title: Toxicological assessment of drugs that affect the endocrine system in puberty-related disorders.
abstract: BACKGROUND
  Toxicologists must ensure that clinical risk-to-benefit analysis should be made both for genders and age groups, with any treatment. Puberty concerns physiological changes leading to organism's maturation. Pubertal growth disorders are increasing in last decades: besides causing physical and psychological distress, they may signal underlying endocrine-metabolic abnormalities with serious health consequences later on. Therapeutic approaches for some health conditions in childhood and adolescence are considered.
  
  
  METHODS
  The authors discuss how some diseases and treatments can impact pubertal growth. The authors look at particular immunological disorders such as asthma and how both the disease and treatment affects pubertal growth. They also discuss how the provision of available data can help to assess the dose-response of the drug, in these cases, and minimize the chance of side effects. The authors also discuss pediatric inflammatory bowel disease and how both the disease and treatment can mitigate the growth delay. Last, but not least, the authors discuss how the effects of the drugs used in the treatment of psychiatric disorders may accentuate endocrine issues in juvenile patients. Hyperprolactinemia induction by some antipsychotics is highlighted as an example.
  
  
  CONCLUSIONS
  Appropriate risk-benefit analysis of drugs prescribed during childhood and adolescence and intended to be used in the long term is required. Furthermore, future treatment strategies and safer compounds development should be supported by the knowledge of mechanisms underlying adverse side effects in pubertal growth and development.
authors.affiliation: Food and Veterinary Toxicology Unit, Department of Veterinary Public Health and Food Safety, Istituto Superiore di Sanità , Viale Regina Elena, 299, 00161 Rome , Italy +39 06 49902527 ; +39 06 4990 2363 ; francesca.maranghi@iss.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Maranghi
authors.forename: Roberta
authors.initials: R
authors.lastname: Tassinari
authors.forename: Alberto
authors.initials: A
authors.lastname: Mantovani
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D002648:Child; D002908:Chronic Disease; D004703:Endocrine System / Q000187:drug effects* / Q000503:physiopathology; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced / Q000188:drug therapy / Q000378:metabolism; D007154:Immune System Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000473:pathology*; D009422:Nervous System Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000473:pathology*; D010372:Pediatrics; D011627:Puberty / Q000187:drug effects*; D018570:Risk Assessment; D012741:Sexual Maturation / Q000187:drug effects
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D005938:Glucocorticoids