynamometry of handgrip, trunk extension, and knee extension; myoelectric activity and muscle fatigue by fractal dimension; conduction velocity in vastus medialis, rectus femoris, and vastus lateralis muscles by surface electromyography. RESULTS The IGHD group showed higher knee extension strength both when corrected for weight and fat free mass, and higher handgrip and trunk extension strength corrected by fat free mass. They also exhibit higher conduction velocity of the muscles vastus medialis, rectus femoris, and vastus lateralis, but lower free fat mass and myoelectric activity of the vastus medialis, rectus femoris and vastus lateralis. There were no differences between the two groups in fractal dimension in all studied muscles. CONCLUSION Individuals with untreated IGHD have better muscle strength parameters adjusted for weight and fat free mass than controls. They also exhibit greater peripheral resistance to fatigue, demonstrating satisfactory muscle function.
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Affiliation(s)
- Alana L Andrade-Guimarães
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | | | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine Baltimore, Baltimore, Maryland, 21287, USA.
| | - Vitor O Carvalho
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | - Fabiano Alvim-Pereira
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
| | - Carlos R Araújo Daniel
- Department of Statistic and Actuarial Sciences, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - Giulliani A Moreira Brasileiro
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
| | - Ananda A Santana-Ribeiro
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
| | - Hugo A Santos-Carvalho
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Edgar R Vieira
- Department of Physical Therapy and Neuroscience, Wertheims'College of Nursing and Health Science, Florida International University, Florida, USA
| | - Miburge B Gois-Junior
- Laboratory of Motor Control and Body Balance, Center for Health Science Research, Federal University of Sergipe, 49060-100, Sergipe, Brazil
- Department of Physical Therapy and Post-Graduate Program in Health Science, Federal University of Sergipe, The GREAT Group (GRupo de Estudos em ATividade física), Sergipe, Brazil
- Department of Physical Therapy and Neuroscience, Wertheims'College of Nursing and Health Science, Florida International University, Florida, USA
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Bartke A, Quainoo N. Impact of Growth Hormone-Related Mutations on Mammalian Aging. Front Genet 2018; 9:586. [PMID: 30542372 PMCID: PMC6278173 DOI: 10.3389/fgene.2018.00586] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/12/2018] [Indexed: 12/21/2022] Open
Abstract
Mutations of a single gene can lead to a major increase in longevity in organisms ranging from yeast and worms to insects and mammals. Discovering these mutations (sometimes referred to as “longevity genes”) led to identification of evolutionarily conserved molecular, cellular, and organismal mechanisms of aging. Studies in mice provided evidence for the important role of growth hormone (GH) signaling in mammalian aging. Mice with mutations or gene deletions leading to GH deficiency or GH resistance have reduced body size and delayed maturation, but are healthier and more resistant to stress, age slower, and live longer than their normal (wild type) siblings. Mutations of the same genes in people can provide remarkable protection from age-related disease, but have no consistent impact on lifespan. Ongoing research indicates that genetic defects in GH signaling are linked to extension of healthspan and lifespan via a variety of interlocking mechanism, including improvements in genome and stem cell maintenance, stress resistance, glucose homeostasis, and thermogenesis, along with reductions in the mechanistic target of rapamycin (mTOR) C1 complex signaling and in chronic low grade inflammation.
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Affiliation(s)
- Andrzej Bartke
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, United States
| | - Nana Quainoo
- Department of Biology, University of Illinois Springfield, Springfield, IL, United States
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Farhat K, Bodart G, Charlet-Renard C, Desmet CJ, Moutschen M, Beguin Y, Baron F, Melin P, Quatresooz P, Parent AS, Desmecht D, Sirard JC, Salvatori R, Martens H, Geenen VG. Growth Hormone (GH) Deficient Mice With GHRH Gene Ablation Are Severely Deficient in Vaccine and Immune Responses Against Streptococcus pneumoniae. Front Immunol 2018; 9:2175. [PMID: 30333823 PMCID: PMC6176084 DOI: 10.3389/fimmu.2018.02175] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/03/2018] [Indexed: 01/01/2023] Open
Abstract
The precise impact of the somatotrope axis upon the immune system is still highly debated. We have previously shown that mice with generalized ablation of growth hormone (GH) releasing hormone (GHRH) gene (Ghrh−/−) have normal thymus and T-cell development, but present a marked spleen atrophy and B-cell lymphopenia. Therefore, in this paper we have investigated vaccinal and anti-infectious responses of Ghrh−/− mice against S. pneumoniae, a pathogen carrying T-independent antigens. Ghrh−/− mice were unable to trigger production of specific IgM after vaccination with either native pneumococcal polysaccharides (PPS, PPV23) or protein-PPS conjugate (PCV13). GH supplementation of Ghrh−/− mice restored IgM response to PPV23 vaccine but not to PCV13 suggesting that GH could exert a specific impact on the spleen marginal zone that is strongly implicated in T-independent response against pneumococcal polysaccharides. As expected, after administration of low dose of S. pneumoniae, wild type (WT) completely cleared bacteria after 24 h. In marked contrast, Ghrh−/− mice exhibited a dramatic susceptibility to S. pneumoniae infection with a time-dependent increase in lung bacterial load and a lethal bacteraemia already after 24 h. Lungs of infected Ghrh−/− mice were massively infiltrated by inflammatory macrophages and neutrophils, while lung B cells were markedly decreased. The inflammatory transcripts signature was significantly elevated in Ghrh−/− mice. In this animal model, the somatotrope GHRH/GH/IGF1 axis plays a vital and unsuspected role in vaccine and immunological defense against S. pneumoniae.
