title: GH activity and markers of inflammation: a crossover study in healthy volunteers treated with GH and a GH receptor antagonist.
abstract: BACKGROUND
  The GH/IGF1 axis may modulate inflammatory processes. However, the relationship seems complicated as both pro- and anti-inflammatory effects have been demonstrated.
  
  
  METHODS
  Twelve healthy volunteers (mean age 36, range 27-49 years) were treated in random order with increasing doses of GH for 3 weeks (first week 0.01  mg/kg per day, second week 0.02  mg/kg per day, and third week 0.03  mg/kg per day) or a GH receptor antagonist (pegvisomant; first week 10  mg/day and last two weeks 15  mg/day), separated by 8 weeks of washout. Circulating levels of the pro-inflammatory cytokines tumor necrosis factor α (TNFα (TNFA)), interleukin 6 (IL6), and IL1β (IL1B) and the acute phase proteins (APPs) C-reactive protein (CRP), haptoglobin, orosomucoid, YKL40 (CHI3L1), and fibrinogen were measured.
  
  
  RESULTS
  During GH treatment, IGF1 (median 131 (Inter-quartile range (IQR) 112-166) vs 390 (322-524) μg/l, P=0.002) increased together with TNFα (0.87 (0.74-1.48) vs 1.27 (0.80-1.69) ng/l, P=0.003), IL6 (1.00 (0.83-1.55) vs 1.35 (0.80-4.28) ng/l, P=0.045), and fibrinogen (9.2 (8.8-9.6) vs 11.1 (9.4-12.4) μM, P=0.002). By contrast, orosomucoid decreased (18.0 (15.5-24.3) vs 15.0 (15.0-17.0) μM, P=0.018). CRP, YKL40, and haptoglobin were unchanged. During pegvisomant treatment, IGF1 decreased (139 (117-171) vs 91 (78-114) ng/ml, P=0.005). Orosomucoid (21.0 (16.3-23.8) vs 22.0 (17.0-29.3) μM, P=0.036) and CRP (1.00 (0.62-1.77) vs 1.43 (0.71-3.29) mg/l, P=0.074) increased without an increase in pro-inflammatory cytokines.
  
  
  CONCLUSIONS
  GH/IGF1 action appears to modulate the initial stage of the inflammatory response as well as downstream processes elucidated by levels of APPs. The data suggest a complicated relationship not allowing any simple conclusions as to whether GH/IGF1 actions have mainly pro- or anti-inflammatory effects in vivo.
authors.affiliation: Endocrine Unit, Laboratory of Endocrinology 54o4, Department of Internal Medicine O, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730 Herlev, Denmark. andreassenmikkel@hotmail.com
authors.forename: Mikkel
authors.initials: M
authors.lastname: Andreassen
authors.forename: Jan
authors.initials: J
authors.lastname: Frystyk
authors.forename: Jens
authors.initials: J
authors.lastname: Faber
authors.forename: Lars Østergaard
authors.initials: LØ
authors.lastname: Kristensen
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D018592:Cross-Over Studies; D005260:Female; D019382:Human Growth Hormone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011986:Receptors, Somatotropin / Q000037:antagonists & inhibitors* / Q000502:physiology; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D018836:Inflammation Mediators; D011986:Receptors, Somatotropin; D019382:Human Growth Hormone; C406545:pegvisomant