1
|
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.
Collapse
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.
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
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.
Collapse
|
4
|
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.
Collapse
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.
| |
Collapse
|
5
|
Gupta S, Dayal D, Rohit MK, Gawalkar AA, Raj KM, Attri SV, Sachdeva N, Kaur H. Comprehensive assessment of cardiovascular disease risk in children with short stature due to isolated growth hormone deficiency: a case-control study. J Pediatr Endocrinol Metab 2022; 35:1059-1068. [PMID: 35822711 DOI: 10.1515/jpem-2021-0693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 06/16/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Growth hormone deficiency (GHD) in adults is associated with an increased risk of cardiovascular morbidity and mortality. Although children with GHD are also believed to have a similar cardiovascular disease (CVD) risk beginning at an early age, the available data in children is scarce. We aimed to determine the various CVD risk parameters in children with isolated GHD (IGHD). METHODS A cross-sectional case-control study was conducted at a tertiary care centre in North India comparing various auxological, biochemical, and echocardiographic parameters between 20 IGHD children aged 5-15 years and their age and sex-matched healthy controls. RESULTS The mean age of children with IGHD and controls was similar (10.5 ± 2.6 yr vs. 9.9 ± 2.7 yr, p=0.48). Children with IGHD had significantly higher waist-hip-ratio (p=0.01), total cholesterol (p=0.02), non-high-density lipoprotein-cholesterol (p=0.02), serum homocysteine (p<0.001), C-reactive protein (CRP) (p=0.01) and pro-brain natriuretic peptide (pro-BNP) (p=0.04) levels as compared to healthy controls. Left ventricular mass (LVM) and interventricular septal thickness were significantly lower (p=0.04; p=0.02) in IGHD children. Correlation analysis showed that pro-BNP and CRP levels had negative correlation (p<0.001, r=-0.70; and p=0.04, r=-0.44, respectively) and LVM had a positive correlation (p=0.02, r=0.53) with height SDS among IGHD children. CONCLUSIONS Children with IGHD showed abnormalities in several biochemical and cardiac parameters that may be associated with an increased CVD risk in later life. More extensive studies, including younger children with IGHD, are needed to determine the lower ages at which the CVD risk is detectable.
Collapse
Affiliation(s)
- Saniya Gupta
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Devi Dayal
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manoj Kumar Rohit
- Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Atit A Gawalkar
- Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kumar Manish Raj
- Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Savita Verma Attri
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Harvinder Kaur
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
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.
Collapse
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
| | | |
Collapse
|
8
|
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.
Collapse
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.
| |
Collapse
|
9
|
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: 15] [Impact Index Per Article: 5.0] [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.
Collapse
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
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Basu R, Kopchick JJ. The effects of growth hormone on therapy resistance in cancer. CANCER DRUG RESISTANCE (ALHAMBRA, CALIF.) 2019; 2:827-846. [PMID: 32382711 PMCID: PMC7204541 DOI: 10.20517/cdr.2019.27] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pituitary derived and peripherally produced growth hormone (GH) is a crucial mediator of longitudinal growth, organ development, metabolic regulation with tissue specific, sex specific, and age-dependent effects. GH and its cognate receptor (GHR) are expressed in several forms of cancer and have been validated as an anti-cancer target through a large body of in vitro, in vivo and epidemiological analyses. However, the underlying molecular mechanisms of GH action in cancer prognosis and therapeutic response had been sparse until recently. This review assimilates the critical details of GH-GHR mediated therapy resistance across different cancer types, distilling the therapeutic implications based on our current understanding of these effects.
Collapse
Affiliation(s)
- Reetobrata Basu
- Ohio University Heritage College of Osteopathic Medicine (OU-HCOM), Ohio University, Athens, OH 45701, USA.,Edison Biotechnology Institute, Ohio University, Athens, OH 45701, USA
| | - John J Kopchick
- Ohio University Heritage College of Osteopathic Medicine (OU-HCOM), Ohio University, Athens, OH 45701, USA.,Edison Biotechnology Institute, Ohio University, Athens, OH 45701, USA
| |
Collapse
|
12
|
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.
Collapse
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
| | | |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
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.
Collapse
Affiliation(s)
| | - Andrzej Bartke
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois
| |
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
Abstract
The interrelationships of growth hormone (GH) actions and aging are complex and incompletely understood. The very pronounced age-related decline in GH secretion together with benefits of GH therapy in individuals with congenital or adult GH deficiency (GHD) prompted interest in GH as an anti-aging agent. However, the benefits of treatment of normal elderly subjects with GH appear to be marginal and counterbalanced by worrisome side effects. In laboratory mice, genetic GH deficiency or resistance leads to a remarkable extension of longevity accompanied by signs of delayed and/or slower aging. Mechanisms believed to contribute to extended longevity of GH-related mutants include improved anti-oxidant defenses, enhanced insulin sensitivity and reduced insulin levels, reduced inflammation and cell senescence, major shifts in mitochondrial function and energy metabolism, and greater stress resistance. Negative association of the somatotropic signaling and GH/insulin-like growth factor 1 (IGF-1)-dependent traits with longevity has also been shown in other mammalian species. In humans, syndromes of GH resistance or deficiency have no consistent effect on longevity, but can provide striking protection from cancer, diabetes and atherosclerosis. More subtle alterations in various steps of GH and IGF-1 signaling are associated with reduced old-age mortality, particularly in women and with improved chances of attaining extremes of lifespan. Epidemiological studies raise a possibility that the relationship of IGF-1 and perhaps also GH levels with human healthy aging and longevity may be biphasic. However, the impact of somatotropic signaling on neoplastic disease is difficult to separate from its impact on aging, and IGF-1 levels exhibit opposite associations with different chronic, age-related diseases.
Collapse
Affiliation(s)
- Andrzej Bartke
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA.
| | - Justin Darcy
- Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA; Department of Medical Microbiology, Immunology and Cell Biology, Southern Illinois School of Medicine, Springfield, IL, USA
| |
Collapse
|