title: Nasal absorption of growth hormone in normal subjects: studies with four different formulations.
abstract: OBJECTIVE
  Current growth hormone (GH) therapy with daily subcutaneous injections results in elevated serum concentrations of GH lasting for several hours, whereas physiologic GH secretion is characterized by a short-duration peak and low basal concentrations. A closer imitation of this pattern might be achieved by administering GH nasally. We studied the effect on the absorption of nasally administered human GH of increasing concentrations of the enhancer didecanoyl-L-alpha-phosphatidylcholine (DDPC).
  
  
  METHODS
  Four formulations of nasal GH containing the enhancer DDPC in the relative concentrations 0, 4, 8, and 16% w/w were administered in random order.
  
  
  METHODS
  Participants were admitted to the hospital during the four study periods.
  
  
  METHODS
  On four occasions the subjects received GH 6 IU (2 mg) in each nostril. Blood was sampled frequently for four hours. Anterior rhinoscopy was performed at 0 and 4 h. During the study the subjects completed a questionnaire to record nasal symptoms.
  
  
  METHODS
  Sixteen healthy subjects were examined at 0800 h after an overnight fast.
  
  
  METHODS
  Bioavailability of a nasal preparation of human GH: area under the curve (AUC), the maximum concentration (Cmax), and the time to reach maximum concentration (tmax). Scores for each nasal symptom were recorded as were the total scores.
  
  
  RESULTS
  AUC, Cmax, and tmax were not significantly affected by increasing the DDPC concentration from 0 to 4 percent or from 8 to 16 percent. AUC and Cmax, however, increased significantly when the concentration of DDPC was changed from 4 to 8 percent. Mean (+/- SD) AUC (microgram.h/L) increased from 20.51 +/- 10.53 (4 percent) to 46.14 +/- 34.59 (8 percent), (p < 0.005). Mean (+/- SD) of Cmax (microgram/L) increased from 11.11 +/- 5.02 (4 percent) to 28.22 +/- 20.85 (8 percent), (p = 0.002). Mean (+/- SD) of tmax (min) was not significantly different on the four occasions (range 40.6 +/- 36.4 to 61.0 +/- 45.2 min, p = 0.13). The symptom scores (range 17.56-21.5, maximum 360) were not significantly different (p = 0.59).
  
  
  CONCLUSIONS
  Increasing the relative concentration of the enhancer DDPC increases the absorption of nasally administered GH.
authors.affiliation: Medical Department M (Diabetes and Endocrinology), Aarhus Kommunehospital, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Laursen
authors.forename: P
authors.initials: P
authors.lastname: Ovesen
authors.forename: B
authors.initials: B
authors.lastname: Grandjean
authors.forename: S
authors.initials: S
authors.lastname: Jensen
authors.forename: J O
authors.initials: JO
authors.lastname: Jørgensen
authors.forename: P
authors.initials: P
authors.lastname: Illum
authors.forename: J S
authors.initials: JS
authors.lastname: Christiansen
mesh_terms: D000042:Absorption; D000281:Administration, Intranasal; D000328:Adult; D002626:Chemistry, Pharmaceutical; D004311:Double-Blind Method; D005260:Female; D013006:Growth Hormone / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology; D006801:Humans; D008297:Male; D009297:Nasal Mucosa / Q000378:metabolism*; D010713:Phosphatidylcholines / Q000494:pharmacology
chemical_list: D010713:Phosphatidylcholines; C015132:1,2-didecanoylphosphatidylcholine; D013006:Growth Hormone