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Growth Hormone Deficiency: Molecular Pathologies and Therapeutic Strategies

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 2724

Special Issue Editor


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Guest Editor
1. Department of Pediatric Endocrinology, Medical University of Lodz, Lodz, Poland
2. Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital–Research Institute, Lodz, Poland
Interests: short stature in children; growth hormone deficiency (GHD); primary and secondary insulin-like growth factor-1 (IGF-1) deficiency; GH therapy; long-acting GH (LAGH); transition phase in GHD patients from pediatric to adult services; disorders of GH-IGF-1 axis signaling pathways; GH secretagogues; ghrelin; sirtuins
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Special Issue Information

Dear Colleagues,

Treatment with recombinant human growth hormone (rhGH) in children and in adults with growth hormone deficiency (GHD) has been used for many years and has an established position when it comes to the principles of introducing therapy, its monitoring, dosage, safety, as well as the effectiveness and benefits of treatment. There are also known retesting principles during the process of transitioning children with GHD treated for growth promotion to the care of endocrinologists for adults who treat GHD patients to ensure the metabolic effects of GH.

Recently, however, GH treatment has become a hot topic again due to the emergence of long-acting GH (LAGH) preparations that can be used less frequently, e.g., once a week instead of the treatment used so far, which is once a day. The principles of LAGH treatment are still under analysis, and it is necessary to share the results of studies of individual research groups so that endocrinologists can gain experience in this field.

On the other hand, there are increasing amounts of reports on molecular mechanisms and their disorders involved in the transmission of signaling pathways in the GH-IGF-1 axis, both in the CNS, in the pituitary, in hepatocytes, or in the growth plate, which change and modify the secretion of GH and IGF-1.

New findings in this field allow us to define more precisely the type of mechanisms responsible for growth hormone deficiency, helping to identify further diagnostic and therapeutic areas in patients with GH and IGF-1 deficiency.

Therefore, researchers are invited to submit their reviews or original research on the discussed issues or other topics—related to various aspects of GHD—to this Special Issue of the International Journal of Molecular Sciences, titled “Growth Hormone Deficiency: Molecular Pathologies and Therapeutic Strategies” in order to create a collection of exciting papers that will be of interest to scientists and clinicians dealing with the treatment of GHD in children and adults.

Dr. Renata Stawerska
Guest Editor

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Keywords

  • growth hormone (GH)
  • growth hormone deficiency (GHD)
  • growth hormone therapy
  • long-acting growth hormone (LAGH)
  • insulin-like growth factor-1 (IGF-1)
  • growth hormone secretagogues
  • signaling pathways of the GH-IGF-1 axis
  • transition phase

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Published Papers (2 papers)

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Research

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13 pages, 840 KiB  
Article
Differences in Bone Metabolism between Children with Prader–Willi Syndrome during Growth Hormone Treatment and Healthy Subjects: A Pilot Study
by Joanna Gajewska, Magdalena Chełchowska, Katarzyna Szamotulska, Witold Klemarczyk, Małgorzata Strucińska and Jadwiga Ambroszkiewicz
Int. J. Mol. Sci. 2024, 25(17), 9159; https://doi.org/10.3390/ijms25179159 - 23 Aug 2024
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Abstract
Despite therapy with growth hormone (GH) in children with Prader–Willi syndrome (PWS), low bone mineral density and various orthopedic deformities have been observed often. Therefore, this study aimed to analyze bone markers, with an emphasis on vitamin K-dependent proteins (VKDPs), in normal-weight children [...] Read more.
Despite therapy with growth hormone (GH) in children with Prader–Willi syndrome (PWS), low bone mineral density and various orthopedic deformities have been observed often. Therefore, this study aimed to analyze bone markers, with an emphasis on vitamin K-dependent proteins (VKDPs), in normal-weight children with PWS undergoing GH therapy and a low-energy dietary intervention. Twenty-four children with PWS and 30 healthy children of the same age were included. Serum concentrations of bone alkaline phosphatase (BALP), osteocalcin (OC), carboxylated-OC (Gla-OC), undercarboxylated-OC (Glu-OC), periostin, osteopontin, osteoprotegerin (OPG), sclerostin, C-terminal telopeptide of type I collagen (CTX-I), and insulin-like growth factor-I (IGF-I) were determined using immunoenzymatic methods. OC levels and the OC/CTX-I ratios were lower in children with PWS than in healthy children (p = 0.011, p = 0.006, respectively). Glu-OC concentrations were lower (p = 0.002), but Gla-OC and periostin concentrations were higher in patients with PWS compared with the controls (p = 0.005, p < 0.001, respectively). The relationships between IGF-I and OC (p = 0.013), Gla-OC (p = 0.042), and the OC/CTX-I ratio (p = 0.017) were significant after adjusting for age in children with PWS. Bone turnover disorders in children with PWS may result from impaired bone formation due to the lower concentrations of OC and the OC/CTX-I ratio. The altered profile of OC forms with elevated periostin concentrations may indicate more intensive carboxylation processes of VKDPs in these patients. The detailed relationships between the GH/IGF-I axis and bone metabolism markers, particularly VKDPs, in children with PWS requires further research. Full article
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Review

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19 pages, 882 KiB  
Review
Transition Period and Young Adulthood in Patients with Childhood Onset Growth Hormone Deficiency (COGHD): Impact of Growth Hormone Replacement on Bone Mass and Body Composition
by Mirjana Doknic, Marko Stojanovic and Aleksandra Markovic
Int. J. Mol. Sci. 2024, 25(19), 10313; https://doi.org/10.3390/ijms251910313 - 25 Sep 2024
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Abstract
The aim of this review article is to highlight the consequences of COGHD after the end of linear growth on bone mass and body composition and the opposing beneficial effects of continuing GH replacement in the transition period and young adults. The role [...] Read more.
The aim of this review article is to highlight the consequences of COGHD after the end of linear growth on bone mass and body composition and the opposing beneficial effects of continuing GH replacement in the transition period and young adults. The role of growth hormone in the period of late adolescence and young adulthood is well established, mainly in achieving peak bone mass and a favorable body composition, characterized by muscle mass increase and fat mass reduction. Patients with childhood onset growth hormone deficiency (COGHD), after reaching the adult height, have a reduced bone mineral density and muscle mass with increased fat mass compared to healthy controls. Inadequate body composition is a predictor for cardiovascular risk, while low bone mass in early youth hallmarks the risk of osteoporosis and bone fractures in later life. Cessation of growth hormone replacement (GHr) after completion of growth will lead to delayed peak bone mass and unbalanced body composition with increased abdominal fat deposits. According to numerous clinical studies monitoring the effects of GH treatment on the physical and psychological status of patients with persistent GHD after completion of growth, we suggest continuing this treatment between 16 and 25 years of age. It is advised that GHr in the transition period be administered in intermediate doses between those for the pediatric population and those for the adult population. Usual daily GHr doses are between 0.3 and 0.5 mg but need to be individually optimized, with the aim of maintaining IGF-I in the age-specific normal range. Full article
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