Deficiency of Growth Hormone-Releasing Hormone
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The Endocrine System Brightside July, 2019 by Dr
The Endocrine System Brightside July, 2019 By Dr. Derek Conte How does the body regulate and balance itself from minute to minute, hour to hour and month to month? What is it that allows the food we eat to be utilized for growth, healing and energy? What causes the female egg to drop each month or a mother’s milk to flow? The answer is the endocrine system, which is comprised of the hypothalamus, pituitary gland, pineal gland, thyroid and parathyroid glands, thymus gland, the adrenals, pancreas, ovaries and testes. The brain signals these specialized glands to release hormones to initiate essential chemical actions that sustain life. The word “endocrine” literally means “to cry inside” and that is exactly what happens when the endocrine system works. An example is growth hormone (GH) or somatotropin, responsible for growth and tissue repair. During exercise or when we have low blood sugar or high blood amino acid levels, the hypothalamus leaks (“cries”) growth hormone releasing hormone (GHRH) through very small vessels into the anterior pituitary gland which then leaks growth hormone into the general circulation, acting on cells for growth or replacement of old or damaged tissues. Pro ballplayers looking for an edge have been using growth hormone. The hormone that shuts this process off is called growth hormone inhibiting hormone (GHIH) or somatostatin (“growth stop”), released when blood sugar levels are high. If there ever is an excess of growth hormone, it can result in gigantism or acromegaly depending on whether its onset occurred before or after the growth plates in the bones have closed around the age of 17. -
Growth Hormone Booklet
GROWTH HORMONE AND PRADER-WILLISECOND EDITION SYNDROME A REFerence For FaMILies and Care ProViders Donald G. Goranson, Jr., Editor Growth Hormone and Prader-Willi Syndrome — Second Edition Published By: Prader-Willi Syndrome Association (Usa) 8588 Potter Park Drive, Suite 500 Sarasota, Florida 34238 Toll Free: 800-926-4797 Local: 941-312-0400 Fax: 941-312-0142 www.pwsausa.org © Copyright 2011 A Reference for Families and Care Providers Growth HORMONE AND PraderSECOND-WILLI EDITION Syndrome A REFerence For FaMILies and Care ProViders Donald G. Goranson, Jr., Editor Growth Hormone and Prader-Willi Syndrome — Second Edition A Reference for Families and Care Providers CONTENTS Acknowledgments....................................................................... 5 Introduction and History .............................................................. 7 Prader-Willi Syndrome and Growth ...................................................... 9 Effects of Growth Hormone Treatment in Children with PWS ................................ 20 What Is Involved in Growth Hormone Treatment? .......................................... 26 Questions, Wisdom and Survey Data from our Families ..................................... 34 Appendix: A. Overview of Prader-Willi Syndrome................................................ 40 B. Information Resources on Prader-Willi Syndrome .................................... 42 C. Information Resources on Growth Hormone Use and Products ........................ 43 D. Glossary of Terms ............................................................ -
Growth and Growth Hormone I
Pediat. Res. 2: 43-63 (1968) Dwarfism, constitutional hypoglycemia dwarfism, psychosocial insulin gonadal dysgenesis maternal depriva- growth hormone tion syndrome growth retardation panhypopituitarism Growth and Growth Hormone I. Changes in Serum Level of Growth Hormone Following Hypoglycemia in 134 Children with Growth Retardation S.L.KAPLAN, C.A.L.ABRAMS, J.J.BELL, F.A.CONTE and M.M.GRUMBACH[41] Department of Pediatrics, University of California, San Francisco Medical Center, San Francisco, California, and College of Physicians and Surgeons, Columbia University, New York, New York, USA Extract The change in levels of growth hormone in serum (SGH) following insulin-induced hypoglycemia was evaluated in 134 prepubertal children with growth retardation and 10 control subjects with normal