Glucocorticoid therapy suppresses abnormal secretion of big IGF-II by non-islet cell tumours inducing hypoglycaemia (NICTH)
OBJECTIVE
To assess the relative efficacy of hGH and glucocorticoids in the treatment of non-islet cell tumour hypoglycaemia (NICTH) by examination of their influence on the composition of the various molecular species involving tumour and mature forms of IGF-II in association with IGFBP-3.


METHODS
Two groups each of 4 patients, all diagnosed as cases of NICTH, were treated with either hGH or glucocorticoids. Through the use of acidic size exclusion chromatography serum levels of tumour (big) and mature IGF-II were evaluated. Neutral size exclusion chromatography was used in the separation of molecular species before assay for immunoreactive IGF-II and IGFBP-3 content.


RESULTS
High-dose hGH treatment produced increases in serum levels of big and mature IGF-II and IGFBP-3 but without generation of high molecular weight complexes. Glucocorticoid treatment suppressed big IGF-II permitting re-establishment of normal IGF/IGFBP association patterns.


CONCLUSIONS
Glucocorticoid therapy has been demonstrated to consistently reverse the biochemical abnormalities caused by tumour-derived big IGF-II compared with the potentially adverse stimulatory effects of hGH treatment in causing increases in serum levels of big IGF-II.
Teale
J D
JD
Supraregional Hormone Centre, Royal Surrey County Hospital, Guildford, UK.
Marks
V
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003864:Depression, Chemical; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000032:analysis; D007335:Insulin-Like Growth Factor II / Q000032:analysis / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000378:metabolism; D011498:Protein Precursors / Q000032:analysis / Q000378:metabolism*; D013577:Syndrome
D005938:Glucocorticoids; D018972:Insulin-Like Growth Factor Binding Protein 3; D011498:Protein Precursors; C066038:proinsulin-like growth factor II; D019382:Human Growth Hormone; D007335:Insulin-Like Growth Factor II