Effects of growth hormone on insulin-like growth factors and binding proteins before and after renal transplantation.
Three short children with severe chronic renal failure were treated with recombinant human growth hormone (rhGH) for 2 years. Each received a transplant in the 2nd year. Serum collected before and during rhGH therapy was analysed retrospectively by Western ligand blot and immunoblotting techniques. In addition, radioimmuno-assays for insulin-like growth factor-I (IGF-I), IGF binding protein-3 (IGFBP-3), acid-labile subunit (ALS) and IGFBP-1 were performed. IGFBPs in serum, detected by Western ligand blot, were identified as IGFBP-3, -2, -1 and -4 by immunoblot. The serum concentration of IGF-I in each child rose approximately fourfold with rhGH before transplantation and subsequently remained elevated. IGFBP-3 levels rose to double the pretreatment value, but dropped to normal levels following transplantation, while ALS rose with rhGH treatment and remained increased after transplantation. IGFBP-1 levels changed little with rhGH but fell following transplantation. A low molecular weight form of IGFBP-3 was noted at 30 kilodaltons on immunoblot which was not clearly seen on the ligand blot. IGFBP-2 was present as a distinct band on Western ligand blot before transplantation and appeared decreased in intensity subsequently. IGFBP-1, seen on immunoblot clearly before transplant, disappeared after the transplant. rhGH successfully improved growth in these children, in association with a fourfold increase in IGF-I levels, which was maintained following transplantation. The reduction in IGFBPs following transplantation suggests correction of impaired clearance by the diseased kidney.
van Renen
M J
MJ
Department of Nephrology, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
Harrer
S
S
Jureidini
K F
KF
Martin
A A
AA
D015153:Blotting, Western; D001827:Body Height / Q000187:drug effects; D002648:Child; D005260:Female; D013006:Growth Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000378:metabolism*; D007457:Iodine Radioisotopes; D016030:Kidney Transplantation / Q000502:physiology*; D008024:Ligands; D008297:Male; D012189:Retrospective Studies; D013002:Somatomedins / Q000378:metabolism*
D018969:Insulin-Like Growth Factor Binding Proteins; D007457:Iodine Radioisotopes; D008024:Ligands; D013002:Somatomedins; D013006:Growth Hormone