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Growth hormone is safe in children after renal transplantation
1Department of Pediatrics, University of Alabama at Birmingham 36233, USA.
Insights
Recombinant human growth hormone (GH) aids growth in children with kidney issues post-transplant. In vitro tests may predict risks of organ rejection and kidney function decline, ensuring GH therapy safety.
Area of Science:
- Pediatric Endocrinology
- Nephrology
- Immunology
Background:
- Recombinant human growth hormone (GH) availability has expanded its clinical uses.
- GH therapy is recognized for treating growth failure in children with chronic renal insufficiency and post-renal transplant.
- While promoting growth, GH therapy may be associated with increased organ rejection or kidney function decline in some pediatric transplant recipients.
Purpose of the Study:
- To evaluate the safety and efficacy of GH therapy in children with growth failure after renal transplantation.
- To investigate the immunomodulatory effects of GH and their potential impact on organ rejection and kidney function.
- To determine if in vitro assays can predict adverse outcomes in patients receiving GH therapy post-transplant.
Main Methods:
- Review of recent studies on GH therapy in children with chronic renal insufficiency and post-renal transplantation.
- In vitro studies assessing the effect of GH on immune responses, including mixed leukocyte cultures and responses to donor-specific alloantigens.
- Analysis of clinical outcomes related to organ rejection and kidney function in patients undergoing GH therapy.
Main Results:
- GH therapy has demonstrated effectiveness in increasing growth in children with growth failure post-renal transplantation.
- GH exhibits pleiotropic effects, influencing various cells and organ systems, including the immune system.
- In vitro studies indicated that GH can augment immune responses, suggesting a potential mechanism for adverse effects.
Conclusions:
- GH therapy can be safe for children with growth failure after renal transplantation.
- In vitro assays assessing immune responses may help identify patients at risk for organ rejection and worsening kidney function.
- Predictive in vitro assays could enable safer application of GH therapy in this patient population.
Abstract:
With the availability of an easily produced and safely administered form of recombinant human growth hormone (GH), the clinical indications for its use have increased. Recent studies have shown that GH therapy is both safe and effective in the treatment of growth failure in children with chronic renal insufficiency. Similarly, GH has been used to treat growth failure in children after renal transplantation. GH therapy increases growth in these patients, but in some of them increased organ rejection or worsening of kidney function occurs. GH is a neuroendocrine peptide that is important to somatic growth, but it has also been shown to have pleiotropic effects on many cells and organ systems including the immune system. We have shown that GH in vitro augments the responses during a mixed leukocyte culture in normal adult volunteers. GH also augments the responses to donor-specific alloantigens in some patients. We conclude that if in vitro assays such as these can successfully identify those patients who are at risk for organ rejection and worsening kidney function, then GH therapy is safe in children with growth failure after renal transplantation.