growth patterns by radioimmunoassay, utilizing 131I-HGH and rabbit antiserum to human growth hormone. Mean maximum growth hormone concentration (m^g/ml) at any time during the test was: 10 Control subjects 12.4 53 Hypopituitarism 2.5 m^g or less in 52/53 20 Constitutional shortness of stature 12.5 22 Primordial dwarfism 12.1 9 XO gonadal dysgenesis 13.4 5 Delayed adolescence 11.8 5 Maternal deprivation 16.7 9 Psychosocial dwarfism 10.9 11 Miscellaneous disorders 7.0 Among factors found to affect the SGH response to insulin-induced hypoglycemia were: a) elevated fasting concentration of SGH which appeared to alter the responsiveness to stimulation; and b) age. The mean maximum SGH concentration of the control subjects following insulin-induced hypo- glycemia was 12.4 m^Mg/ml. In 52/53 patients with hypopituitarism, the SGH concentration was 1 m/*g or less at rest, with no increase or an increase to a maximum of 2.5 m^Mg/ml following hypoglycemia. -
HORMONES and SPORT Insulin, Growth Hormone and Sport
13 HORMONES AND SPORT Insulin, growth hormone and sport P H Sonksen Guy’s, King’s and St Thomas’ School of Medicine, St Thomas’ Hospital, London SE1 7EH, UK; Email: [email protected] Abstract This review examines some interesting ‘new’ histories of blood rather than urine samples. The first method has a insulin and reviews our current understanding of its window of opportunity lasting about 24 h after an injec- physiological actions and synergy with GH in the regu- tion and is most suitable for ‘out of competition’ testing. lation of metabolism and body composition. It reviews the The second method has reasonable sensitivity for as long as history of GH abuse that antedates by many years the 2 weeks after the last injection of GH and is uninfluenced awareness of endocrinologists to its potent anabolic actions. by extreme exercise and suitable for post-competition Promising methods for detection of GH abuse have been samples. This method has a greater sensitivity in men than developed but have yet to be sufficiently well validated to in women. The specificity of both methods seems accept- be ready for introduction into competitive sport. So far, ably high but lawyers need to decide what level of there are two promising avenues for detecting GH abuse. scientific probability is needed to obtain a conviction. Both The first uses immunoassays that can distinguish the methods need further validation before implementation. isomers of pituitary-derived GH from the monomer of Research work carried out as part of the fight against recombinant human GH. The second works through doping in sport has opened up a new and exciting area of demonstrating circulating concentrations of one or more endocrinology. -
Regulatory Mechanisms of Somatostatin Expression
International Journal of Molecular Sciences Review Regulatory Mechanisms of Somatostatin Expression Emmanuel Ampofo * , Lisa Nalbach, Michael D. Menger and Matthias W. Laschke Institute for Clinical & Experimental Surgery, Saarland University, 66421 Homburg/Saar, Germany; [email protected] (L.N.); [email protected] (M.D.M.); [email protected] (M.W.L.) * Correspondence: [email protected]; Tel.: +49-6841-162-6561; Fax: +49-6841-162-6553 Received: 25 May 2020; Accepted: 9 June 2020; Published: 11 June 2020 Abstract: Somatostatin is a peptide hormone, which most commonly is produced by endocrine cells and the central nervous system. In mammals, somatostatin originates from pre-prosomatostatin and is processed to a shorter form, i.e., somatostatin-14, and a longer form, i.e., somatostatin-28. The two peptides repress growth hormone secretion and are involved in the regulation of glucagon and insulin synthesis in the pancreas. In recent years, the processing and secretion of somatostatin have been studied intensively. However, little attention has been paid to the regulatory mechanisms that control its expression. This review provides an up-to-date overview of these mechanisms. In particular, it focuses on the role of enhancers and silencers within the promoter region as well as on the binding of modulatory transcription factors to these elements. Moreover, it addresses extracellular factors, which trigger key signaling pathways, leading to an enhanced somatostatin expression in health and disease. Keywords: somatostatin; pre-prosomatostatin; δ-cells; central nervous system (CNS); gut; hypothalamus; cAMP resonse element (CRE); pancreas/duodenum homeobox protein (PDX)1; paired box protein (PAX)6; growth hormone (GH); brain-derived neurotrophic factor (BDNF); glutamateric system; pancreas 1. -
