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Lim DW, Lee C. The Effects of Natural Product-Derived Extracts for Longitudinal Bone Growth: An Overview of In Vivo Experiments. Int J Mol Sci 2023; 24:16608. [PMID: 38068932 PMCID: PMC10706747 DOI: 10.3390/ijms242316608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/20/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Approximately 80% of children with short stature are classified as having Idiopathic Short Stature (ISS). While growth hormone (GH) treatment received FDA approval in the United States in 2003, its long-term impact on final height remains debated. Other treatments, like aromatase inhibitors, metformin, and insulin-like growth factor-1 (IGF-1), have been explored, but there is no established standard treatment for ISS. In South Korea and other Asian countries, East Asian Traditional Medicine (EATM) is sometimes employed by parents to potentially enhance their children's height growth, often involving herbal medicines. One such product, Astragalus membranaceus extract mixture HT042, claims to promote height growth in children and has gained approval from the Korean Food and Drug Administration (KFDA). Research suggests that HT042 supplementation can increase height growth in children without skeletal maturation, possibly by elevating serum IGF-1 and IGF-binding protein-3 levels. Preclinical studies also indicate the potential benefits of natural products, including of EATM therapies for ISS. The purpose of this review is to offer an overview of bone growth factors related to ISS and to investigate the potential of natural products, including herbal preparations, as alternative treatments for managing ISS symptoms, based on their known efficacy in in vivo studies.
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Affiliation(s)
| | - Changho Lee
- Division of Functional Food Research, Korea Food Research Institute, Wanju 55365, Republic of Korea;
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Luo X, Zhao S, Yang Y, Dong G, Chen L, Li P, Luo F, Gong C, Xu Z, Xu X, Gong H, Du H, Hou L, Zhong Y, Shi Q, Chen X, Chen X, Xu L, Cheng R, Su C, Ma Y, Xu L, Zhang L, Lu H. Long-acting PEGylated growth hormone in children with idiopathic short stature. Eur J Endocrinol 2022; 187:709-718. [PMID: 36130048 DOI: 10.1530/eje-22-0449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/21/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the safety and efficacy of weekly PEGylated-recombinant human growth hormone (PEG-rhGH) in children with idiopathic short stature (ISS) in China. DESIGN AND METHODS This was a multicenter, phase II study in which all subjects were randomized 1:1:1 to weekly s.c. injections of PEG-rhGH 0.1 (low-dose (LD) group) or 0.2 mg/kg/week (high-dose (HD) group) or control for 52 weeks. The primary end point was change (Δ) in height s.d. score (HT-SDS) from baseline to week 52. Secondary end points were height velocity (HV), bone maturity, insulin-like growth factor-1 (IGF-1) SDS, and IGF-1/insulin-like growth factor-binding protein-3 (IGFBP-3) molar ratio. RESULTS A total of 360 children with ISS were recruited in the study (n = 120 in each group). At week 52, ΔHT-SDS was 0.56 ± 0.26, 0.98 ± 0.35, and 0.20 ± 0.26 in the LD, HD, and control groups, respectively (within-group P < 0.0001; intergroup P < 0.0001). Statistically significant values of ΔHV, IGF-1, IGF-1/IGFBP-3 ratio, and IGF-1 SDS at week 52 from baseline were observed in both treatment groups (P < 0.0001). There were clear dose-dependent responses for all auxological variables. PEG-rhGH was well tolerated throughout the treatment period with treatment-emergent adverse events (TEAEs) reported in 86.5%, 84.6%, and 91.3% of children in the HD, LD, and control groups, respectively. The incidence of TEAEs was similar in all treatment groups despite the difference in doses. A total of 27 (8.7%) children experienced drug-related TEAEs. CONCLUSION Fifty-two-week treatment with PEG-rhGH 0.1 or 0.2 mg/kg/week achieved significant improvement in HT-SDS and other growth-related variables, including HV, IGF-1 SDS, and IGF-1/IGFBP-3 ratio, in a dose-dependent manner. Both doses were well tolerated with similar safety profiles.
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Affiliation(s)
- Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Sha Zhao
- Children's Health Center, Hunan Children's Hospital, Changsha, Hunan, China
| | - Yu Yang
- Department of Endocrinology, Genetics, and Metabolism, Jiangxi Provincial Children's Hospital, Nanchang, Jiangxi, China
| | - Guanping Dong
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Linqi Chen
- Department of Endocrinology, Genetics, and Metabolism, Children's Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Pin Li
- Department of Medical Genetics and Endocrinology, Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Children's Hospital, Shanghai, China
| | - Feihong Luo
- Department of Pediatric Endocrinology, Children's Hospital of Fudan University, Shanghai, China
| | - Chunxiu Gong
- Department of Endocrinology, Genetics, and Metabolism, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Zhuangjian Xu
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Xu Xu
- Department of Pediatric Endocrinology, Wuxi Children's Hospital, Wuxi, Jiangsu, China
| | - Haihong Gong
- Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongwei Du
- Department of Pediatric Endocrinology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ling Hou
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Yan Zhong
- Children's Health Center, Hunan Children's Hospital, Changsha, Hunan, China
| | - Qiao Shi
- Department of Endocrinology, Genetics, and Metabolism, Jiangxi Provincial Children's Hospital, Nanchang, Jiangxi, China
| | - Xuefeng Chen
- Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiuli Chen
- Department of Endocrinology, Genetics, and Metabolism, Children's Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Liya Xu
- Department of Medical Genetics and Endocrinology, Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Children's Hospital, Shanghai, China
| | - Ruoqian Cheng
- Department of Pediatric Endocrinology, Children's Hospital of Fudan University, Shanghai, China
| | - Chang Su
- Department of Endocrinology, Genetics, and Metabolism, Beijing Children's Hospital, Capital Medical University, National Centre for Children's Health, Beijing, China
| | - Yaping Ma
- Department of Pediatrics, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Lulian Xu
- Department of Pediatric Endocrinology, Wuxi Children's Hospital, Wuxi, Jiangsu, China
| | - Lina Zhang
- Department of Pediatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Honghua Lu
- Department of Pediatric Endocrinology, The First Hospital of Jilin University, Changchun, Jilin, China
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