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Affiliation(s)
- Khalil Farhat
- GIGA-I3 Center of Immunoendocrinology, University of Liège, Liège, Belgium
| | - Gwennaëlle Bodart
- GIGA-I3 Center of Immunoendocrinology, University of Liège, Liège, Belgium
| | | | - Christophe J Desmet
- GIGA-I3 Cellular and Molecular Immunology, University of Liège, Liège, Belgium
| | - Michel Moutschen
- GIGA-I3 Infectious diseases, University of Liège, Liège, Belgium
| | - Yves Beguin
- GIGA-I3 Hematology, University of Liège, Liège, Belgium
| | | | - Pierrette Melin
- Department of Clinical Microbiology, University Hospital of Liège, University of Liège, Liège, Belgium
| | | | - Anne-Simone Parent
- Division of Pediatric Endocrinology, University Hospital of Liège, Liège, Belgium
| | - Daniel Desmecht
- Department of Veterinary Pathology, University of Liège, Liège, Belgium
| | - Jean-Claude Sirard
- CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019-UMR8204-Center for Infection and Immunity of Lille, University of Lille, Lille, France
| | - Roberto Salvatori
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Henri Martens
- GIGA-I3 Center of Immunoendocrinology, University of Liège, Liège, Belgium
| | - Vincent G Geenen
- GIGA-I3 Center of Immunoendocrinology, University of Liège, Liège, Belgium
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Duran-Ortiz S, Bell S, Kopchick JJ. Standardizing protocols dealing with growth hormone receptor gene disruption in mice using the Cre-lox system. Growth Horm IGF Res 2018; 42-43:52-57. [PMID: 30195091 PMCID: PMC9704043 DOI: 10.1016/j.ghir.2018.08.003] [Citation(s) in RCA: 4] [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: 05/10/2018] [Revised: 07/19/2018] [Accepted: 08/27/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Mice and humans with reduced growth hormone (GH) action before birth are conferred positive health- and life-span advantages. However, little work has been performed to study the effect of conditional disruption of GH action in adult life. With this as our objective, we sought to elucidate a reproducible protocol that allows generation of adult mice with a global disruption of the GH receptor (Ghr) gene, using the tamoxifen (TAM)-inducible Cre-lox system, driven by the ROSA26 enhancer/promoter. Here we report the optimum conditions for the gene disruption. DESIGN Six month old mice, homozygous for the ROSA26-Cre and the Ghr-floxed gene, were injected, once daily for five days with four distinct TAM doses (from 0.08 to 0.32 mg of TAM/g of body weight). To evaluate the most effective TAM dose that leads to global disruption of the GHR, mRNA expression of the Ghr and insulin growth factor-1 (Igf1) genes were assessed in liver, adipose tissue, kidney, and skeletal and cardiac muscles of experimental and control mice. Additionally, serum GH and IGF-1 levels were evaluated one month after TAM injections in both, TAM-treated and TAM-untreated control mice. RESULTS A dose of 0.25 mg of TAM/g of body weight was sufficient to significantly reduce the Ghr and Igf1 expression levels in the liver, fat, kidney, and skeletal and cardiac muscle of six-month old mice that are homozygous for the Ghr floxed gene and Cre recombinase. The reduction of the Ghr mRNA levels of the TAM-treated mice was variable between tissues, with liver and adipose tissue showing the lowest and skeletal and cardiac muscle the highest levels of Ghr gene expression when compared to control mice. Moreover, liver tissue showed the 'best' Ghr gene disruption, resulting in decreased total circulating IGF-1 levels while GH levels were increased versus control mice. CONCLUSION The results show that in mice at six months of age, a total TAM dose of at least 0.25 mg of TAM/g of body weight is needed for a global downregulation of Ghr gene expression with a regimen of 100 μL intraperitoneal (ip) TAM injections, once daily for five consecutive days. Furthermore, we found that even though this system does not achieve an equivalent disruption of the Ghr between tissues, the circulating IGF-1 is >95% decreased. This work helped to create adult mice with a global GHR knockdown.
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Affiliation(s)
- Silvana Duran-Ortiz
- Edison Biotechnology Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, United States; Department of Biological Sciences, College of Arts and Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, United States; Molecular and Cellular Biology Program, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, United States.
| | - Stephen Bell
- Edison Biotechnology Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, United States.
| | - John J Kopchick
- Edison Biotechnology Institute, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, United States; Molecular and Cellular Biology Program, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, United States; Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH 45701, United States.
