Effects of pyridostigmine on spontaneous and growth hormone-releasing hormone stimulated growth hormone secretion in children on daily glucocorticoid therapy after liver transplantation.
OBJECTIVE
We aimed to investigate both nocturnal spontaneous and morning growth hormone (GH)-releasing hormone (GHRH)-induced GH secretion in children on daily glucocorticoid treatment after liver transplantation and to evaluate the effect of pyridostigmine (an acetylcholinesterase inhibitor thought to reduce hypothalamic somatostatin tone) on GH secretion in these patients.


METHODS
We performed a randomized, single-blind, cross-over study.


METHODS
We studied three male and three female juvenile patients, within a year of orthotopic liver transplantation and under immunosuppressive glucocorticoid therapy (mean dose +/- SEM, 5.92 +/- 0.63 mg/day) and five normal children (four males, one female).


METHODS
Both nocturnal spontaneous and morning GHRH-induced GH secretion were evaluated after administration of placebo, 1 tablet p.o., or pyridostigmine, 2 mg/kg p.o.


RESULTS
Spontaneous GH. Placebo: in liver transplanted children nocturnal GH secretion (mean GH level 10.8 +/- 2.0 mU/l) was not significantly different with respect to normal children (mean GH level 12.8 +/- 1.2 mU/l); pyridostigmine: nocturnal GH secretion was significantly increased as compared to placebo in subjects with liver transplantation but not in normal children. GHRH test. Placebo: liver transplanted patients showed a blunted GH response to GHRH with respect to normal children; pyridostigmine: the GH responses to GHRH (P less than 0.05) increased as compared to placebo and did not differ significantly in the two groups.


CONCLUSIONS
Our data suggest a steroid-mediated increase in hypothalamic somatostatin tone in liver transplanted children.
Giustina
A
A
Clinica Medica, University of Brescia, Italy.
Girelli
A
A
Alberti
D
D
Bossoni
S
S
Buzi
F
F
Doga
M
M
Schettino
M
M
Wehrenberg
W B
WB
D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D013006:Growth Hormone / Q000378:metabolism*; D013007:Growth Hormone-Releasing Hormone / Q000494:pharmacology*; D006801:Humans; D007031:Hypothalamus / Q000187:drug effects / Q000378:metabolism*; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D011729:Pyridostigmine Bromide / Q000494:pharmacology*; D016037:Single-Blind Method
D016572:Cyclosporine; D013006:Growth Hormone; D013007:Growth Hormone-Releasing Hormone; D011239:Prednisolone; D011729:Pyridostigmine Bromide