Related Experiment Videos
Skeletal response to recombinant human growth hormone (rhGH) in children treated with long-term corticosteroids
C P Sanchez1, W G Goodman, D Brandli
1Department of Pediatrics, UCLA Medical Center, USA.
Insights
Recombinant human growth hormone (rhGH) therapy in children with corticosteroid-induced osteopenia significantly increased bone formation rates. This treatment offers a potential therapeutic avenue for improving bone health in pediatric patients experiencing growth retardation.
Area of Science:
- Pediatric Endocrinology
- Bone Biology
- Pharmacology
Background:
- Corticosteroid therapy in children can lead to osteopenia and growth retardation.
- These adverse effects are linked to reduced bone formation and turnover rates.
- Growth hormone is known to stimulate bone remodeling processes.
Purpose of the Study:
- To evaluate the biochemical and skeletal responses to recombinant human growth hormone (rhGH) in pediatric patients with long-term corticosteroid use.
- To assess the impact of rhGH on bone formation and turnover markers.
- To determine if rhGH can counteract corticosteroid-induced bone loss.
Main Methods:
- Four pediatric patients (aged 12.8 ± 3 years) with prolonged corticosteroid use (5 ± 2 years) received rhGH (0.125 mg/kg, 3 times/week) for 12 months.
- Iliac crest bone biopsies were performed before and after therapy for histomorphometric analysis.
- Serum levels of various biochemical markers, including IGF-1, were measured every 3 months.
Main Results:
- Serum insulin-like growth factor-1 (IGF-1) levels increased by 71% (p < 0.01) during rhGH therapy.
- Bone formation rates significantly increased from 423 ± 475 to 781 ± 407 microns²/mm²/day (p < 0.05).
- The length of double tetracycline-labeled bone perimeter increased by 85% (p < 0.05), indicating enhanced bone apposition.
Conclusions:
- rhGH therapy effectively stimulated bone formation in pediatric patients with corticosteroid-induced osteopenia.
- The observed increase in bone formation rates exceeded those of an age-matched reference group.
- rhGH represents a promising therapeutic strategy for mitigating bone loss and promoting skeletal recovery in children on long-term corticosteroids.
Abstract:
Corticosteroid therapy causes osteopenia and growth retardation in children; such changes are associated with diminished rates of bone formation and turnover. Since growth hormone activates bone remodeling, the biochemical and skeletal responses to rhGH were evaluated in four pediatric patients, aged 12.8 +/- 3 years, with long-term corticosteroid use (5 +/- 2 years). Recombinant human growth hormone (rhGH), 0.125 mg/kg, was given 3 times/week by subcutaneous injection for 12 months. Iliac crest bone biopsies were obtained after double tetracycline labeling before and at the end of rhGH therapy; serum levels of calcium, phosphorus, alkaline phosphatase, parathyroid hormone (intact), 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D3, osteocalcin (BGP), and insulin-like growth factor-1 (IGF-1) were measured every 3 months during the treatment period. The average dose of prednisone was 0.24 +/- 0.05 mg/kg/day initially, and this did not change during the study. Serum calcium, phosphorus, alkaline phosphatase, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D3, and BGP were unchanged during the rhGH therapy, but the serum IGF-1 level increased by 71%, p < 0.01. Eroded bone perimeter and cancellous bone area did not change significantly during rhGH therapy. Bone formation rates rose from 423 +/- 475 to 781 +/- 407 microns2/mm2/day, p < 0.05, and the length of double tetracycline-labeled bone perimeter increased by 85%, p < 0.05. The bone formation rate in the growth hormone group exceeded the values of an age-matched reference group (14.3 +/- 3 years), 780 +/- 407 microns2/mm2/day versus 411 +/- 479 microns2/mm2/day, p < 0.05.(ABSTRACT TRUNCATED AT 250 WORDS)