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40
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Araújo IMP, Albuquerque-Souza E, Aguiar-Oliveira MH, Holzhausen M, Oliveira-Neto LA, Salvatori R, Saraiva L, Mayer MPA, Pannuti CM, Ribeiro AO, Romito GA, Pustiglioni FE. Immunological and microbiological periodontal profiles in isolated growth hormone deficiency. J Periodontol 2018; 89:1351-1361. [PMID: 29797719 DOI: 10.1002/jper.17-0687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 04/09/2018] [Accepted: 04/29/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Growth hormone (GH) has been identified as an important regulator of the immune response. We have previously shown that adults with isolated GH deficiency (IGHD) due to a mutation in the GH releasing hormone receptor (GHRHR) gene, have a greater chance of having periodontitis. However, the interaction of GH with periodontal tissues is still unknown, and this population has emerged as a unique model to investigate this issue. Therefore, we evaluated the microbiological and immunological periodontal profiles of such individuals. METHODS Nineteen IGHD and 19 controls matched by age, sex, diabetes, and smoking status, were enrolled in this case-control study. Periodontal clinical parameters (probing depth [PD] and clinical attachment loss [AL]) were measured at six sites per tooth. Immune mediators (C-reactive protein, matrix metalloproteinase [MMP]-8, MMP-9, interleukin [IL]-1α, IL-6, IL-8, tumor necrosis factor [TNF]-α, adiponectin, and leptin) were analyzed by enzyme-linked immunosorbent assay (ELISA) in the gingival crevicular fluid (GCF) in four non-adjacent sites for each participant (two with PD ≤3 mm [shallow sites] and two with PD ≥7 mm or the worst PD found in the mouth [deep sites]). Bacterial quantification (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia) of subgingival biofilm samples collected from these same sites was performed by quantitative real-time polymerase chain reaction (qPCR). RESULTS IGHD individuals presented higher values of PD and AL, and increased levels of CRP, IL-8, MMP-8, and adiponectin in the GCF. Bacterial quantification did not identify differences between the two groups. CONCLUSION IGHD alters the local immune response in periodontal pockets leading to greater attachment loss, and GH stands out as an important hormone to be evaluated in the pathogenesis of periodontitis.
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Affiliation(s)
- I M P Araújo
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - E Albuquerque-Souza
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - M H Aguiar-Oliveira
- Division of Endocrinology, Federal University of Sergipe, 49060-100, Aracaju, SE, Brazil
| | - M Holzhausen
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - L A Oliveira-Neto
- Division of Endocrinology, Federal University of Sergipe, 49060-100, Aracaju, SE, Brazil
| | - R Salvatori
- Division of Endocrinology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - L Saraiva
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - M P A Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, SP, Brazil
| | - C M Pannuti
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - A O Ribeiro
- Federal University of Sergipe, Division of Immunology and Molecular Biology Laboratory, SE, Brazil
| | - G A Romito
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - F E Pustiglioni
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
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Basu R, Qian Y, Kopchick JJ. MECHANISMS IN ENDOCRINOLOGY: Lessons from growth hormone receptor gene-disrupted mice: are there benefits of endocrine defects? Eur J Endocrinol 2018; 178:R155-R181. [PMID: 29459441 DOI: 10.1530/eje-18-0018] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/19/2018] [Indexed: 12/12/2022]
Abstract
Growth hormone (GH) is produced primarily by anterior pituitary somatotroph cells. Numerous acute human (h) GH treatment and long-term follow-up studies and extensive use of animal models of GH action have shaped the body of GH research over the past 70 years. Work on the GH receptor (R)-knockout (GHRKO) mice and results of studies on GH-resistant Laron Syndrome (LS) patients have helped define many physiological actions of GH including those dealing with metabolism, obesity, cancer, diabetes, cognition and aging/longevity. In this review, we have discussed several issues dealing with these biological effects of GH and attempt to answer the question of whether decreased GH action may be beneficial.
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Affiliation(s)
- Reetobrata Basu
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA
| | - Yanrong Qian
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA
| | - John J Kopchick
- Edison Biotechnology Institute, Ohio University, Athens, Ohio, USA
- Ohio University Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
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Aguiar-Oliveira MH, Davalos C, Campos VC, Oliveira Neto LA, Marinho CG, Oliveira CRP. Hypothalamic abnormalities: Growth failure due to defects of the GHRH receptor. Growth Horm IGF Res 2018; 38:14-18. [PMID: 29277338 DOI: 10.1016/j.ghir.2017.12.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/19/2017] [Accepted: 12/19/2017] [Indexed: 12/16/2022]
Abstract
Several acquired or congenital hypothalamic abnormalities may cause growth failure (GF). We described two of these congenital abnormalities. First, a case of CHARGE syndrome, an epigenetic disorder mostly caused by heterozygous mutations in the gene encoding CHD7, a chromatin remodeling protein, causing several malformations, some life-threatening, with additional secondary hypothalamus-hypophyseal dysfunction, including GF. Second, a cohort of individuals with genetic isolated severe GH deficiency (IGHD), due to a homozygous mutation in the GH-releasing hormone (GHRH) receptor gene described in Itabaianinha County, in northeast Brazil. In this IGHD, with marked reduction of serum concentrations of IGF-I, and an up regulation of IGF-II, GF is the principal finding in otherwise normal subjects, with normal quality of life and longevity. This IGHD may unveil the effects of GHRH, pituitary GH and IGF-I, IGF-II and local GH and growth factor on the size and function of body and several systems. For instance, anterior pituitary hypoplasia, and impairment of the non-REM sleep may be due to GHRH resistance. Proportionate short stature, doll facies, high-pitched pre-pubertal voice, and reduced muscle mass reflect the lack of the synergistic effect of pituitary GH and IGF-I in bones and muscles. Central adiposity may be due to a direct effect of the lack of GH. Brain, eyes and immune system may also involve IGF-II and local GH or growth factors. A concept of physiological hierarchy controlling body size and function by each component of the GH system may be drawn from this model.
