title: Effects of growth hormone on growth factors after renal transplantation.
abstract: Growth retardation occurs frequently in renal transplanted children (RTx) and can be improved by growth hormone (GH) treatment. This study retrospectively examines the insulin-like growth factor-1 (IGF-1) and IGF binding protein (IGFBP) profile of ten growth-retarded children previously given renal allografts, after 1 year of GH treatment period. Ten prepubertal patients (nine boys and one girl) were investigated. They had a mean chronological age (CA) of 11.4 +/- 1.1 years and a mean bone age (BA) of 7.3 +/- 0.9 years. Mean height was -3.9 +/- 0.4 SD units below the mean for CA. The mean body mass index (BMI) was 16.9 +/- 0.6 and the mean inulin clearance was 36.5 +/- 4.9 ml/min/1.73 m2. Recombinant hGH was given at 4 IU/m2/day. Plasma GH, total and free IGF-1, IGFBP-2 and -3 were measured by specific radioimmunoassay (RIA). IGFBPs were characterized by SDS PAGE techniques and ligand and immunoblot analyses. Mean velocity was markedly increased (P < 0.01) after 1 year of GH therapy, expressed as SD score for BA. The range of growth response was wide. The total and free plasma IGF-1 increased (P < 0.01) by about 100% (mean values after GH therapy: 95.9 +/- 2.1 nM and 165 +/- 29 pM, respectively). Plasma IGFBP-3 concentrations increased by about 40% (mean value: 148 +/- 18 pM, P < 0.01), with a concomitant increase in both intact IGFBP-3 and its 30-kDa proteolytic fragment. There was no change in plasma IGFBP-2 concentration. Both mean values of inulin clearance and BMI were unchanged during the treatment. In view of the IGF-1/IGFBP concentration changes, there should have been an even better growth response to GH therapy in these patients. This strongly suggests IGF-1 insensitivity, probably as a result of corticosteroid therapy.
authors.affiliation: INSERM U530, Hôpital des Enfants Malades, 149 rue de Sèvres, 75743 Paris Cedex 15, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Clot
authors.forename: H
authors.initials: H
authors.lastname: Crosnier
authors.forename: G
authors.initials: G
authors.lastname: Guest
authors.forename: C
authors.initials: C
authors.lastname: Saucet
authors.forename: J C
authors.initials: JC
authors.lastname: Souberbielle
authors.forename: J L
authors.initials: JL
authors.lastname: Andre
authors.forename: M
authors.initials: M
authors.lastname: Broyer
authors.forename: R
authors.initials: R
authors.lastname: Rappaport
authors.forename: C
authors.initials: C
authors.lastname: Benelli
mesh_terms: D000293:Adolescent; D015153:Blotting, Western; D001827:Body Height / Q000187:drug effects; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D005919:Glomerular Filtration Rate; D006128:Growth / Q000187:drug effects; D013006:Growth Hormone / Q000494:pharmacology*; D006133:Growth Substances / Q000378:metabolism*; D006801:Humans; D007202:Indicators and Reagents; D018969:Insulin-Like Growth Factor Binding Proteins / Q000378:metabolism; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D013002:Somatomedins / Q000378:metabolism
chemical_list: D006133:Growth Substances; D007202:Indicators and Reagents; D018969:Insulin-Like Growth Factor Binding Proteins; D013002:Somatomedins; D013006:Growth Hormone