Hypothalamic-Pituitary Axes
Hypothalamic-Pituitary Axes Hypothalamic Factors Releasing/Inhibiting Pituitary Anterior Pituitary Hormones Circulating ACTH PRL GH Hormones February 11, 2008 LH FSH TSH Posterior Target Pituitary Gland and Hormones Tissue Effects ADH, oxytocin The GH/IGF-I Axis Growth Hormone Somatostatin GHRH Hypothalamus • Synthesized in the anterior lobe of the pituitary gland in somatotroph cells PITUITARY • ~75% of GH in the pituitary and in circulation is Ghrelin 191 amino acid single chain peptide, 2 intra-molecular disulfide bonds GH Weight; 22kD • Amount of GH secreted: IGF-I Women: 500 µg/m2/day Synthesis IGF- I Men: 350 µg/m2/day LIVER Local IGF-I Synthesis CIRCULATION GH Secretion: Primarily Pulsatile Pattern of GH Secretion Regulation by two hypothalamic in a Healthy Adult hormones 25 Sleep 20 Growth - SMS Hormone 15 Somatostatin Releasing GHRH + GH (µg/L) Hormone Inhibitory of 10 Stimulatory of GH Secretion GH Secretion 05 0 GHRH induces GH Somatostatin: Decreases to allow 0900 2100 0900 synthesis and secretion Clocktime GH secretory in somatotrophs Bursts GH From: “Acromegaly” by Alan G. Harris, M.D. 1 Other Physiological Regulators of GH Secretion Pharmacologic Agents Used to Stimulate GH Secretion Amino Sleep Exercise Stress Acids Fasting Glucose Stimulate hypothalamic GHRH or Inhibit Somatostatin Hypothalamus GHRH SMS Hypoglycemia(Insulin) Pituitary L-dopa Arginine Clonidine GHRH + - SMS Pyridostigmine GH Target Tissues Metabolic & Growth Promoting GH Effects IGF-I Insulin-like growth factor I (IGF-I) Major Determinants of Circulating -
Dwarfism Awareness
LPA Mission Statement LPA is dedicated to improving the quality of life for people with dwarfism throughout their lives, while celebrating with great pride little people’s contribution to social diversity. LPA strives to bring solutions and global For More Information awareness to the prominent issues affecting individuals of Contact LPA short stature and their families. Toll Free…(888) LPA-2001 Direct....(714) 368-3689 Fax…..(707) 721-1896 Dwarfism Check out our website at Awareness www.lpaonline.org A Community Outreach Program 617 Broadway #518 Sponsored by Little People of America Sonoma, CA 95476 LPA is a non-profit tax exempt 501(c)3 organization funded by individual donations. Contact LPA to help. Dwarfism - Facts and Fiction Mythbusters Terminology Bodies come in all shapes and sizes. There are about 400 People with dwarfism are not magical; they do not fly, nor are Preferred terminology is a personal decision, but different types of dwarfism. Each type of dwarfism is they leprechauns, elves, fairies or any other mythological commonly accepted terms are - short stature, different than the other. Many types of dwarfism have creature. They are people - people whose bones happen to dwarfism, little person, dwarf. And we say some medical complications but most people have an grow differently than yours. That is all. "average-height" instead of "normal height". average lifespan, being productive members of society. People with dwarfism do not all know each People with dwarfism are different, yes, but not Eighty percent of people with dwarfism have average- other or look alike, nor are there towns "abnormal". height parents and siblings. -
Plasma Somatostatin and Cholecystokinin Levels in Preterm Infants and Their Mothers at Birth