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Affiliation(s)
- Manuel H Aguiar-Oliveira
- Division of Endocrinology, Department of Medicine, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil.
| | - Caridad Davalos
- Division of Pediatrics, Pediatric Critical Care, Hospital Pediatrico Baca Ortiz, Universidad San Francisco de Quito, 1712-841 Quito, Ecuador
| | - Viviane C Campos
- Division of Endocrinology, Department of Medicine, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Luiz A Oliveira Neto
- Department of Orthodontics, School of Dentistry, Federal University of Sergipe, 49060-100 Aracaju, Sergipe, Brazil
| | - Cindi G Marinho
- Division of Endocrinology, Department of Medicine, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
| | - Carla R P Oliveira
- Division of Endocrinology, Department of Medicine, Federal University of Sergipe, 49060-100, Aracaju, Sergipe, Brazil
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Cabrera-Salcedo C, Shah AS, Andrew M, Tyzinski L, Hwa V, Gutmark-Little I, Backeljauw P, Dauber A. Isolated growth hormone deficiency due to the R183H mutation in GH1: Clinical analysis of a four-generation family. Clin Endocrinol (Oxf) 2017; 87. [PMID: 28626954 PMCID: PMC5698139 DOI: 10.1111/cen.13400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Catalina Cabrera-Salcedo
- Cincinnati Center for Growth Disorders, Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Amy S. Shah
- Cincinnati Center for Growth Disorders, Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Melissa Andrew
- Cincinnati Center for Growth Disorders, Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Leah Tyzinski
- Cincinnati Center for Growth Disorders, Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Vivian Hwa
- Cincinnati Center for Growth Disorders, Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Iris Gutmark-Little
- Cincinnati Center for Growth Disorders, Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Philippe Backeljauw
- Cincinnati Center for Growth Disorders, Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Andrew Dauber
- Cincinnati Center for Growth Disorders, Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Oliveira FT, Salvatori R, Marcondes J, Macena LB, Oliveira-Santos AA, Faro ACN, Campos VC, Oliveira CRP, Costa UMM, Aguiar-Oliveira MH. Altered sleep patterns in patients with non-functional GHRH receptor. Eur J Endocrinol 2017; 177:51-57. [PMID: 28432269 DOI: 10.1530/eje-17-0145] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 04/10/2017] [Accepted: 04/21/2017] [Indexed: 01/24/2023]
Abstract
OBJECTIVES GH-releasing hormone (GHRH) exerts hypnotic actions increasing the non-rapid eye movement (NREM) sleep. Conversely, GH stimulates the REM sleep. GH deficiency (GHD) often leads to sleep problems, daytime fatigue and reduced quality of life (QoL). GHD may be due to lack of hypothalamic GHRH or destruction of somatotroph cells. We have described a cohort with isolated GHD (IGHD) due to GHRH resistance caused by a homozygous null mutation (c.57 + 1G > A) in the GHRH receptor gene. They have normal QoL and no obvious complaints of chronic tiredness. The aim of this study was to determine the sleep quality in these subjects. METHODS A cross-sectional study was carried out in 21 adult IGHD subjects, and 21 age- and gender-matched controls. Objective sleep assessment included polygraphic records of the awake, stages NREM [N1 (drowsiness), N2 and N3 (already sleeping)] and REM (R). Subjective evaluation included the Pittsburgh Sleep Quality Index, the Insomnia Severity Index and the Epworth Sleepiness Scale. RESULTS IGHD subjects showed a reduction in sleep efficiency (P = 0.007), total sleep time (P = 0.028), duration of N2 and R in minutes (P = 0.026 and P = 0.046 respectively), but had increased duration and percentage of N1 stage (P = 0.029 and P = 0.022 respectively), wake (P = 0.007) and wake-time after sleep onset (P = 0.017). There was no difference in N3 or in sleep quality questionnaire scores. CONCLUSION Patients with IGHD due to GHRH resistance exhibit objective reduction in the sleep quality, with changes in NREM and REM sleep, with no detectable subjective consequences. GHRH resistance seems to have a preponderant role over GHD in the sleep quality of these subjects.
