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This book addresses a wide range of basic and clinical issues in the physiology and pharmacology of growth hormone. The volume is organized like a textbook. It begins with factors contributing to GH gene expression, the functional relationships of the GH receptor, molecular biological analysis of the GH-GH receptor complex and proceeds to describe the insulin-like growth factor axis. Transgenic models are discussed for analysis of discrete effects. These discussions provide a bridge to clinically oriented discussions of growth abnormalities in GH deficient children, GH insensitivity due to deficiency of the GH receptor, and the concept of aging as a GH/IGF-I deficiency state. Discussions also include the immune system as a source and a responder to GH, GHRH, IGF-I and the effects of GH excess.
This revised new edition reviews the substantial advances in our understanding of the vital role of growth hormone (GH) in maintaining adult health, and the resulting disorders from GH deficiency. The first edition, published in 1996, provided a pioneering overview of the subject; this new edition provides an even more comprehensive account, fully updated with the latest research, clinical applications, and references. The therapeutic benefits of GH treatment in GH deficiency are thoroughly evaluated, including effects on metabolism, cardiac function, exercise performance, psychosocial aspects, and aging and gender-specific effects. This compilation by the world's leading experts covers clinical investigation, diagnosis and treatment issues, and encompasses new knowledge of the control and action of GH secretion. This volume is the most authoritative, comprehensive, and detailed account available and will be an essential source of reference for all endocrinologists.
Breaking new ground in terms of scientific analysis, this book addresses the question of who benefits most from treatment with recombinant human growth hormone. Outlined at the beginning of this book are the principles of evidence-based medicine along with a critical appraisal of the statistical issues that lie at the center of growth hormone trials. Each chapter reviews the current state of knowledge on the use of growth hormone in conditions ranging from Turner syndrome through other syndromes of intrauterine growth retardation to the short normal child, also highlighting issues that remain to be addressed in further research. Evaluating therapies in terms of efficacy and safety or the health benefit for the individual or society as a whole are rarely approached in pediatric endocrinology and for this reason a special chapter on health economic evaluation is included. This book is of interest and offers practical help to pediatricians and endocrinologists.
In this era of proliferation of synthetic growth hormone in the marketplace, there is a parallel and accentuated interest in growth hormone in the scientific arena. Because many more people can be treated with available growth hormone, clinicians must be prepared to answer hard questions regarding appropriate therapeutic usage and their decisions should be based on substantiated research in growth hormone. In June 1987, an international group of basic and clinical inves tigators gathered in Tampa, Florida, to address these issues and to further explore the very nature of growth hormone. The presentations contained within this book bring together their most current and vital research related to growth hormone. Section I deals with an examination of the molecular and biochemical events which define the growth hormone process. In Section II the neuroregulation of growth hormone secretion is highlighted from contrasting perspectives. The third section emphasizes and defines methods of diagnosis of growth hormone deficiency states. Section IV reviews the physiology, biochemistry and molecular actions of growth hormone and somatomedin. Section V represents an assessment of growth hormone treatment for various disorders, and the sixth section expands current uses of growth hormone therapy as it evolves into the next decade. The symposium upon which this book is based proved to be a dynamic blending of scholarly interaction between basic and clinical scientists. I am indebted to the participants whose worthy contributions are reflected in these pages.
Human Growth Hormone is a compendium of papers that discusses all aspects of human growth hormone (HGH) relevant in the treatment of dwarfs who are HGH deficient. This book discusses the approach of growth hormone treatment including the preparation of the hormone, its effect and interactions with other hormones, the methods used to detect growth hormone in human plasma, as well as its clinical applications. One author discusses the preparation of human growth hormone, its storage, method of bioassay, and procedures for ampouling HGH for clinical use. A couple of authors review the metabolic a ...
