Growth hormone, burns and tissue healing.
Severe illness or trauma alters the body's metabolic rate. After injury, host-defence protein synthesis and increased energy requirements are satisfied from available protein, usually active muscle tissue. A prolonged hypercatabolic state persists and may lead to increased morbidity and mortality in severely burned patients. Growth hormone (GH) is an anabolic agent shown to decrease some of the deleterious effects of hypermetabolism. This article will review the effects of GH on burn wound repair and gut healing. Studies on GH have shown a significant reduction in wound-healing times in burned patients given GH at a dose of 0.6 IU/kg/day (0.2 mg/kg/day). At this dose, other studies have shown no increase in mortality, and a number of beneficial effects in critically burned children have been demonstrated. Animal studies have suggested that insulin-like growth factor I (IGF-I), stimulated through the GH axis, plays an important role in the reconstitution of intestinal epithelial integrity following mucosal injury. Many encouraging papers report positive results regarding both the efficacy and safety of GH and IGF-I, therefore warranting continued investigation.
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Department of Surgery, Shriners Burns Hospital and University of Texas Medical Branch, Galveston, USA.
Wolf
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Herndon
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D000293:Adolescent; D002056:Burns / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000188:drug therapy; D003094:Collagen / Q000096:biosynthesis; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004847:Epithelial Cells / Q000378:metabolism; D005260:Female; D013006:Growth Hormone / Q000627:therapeutic use*; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000627:therapeutic use; D007413:Intestinal Mucosa / Q000293:injuries / Q000378:metabolism; D007633:Keratins / Q000096:biosynthesis; D007797:Laminin / Q000096:biosynthesis; D008297:Male; D014947:Wounds and Injuries / Q000188:drug therapy*
D007797:Laminin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D007633:Keratins; D013006:Growth Hormone; D003094:Collagen