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Affiliation(s)
| | - Roberto Salvatori
- Division of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine (R.S.) Baltimore, Maryland, USA
| | - José Marcondes
- Institute of Sleep and Integrated MedicineAracaju, Brazil
| | - Larissa B Macena
- Federal University of SergipeDivision of Endocrinology, Aracaju, Brazil
| | | | - Augusto C N Faro
- Federal University of SergipeDivision of Endocrinology, Aracaju, Brazil
| | - Viviane C Campos
- Federal University of SergipeDivision of Endocrinology, Aracaju, Brazil
| | | | - Ursula M M Costa
- Federal University of SergipeDivision of Endocrinology, Aracaju, Brazil
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45
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Faro ACN, Pereira-Gurgel VM, Salvatori R, Campos VC, Melo GB, Oliveira FT, Oliveira-Santos AA, Oliveira CRP, Pereira FA, Hellström A, Oliveira-Neto LA, Valença EHO, Aguiar-Oliveira MH. Ocular findings in adult subjects with an inactivating mutation in GH releasing hormone receptor gene. Growth Horm IGF Res 2017; 34:8-12. [PMID: 28456063 DOI: 10.1016/j.ghir.2017.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 02/28/2017] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Ocular function is fundamental for environmental adaptation and survival capacity. Growth factors are necessary for a mature eyeball, needed for adequate vision. However, the consequences of the deficiency of circulating growth hormone (GH) and its effector insulin-like growth factor I (IGF-I) on the physical aspects of the human eye are still debated. A model of untreated isolated GH deficiency (IGHD), with low but measurable serum GH, may clarify this issue. The aim of this study was to assess the ocular aspects of adult IGHD individuals who have never received GH therapy. DESIGN Cross sectional study. METHODS Setting: University Hospital, Federal University of Sergipe, Brazil. PATIENTS Twenty-five adult (13 males, mean age 50.1years, range 26 to 70years old) IGHD subjects homozygous for a null mutation (c.57+1G>A) in the GHRH receptor gene, and 28 (15 males, mean age 51.1years, range 26 to 67years old) controls were submitted to an endocrine and ophthalmological assessment. Forty-six IGHD and 50 control eyes were studied. MAIN OUTCOME MEASURES Visual acuity, intraocular pressure, refraction (spherical equivalent), ocular axial length (AL), anterior chamber depth (ACD), lens thickness (LT), vitreous depth (VD), mean corneal curvature (CC) and central corneal thickness (CCT). RESULTS IGHD subjects exhibited unmeasurable serum IGF-I levels, similar visual acuity, intraocular pressure and LT, higher values of spherical equivalent and CC, and lower measures of AL, ACD, VD and CCT in comparison to controls, but within their respective normal ranges. While mean stature in IGHD group was 78% of the control group, mean head circumference was 92% and axial AL was 96%. CONCLUSIONS These observations suggest mild ocular effects in adult subjects with severe IGF-I deficiency due to non-treated IGHD.
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Affiliation(s)
- Augusto C N Faro
- Division of Ophthalmology, Federal University of Sergipe, Aracaju, SE, Brazil
| | | | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Viviane C Campos
- Division of Endocrinology, Federal University of Sergipe, Aracaju, SE, Brazil
| | | | | | | | - Carla R P Oliveira
- Division of Endocrinology, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Francisco A Pereira
- Division of Endocrinology, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Ann Hellström
- Sahlgrenska Academy, The Queen Silvia Children's Hospital, Göteborg, Sweden
| | | | - Eugenia H O Valença
- Division of Speech Therapy, Federal University of Sergipe, Aracaju, SE, Brazil
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Abstract
Growth hormone (GH) replacement in GH deficient (GHD) children secures normal linear growth, while in GHD adults it improves metabolic status, body composition and quality of life. Safety of GH treatment is an important issue in particular concerning the controversy of potential cancer risk. Unlike in congenital IGF-1 deficiency, there is no complete protection against cancer in GHD patients. Important modifiable risk factors in GHD patients are obesity, insulin resistance, sedentary behavior, circadian rhythm disruption, chronic low grade inflammation and concomitant sex hormone replacement. Age, family history, hereditary cancer predisposition syndromes or cranial irradiation may present non-modifiable risk factors. Quantifying the risk of cancer in relation to GH therapy in adult GHD patients is complex. There is evidence that links GH to cancer occurrence or promotion, but the evidence is progressively weaker when moving from in vitro studies to in vivo animal studies to epidemiological studies and finally to studies on GH treated patients. GH-IGF inhibition in experimental animals leads to decreased cancer incidence and progression. Epidemiological studies suggest an association of high normal circulating IGF-1 or GH to cancer incidence in general population. Data regarding cancer incidence in acromegaly are inconsistent but thyroid and colorectal neoplasias are the main source of concern. Replacement therapy with rhGH for GHD is generally safe. Overall the rate of de novo cancers was not increased in studies of GH-treated GHD patients. Additional caution is mandated in patients with history of cancer, strong family history of cancer and with advancing age. Childhood cancer survivors may be at increased risk for secondary neoplasms compared with general population. In this subgroup GH therapy should be used cautiously and with respect to other risk factors (cranial irradiation etc). We believe that the benefits of GH therapy against the morbidity of untreated GH deficiency outweigh the theoretical cancer risk. Proper monitoring of GH treatment with diligent cancer surveillance remains essential.