0031-399819513706-0771$03.0010 PEDIATRIC RESEARCH Vol. 37, No. 6, 1995 Copyright O 1995 International Pediatric Research Foundation, Inc Printed in U.S.A. Plasma Somatostatin and Cholecystokinin Levels in Preterm Infants and Their Mothers at Birth C.-J. TORNHAGE, F. SERENIUS, K. UVNAS-MOBERG,AND T. LINDBERG Department of Pediatrics, UmeB University, UmeB [C.-J.T., F.S., T.L.] and Department of Pharmacology, Karolinska Institute, Stockholm, Sweden [K. U-M.] Regulatory gut peptides play an important role in regulating same. They were also independent of sex, birth weight, gesta- the gastrointestinal tract. Our knowledge about the pattern of tional age, umbilical cord blood pH, or glucose level. In mothers, secretion and function of these peptides is scanty in preterm but not in infants, plasma SS levels were higher after vaginal infants. Therefore, plasma somatostatin (SS) and cholecystokinin delivery than after cesarean section. After multiple birth, new- (CCK) levels were estimated just after birth in 65 mothers and 73 born plasma SS, but not plasma CCK, was significantly lower preterm infants (umbilical cord blood). The gestational age was than after single birth (9.1 + 7.7 versus 16.9 2 12.7 pmol/L). 32 (24-36 median ranges) wk and birth weight 1900 (475-3350) (Pediatr Res 37: 771-776, 1995) g. The umbilical cord blood pH was 7.32 + 0.10 (mean t- SD). After Sep-Pak-C,, semichromatography of plasma, SS and CCK Abbreviations were analyzed by RIA. Both plasma SS and CCK levels were SS, somatostatin significantly higher in infants than in mothers (SS = 14.5 i. -
Influence of the Endocrine System on Growth and Development R
331. INFLUENCE OF THE ENDOCRINE SYSTEM ON GROWTH AND DEVELOPMENT R. J. GERRITS A. R. S., U. S. D. A. Introduction The field of endocrinology cannot be defined in a manner entirely acceptable to all biologists or animal scientists. This is understandable as there are many points of view and many voids in our knowledge in this area. It is very hard to give a precise definition for an endocrine gland because all cells possess some secretory capacity and therefore contribute to the internal environment of the organism. For the most part the term "hormone" is probably applied too loosely and to a great variety of unrelated substances. Hormones can be identified as chemical agents which are synthesized by circumscribed parts of the body, generally specialized ductless glands, and are carried by the circulatory system to another part of the body where they evoke systemic adjustments by acting on rather specific target tissues or organs (Turner, 1966). In general, hormones regulate many processes such as growth, regeneration, reproduction, blood chemistry, metabolic rate, etc. Hormones act on the organs and tissues of the body by regulating the rate of specific metabolic reactions without contributing much at all to the constituent cell. It can be said that ad- justments to hormone levels require duration rather than speed, as opposed to the rapid coordinations of the body that are controlled by the nervous system. These biochemical adjustments are accomplished at the cellular level by virtue of their power to augwnt or restrain special enzyme sys- tems. It is important that hormones be released at the right time and in the proper amounts of the normal organism if they are to accomplish their specific mission. -
MECHANISMS in ENDOCRINOLOGY: Novel Genetic Causes of Short Stature
J M Wit and others Genetics of short stature 174:4 R145–R173 Review MECHANISMS IN ENDOCRINOLOGY Novel genetic causes of short stature 1 1 2 2 Jan M Wit , Wilma Oostdijk , Monique Losekoot , Hermine A van Duyvenvoorde , Correspondence Claudia A L Ruivenkamp2 and Sarina G Kant2 should be addressed to J M Wit Departments of 1Paediatrics and 2Clinical Genetics, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, Email The Netherlands [email protected] Abstract The fast technological development, particularly single nucleotide polymorphism array, array-comparative genomic hybridization, and whole exome sequencing, has led to the discovery of many novel genetic causes of growth failure. In this review we discuss a selection of these, according to a diagnostic classification centred on the epiphyseal growth plate. We successively discuss disorders in hormone signalling, paracrine factors, matrix molecules, intracellular pathways, and fundamental cellular processes, followed by chromosomal aberrations including copy number variants (CNVs) and imprinting disorders associated with short stature. Many novel causes of GH deficiency (GHD) as part of combined pituitary hormone deficiency have been uncovered. The most frequent genetic causes of isolated