Gigantism and Acromegaly brings together pituitary experts, taking readers from bench research, to genetic analysis, clinical analysis, and new therapeutic approaches. This book serves as a reference for growth hormone over-secretion and its diagnosis and treatment for endocrinologists, pediatricians, internists, and neurosurgeons, and for geneticists. Pharmaceutical companies may use it as a reference for drug development and research. Students, residents and fellows in medicine and endocrinology and genetics will also find it valuable as it provides a single up-to-date review of the molecular biology of gigantism and acromegaly as well as recommended approaches to evaluation and management. Acromegaly is a rare pituitary disorder that slowly changes its adult victim’s appearance over time: larger hands and feet, bigger jaw, forehead, nose, and lips. Generally, a benign pituitary tumor is the cause and symptoms of acromegaly can vary from patient to patient, making a diagnosis difficult and prolonging suffering for years. Early detection is key in the management of acromegaly as the pathologic effects of increased growth hormone (GH) production are progressive and can be life-threatening as the result of associated cardiovascular, cerebrovascular, and respiratory disorders and malignancies. Accessible, up-to-date overview of the characteristics, state-of-the-art diagnostic procedures, and management of acromegaly and gigantism Provides a unique compendium of endocrinology, genetics, clinical diagnosis and therapeutics Contains contributions from internationally known experts who have treated patients with acromegaly and gigantism
The traditional concept of a neuroendocrine mechanism for regulation of growth hormone (GH) secretion is based in large part on the work of Roger Guillemin. The work of Dr. Guillemin, who was awarded the 1977 Nobel Prize in Physiology and Medicine, supported the view that quantita tive change in GH secretion was the net result of pituitary stimulation and inhibition by the hypothalamic neurohormones, GH releasing hormone (GHRH), and somatostatin (somatotropin release inhibiting factor; SRIF), respectively. During the 1970s, another endocrine research pioneer, Dr. Cyril Bowers, discovered that structural modification of enkephalin re sulted in a family of peptides with GH releasing properties. These com pounds, simply called GH releasing peptide (GHRP), were originally thought to mimic GHRH. However, upon subsequent investigation they were found to supplement the activity of the natural hormone through a different mechanism. Nearly two decades after their discovery, the differ ences between GHRP and GHRH have been described by many different laboratories throughout the world. The complementary GH secretagogues have different binding sites, second messengers, and effects on gene expres sion. Based on these differences, it has been suggested that expansion of the original two hormone mechanisms for GH regulation to include a third molecule may be appropriate, even though the naturally occurring ana logue of GHRP has not yet been identified. Despite our lack of knowledge concerning the natural product mimicked by GHRP, clinical development of the new family of GH secretagogues for diagnostic and therapeutic purposes has begun in earnest.
The authors have provided an overview of the relationships between hormones that are physiologic constituents of the body as well as their pharmacologic use in replacement therapies and related endocrine dys function. Principles of Endocrine Pharmacology concerns itself with the ther apeutic use of hormones, and hormone like substances, or drugs that can act either by suppressing or enhancing the metabolism of certain glands of internal secretion. Other drugs used for nonendocrine ther apies can likewise affect the endocrine system. Endocrine pharmacology emerged in the early 1900s with the use of crude pituitary extracts. By the mid-1900s several investigators had isolated and begun to synthesize hormones or hormonelike substances. Recognizing the limited supply of hormones that could be obtained both from animal sources and human autopsy material, the search for so called hormone substitutes also began early in the 1900s. Recently, re combinant DNA technologies have been used to provide alternative therapeutic sources of human insulin and human growth hormone. Aside from insulin, perhaps no other use of hormonally-active sub stance is better exemplified by those drugs which affect fertility. The synthesis of an orally-effective steroid represented one of the first major breakthroughs in the chemical suppression of ovulation. Since the orally active 19-norsteroids were introduced in the 1950s, several oral contra ceptive steroid preparations have been marketed. Indeed, the advent of oral contraceptives for birth control has led to a renewed interest in endocrine pharmacology.