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Affiliation(s)
- Sandra Pekic
- University of Belgrade, School of Medicine, Dr Subotica 8, 11000 Belgrade, Serbia; Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Dr Subotica 13, 11000 Belgrade, Serbia
| | - Marko Stojanovic
- University of Belgrade, School of Medicine, Dr Subotica 8, 11000 Belgrade, Serbia; Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia, Dr Subotica 13, 11000 Belgrade, Serbia
| | - Vera Popovic
- University of Belgrade, School of Medicine, Dr Subotica 8, 11000 Belgrade, Serbia.
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Fleseriu M, Hashim IA, Karavitaki N, Melmed S, Murad MH, Salvatori R, Samuels MH. Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2016; 101:3888-3921. [PMID: 27736313 DOI: 10.1210/jc.2016-2118] [Citation(s) in RCA: 490] [Impact Index Per Article: 61.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To formulate clinical practice guidelines for hormonal replacement in hypopituitarism in adults. PARTICIPANTS The participants include an Endocrine Society-appointed Task Force of six experts, a methodologist, and a medical writer. The American Association for Clinical Chemistry, the Pituitary Society, and the European Society of Endocrinology co-sponsored this guideline. EVIDENCE The Task Force developed this evidence-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned two systematic reviews and used the best available evidence from other published systematic reviews and individual studies. CONSENSUS PROCESS One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, the American Association for Clinical Chemistry, the Pituitary Society, and the European Society of Endocrinology reviewed and commented on preliminary drafts of these guidelines. CONCLUSIONS Using an evidence-based approach, this guideline addresses important clinical issues regarding the evaluation and management of hypopituitarism in adults, including appropriate biochemical assessments, specific therapeutic decisions to decrease the risk of co-morbidities due to hormonal over-replacement or under-replacement, and managing hypopituitarism during pregnancy, pituitary surgery, and other types of surgeries.
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Affiliation(s)
- Maria Fleseriu
- Oregon Health & Science University, Northwest Pituitary Center (M.F.), and Departments of Neurological Surgery and Medicine (Division of Endocrinology, Diabetes, and Clinical Nutrition), Portland, Oregon 97239; Department of Pathology (I.A.H.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Institute of Metabolism and Systems Research (N.K.), College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom; Centre for Endocrinology, Diabetes, and Metabolism (N.K.), Birmingham Health Partners, Birmingham B15 2TH, United Kingdom, Pituitary Center (S.M.), Cedars-Sinai Medical Center, Los Angeles, California 90048; Mayo Clinic Evidence-Based Practice Center, (M.H.M), Rochester, Minnesota 55905; Department of Medicine, Division of Endocrinology and Metabolism (R.S.), Pituitary Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; and Division of Endocrinology, Diabetes, and Clinical Nutrition (M.H.S.), Oregon Health & Science University, Portland, Oregon 97239
| | - Ibrahim A Hashim
- Oregon Health & Science University, Northwest Pituitary Center (M.F.), and Departments of Neurological Surgery and Medicine (Division of Endocrinology, Diabetes, and Clinical Nutrition), Portland, Oregon 97239; Department of Pathology (I.A.H.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Institute of Metabolism and Systems Research (N.K.), College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom; Centre for Endocrinology, Diabetes, and Metabolism (N.K.), Birmingham Health Partners, Birmingham B15 2TH, United Kingdom, Pituitary Center (S.M.), Cedars-Sinai Medical Center, Los Angeles, California 90048; Mayo Clinic Evidence-Based Practice Center, (M.H.M), Rochester, Minnesota 55905; Department of Medicine, Division of Endocrinology and Metabolism (R.S.), Pituitary Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; and Division of Endocrinology, Diabetes, and Clinical Nutrition (M.H.S.), Oregon Health & Science University, Portland, Oregon 97239
| | - Niki Karavitaki
- Oregon Health & Science University, Northwest Pituitary Center (M.F.), and Departments of Neurological Surgery and Medicine (Division of Endocrinology, Diabetes, and Clinical Nutrition), Portland, Oregon 97239; Department of Pathology (I.A.H.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Institute of Metabolism and Systems Research (N.K.), College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom; Centre for Endocrinology, Diabetes, and Metabolism (N.K.), Birmingham Health Partners, Birmingham B15 2TH, United Kingdom, Pituitary Center (S.M.), Cedars-Sinai Medical Center, Los Angeles, California 90048; Mayo Clinic Evidence-Based Practice Center, (M.H.M), Rochester, Minnesota 55905; Department of Medicine, Division of Endocrinology and Metabolism (R.S.), Pituitary Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; and Division of Endocrinology, Diabetes, and Clinical Nutrition (M.H.S.), Oregon Health & Science University, Portland, Oregon 97239
| | - Shlomo Melmed