GHD are GH1 and GHRHR defects, but several novel causes have recently been found, such as GHSR, RNPC3, and IFT172 mutations. Besides well-defined causes of GH insensitivity (GHR, STAT5B, IGFALS, IGF1 defects), disorders of NFkB signalling, STAT3 and IGF2 have recently been discovered. Heterozygous IGF1R defects are a relatively frequent cause of prenatal and postnatal growth retardation. TRHA mutations cause a syndromic form of short stature with elevated T3/T4 ratio. Disorders of signalling of various paracrine factors (FGFs, BMPs, WNTs, PTHrP/IHH, and CNP/NPR2) or genetic defects affecting cartilage extracellular matrix usually cause disproportionate short stature. -
Laron Syndrome
Laron syndrome Description Laron syndrome is a rare form of short stature that results from the body's inability to use growth hormone, a substance produced by the brain's pituitary gland that helps promote growth. Affected individuals are close to normal size at birth, but they experience slow growth from early childhood that results in very short stature. If the condition is not treated, adult males typically reach a maximum height of about 4.5 feet; adult females may be just over 4 feet tall. Other features of untreated Laron syndrome include reduced muscle strength and endurance, low blood sugar levels (hypoglycemia) in infancy, small genitals and delayed puberty, hair that is thin and fragile, and dental abnormalities. Many affected individuals have a distinctive facial appearance, including a protruding forehead, a sunken bridge of the nose (saddle nose), and a blue tint to the whites of the eyes (blue sclerae). Affected individuals have short limbs compared to the size of their torso, as well as small hands and feet. Adults with this condition tend to develop obesity. However, the signs and symptoms of Laron syndrome vary, even among affected members of the same family. Studies suggest that people with Laron syndrome have a significantly reduced risk of cancer and type 2 diabetes. Affected individuals appear to develop these common diseases much less frequently than their unaffected relatives, despite having obesity (a risk factor for both cancer and type 2 diabetes). However, people with Laron syndrome do not seem to have an increased lifespan compared with their unaffected relatives. Frequency Laron syndrome is a rare disorder. -
Fibrochondrogenesis
Fibrochondrogenesis Description Fibrochondrogenesis is a very severe disorder of bone growth. Affected infants have a very narrow chest, which prevents the lungs from developing normally. Most infants with this condition are stillborn or die shortly after birth from respiratory failure. However, some affected individuals have lived into childhood. Fibrochondrogenesis is characterized by short stature (dwarfism) and other skeletal abnormalities. Affected individuals have shortened long bones in the arms and legs that are unusually wide at the ends (described as dumbbell-shaped). People with this condition also have a narrow chest with short, wide ribs and a round and prominent abdomen. The bones of the spine (vertebrae) are flattened (platyspondyly) and have a characteristic pinched or pear shape that is noticeable on x-rays. Other skeletal abnormalities associated with fibrochondrogenesis include abnormal curvature of the spine and underdeveloped hip (pelvic) bones. People with fibrochondrogenesis also have distinctive facial features. These include prominent eyes, low-set ears, a small mouth with a long upper lip, and a small chin ( micrognathia). Affected individuals have a relatively flat-appearing midface, particularly a small nose with a flat nasal bridge and nostrils that open to the front rather than downward (anteverted nares). Vision problems, including severe nearsightedness (high myopia) and clouding of the lens of the eye (cataract), are common in those who survive infancy. Most affected individuals also have sensorineural hearing loss, which is caused by abnormalities of the inner ear. Frequency Fibrochondrogenesis appears to be a rare disorder. About 20 affected individuals have been described in the medical literature. Causes Fibrochondrogenesis can result from mutations in the COL11A1 or COL11A2 gene.