- Oregon Health & Science University, Northwest Pituitary Center (M.F.), and Departments of Neurological Surgery and Medicine (Division of Endocrinology, Diabetes, and Clinical Nutrition), Portland, Oregon 97239; Department of Pathology (I.A.H.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Institute of Metabolism and Systems Research (N.K.), College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom; Centre for Endocrinology, Diabetes, and Metabolism (N.K.), Birmingham Health Partners, Birmingham B15 2TH, United Kingdom, Pituitary Center (S.M.), Cedars-Sinai Medical Center, Los Angeles, California 90048; Mayo Clinic Evidence-Based Practice Center, (M.H.M), Rochester, Minnesota 55905; Department of Medicine, Division of Endocrinology and Metabolism (R.S.), Pituitary Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; and Division of Endocrinology, Diabetes, and Clinical Nutrition (M.H.S.), Oregon Health & Science University, Portland, Oregon 97239
| | - M Hassan Murad
- Oregon Health & Science University, Northwest Pituitary Center (M.F.), and Departments of Neurological Surgery and Medicine (Division of Endocrinology, Diabetes, and Clinical Nutrition), Portland, Oregon 97239; Department of Pathology (I.A.H.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Institute of Metabolism and Systems Research (N.K.), College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom; Centre for Endocrinology, Diabetes, and Metabolism (N.K.), Birmingham Health Partners, Birmingham B15 2TH, United Kingdom, Pituitary Center (S.M.), Cedars-Sinai Medical Center, Los Angeles, California 90048; Mayo Clinic Evidence-Based Practice Center, (M.H.M), Rochester, Minnesota 55905; Department of Medicine, Division of Endocrinology and Metabolism (R.S.), Pituitary Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; and Division of Endocrinology, Diabetes, and Clinical Nutrition (M.H.S.), Oregon Health & Science University, Portland, Oregon 97239
| | - Roberto Salvatori
- Oregon Health & Science University, Northwest Pituitary Center (M.F.), and Departments of Neurological Surgery and Medicine (Division of Endocrinology, Diabetes, and Clinical Nutrition), Portland, Oregon 97239; Department of Pathology (I.A.H.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Institute of Metabolism and Systems Research (N.K.), College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom; Centre for Endocrinology, Diabetes, and Metabolism (N.K.), Birmingham Health Partners, Birmingham B15 2TH, United Kingdom, Pituitary Center (S.M.), Cedars-Sinai Medical Center, Los Angeles, California 90048; Mayo Clinic Evidence-Based Practice Center, (M.H.M), Rochester, Minnesota 55905; Department of Medicine, Division of Endocrinology and Metabolism (R.S.), Pituitary Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; and Division of Endocrinology, Diabetes, and Clinical Nutrition (M.H.S.), Oregon Health & Science University, Portland, Oregon 97239
| | - Mary H Samuels
- Oregon Health & Science University, Northwest Pituitary Center (M.F.), and Departments of Neurological Surgery and Medicine (Division of Endocrinology, Diabetes, and Clinical Nutrition), Portland, Oregon 97239; Department of Pathology (I.A.H.), University of Texas Southwestern Medical Center, Dallas, Texas 75390; Institute of Metabolism and Systems Research (N.K.), College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom; Centre for Endocrinology, Diabetes, and Metabolism (N.K.), Birmingham Health Partners, Birmingham B15 2TH, United Kingdom, Pituitary Center (S.M.), Cedars-Sinai Medical Center, Los Angeles, California 90048; Mayo Clinic Evidence-Based Practice Center, (M.H.M), Rochester, Minnesota 55905; Department of Medicine, Division of Endocrinology and Metabolism (R.S.), Pituitary Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; and Division of Endocrinology, Diabetes, and Clinical Nutrition (M.H.S.), Oregon Health & Science University, Portland, Oregon 97239
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Pereira-Gurgel VM, Faro ACN, Salvatori R, Chagas TA, Carvalho-Junior JF, Oliveira CRP, Costa UMM, Melo GB, Hellström A, Aguiar-Oliveira MH. Abnormal vascular and neural retinal morphology in congenital lifetime isolated growth hormone deficiency. Growth Horm IGF Res 2016; 30-31:11-15. [PMID: 27552668 DOI: 10.1016/j.ghir.2016.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 07/10/2016] [Accepted: 07/26/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Experimental models demonstrate an important role of GH in retinal development. However, the interactions between GH and the neuro-vascularization of the human retina are still not clear. A model of untreated congenital isolated GH deficiency (IGHD) may clarify the actions of GH on the retina. The purpose of this work was to assess the retinal neuro-vascularization in untreated congenital IGHD (cIGHD). DESIGN In a cross sectional study, we performed an endocrine and ophthalmological assessment of 25 adult cIGHD subjects, homozygous for a null mutation (c.57+1G>A) in the GHRH receptor gene and 28 matched controls. Intraocular pressure measurement, retinography (to assess the number of retinal vascular branching points and the optic disc and cup size), and optical coherence tomography (to assess the thickness of macula) were performed. RESULTS cIGHD subjects presented a more significant reduction of vascular branching points in comparison to controls (91% vs. 53% [p=0.049]). The percentage of moderate reduction was higher in cIGHD than in controls (p=0.01). The percentage of individuals with increased optic disc was higher in cIGHD subjects in comparison to controls (92.9% vs. 57.1%). The same occurred for cup size (92.9% vs. 66.7%), p<0.0001 in both cases. There was no difference in macula thickness. CONCLUSIONS Most cIGHD individuals present moderate reduction of vascular branching points, increase of optic disc and cup size, but have similar thickness of the macula.
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Affiliation(s)
| | - Augusto C N Faro
- Division of Ophthalmology Federal University of Sergipe, Aracaju, SE 49060-100, Brazil
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
| | - Thiago A Chagas
- Division of Ophthalmology Federal University of Sergipe, Aracaju, SE 49060-100, Brazil
| | | | - Carla R P Oliveira
- Division of Endocrinology, Federal University of Sergipe, Aracaju, SE 49060-100, Brazil
| | - Ursula M M Costa
- Division of Endocrinology, Federal University of Sergipe, Aracaju, SE 49060-100, Brazil
| | | | - Ann Hellström
- Sahlgrenska Academy, The Queen Silvia Children's Hospital, Göteborg, Sweden
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49
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Campos VC, Barrios MR, Salvatori R, de Almeida RP, de Melo EV, Nascimento ACS, de Jesus AR, Aguiar-Oliveira MH. Infectious diseases and immunological responses in adult subjects with lifetime untreated, congenital GH deficiency. Endocrine 2016; 54:182-190. [PMID: 27484773 DOI: 10.1007/s12020-016-1061-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 07/12/2016] [Indexed: 12/30/2022]
Abstract
Growth hormone is important for the development and function of the immune system, but there is controversy on whether growth hormone deficiency is associated to immune disorders. A model of isolated growth hormone deficiency may clarify if the lack of growth hormone is associated with increased susceptibility to infections, or with an altered responsiveness of the immune system. We have studied the frequency of infectious diseases and the immune function in adults with congenital, untreated isolated growth hormone deficiency. In a cross-sectional study, 35 adults with isolated growth hormone deficiency due to a homozygous mutation in the growth hormone releasing hormone receptor gene and 31 controls were submitted to a clinical questionnaire, physical examination serology for tripanosomiasis, leishmaniasis, HIV, tetanus, hepatitis B and C, and serum total immunoglobulin G, M, E and A measurement. The immune response was evaluated in a subset of these subjects by skin tests and response to vaccination for hepatitis B, tetanus, and bacillus Calmette-Guérin. There was no difference between the groups in history of infectious diseases and baseline serology. Isolated growth hormone deficiency subjects had lower total IgG, but within normal range. There was no difference in the response to any of the vaccinations or in the positivity to protein Purified Derived, streptokinase or candidin. Adult untreated isolated growth hormone deficiency does not cause an increased frequency of infectious diseases, and does not alter serologic tests, but is associated with lower total IgG levels, without detectable clinical impact.
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Affiliation(s)
- Viviane C Campos
- Federal University of Sergipe, Division of Endocrinology, Aracaju, Sergipe, 49060-100, Brazil
| | - Mônica R Barrios
- Federal University of Sergipe, Division of Immunology and Molecular Biology Laboratory, Aracaju, Sergipe, 49060-100, Brazil
| | - Roberto Salvatori
- Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | - Roque Pacheco de Almeida
- Federal University of Sergipe, Division of Immunology and Molecular Biology Laboratory, Aracaju, Sergipe, 49060-100, Brazil
| | - Enaldo V de Melo
- Federal University of Sergipe, Division of Endocrinology, Aracaju, Sergipe, 49060-100, Brazil
| | - Ana C S Nascimento
- Federal University of Sergipe, Division of Endocrinology, Aracaju, Sergipe, 49060-100, Brazil
| | - Amélia Ribeiro de Jesus
- Federal University of Sergipe, Division of Immunology and Molecular Biology Laboratory, Aracaju, Sergipe, 49060-100, Brazil
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50
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Boguszewski CL, Ayuk J. MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and cancer: an old debate revisited. Eur J Endocrinol 2016; 175:R147-56. [PMID: 27089890 DOI: 10.1530/eje-16-0178] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/11/2016] [Indexed: 12/18/2022]
Abstract
Based on experimental and animal models, epidemiological data from non-acromegaly populations, and longitudinal and cross-sectional cohorts of patients with acromegaly, a potential association between acromegaly and cancer has long been hypothesized, in particular colorectal cancer, and, to a lesser extent, breast, thyroid and prostate cancers. The exact mechanisms underlying this potential association have not been fully elucidated. Results from studies examining cancer incidence and mortality in acromegaly have been inconsistent, with some demonstrating increased risk, whereas others show no increase. This article reviews the existing data relating to cancer risk and mortality in acromegaly, exploring the limitations of study designs and the impact of changes in disease control and patient outcomes over time.
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Affiliation(s)
- Cesar Luiz Boguszewski
- Department of Internal MedicineEndocrine Division (SEMPR), Federal University of Paraná, Curitiba, Brazil
| | - John Ayuk
- Consultant Endocrinologist/Honorary Senior LecturerDepartment of Endocrinology, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK
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