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      The Rationale for the Use of Recombinant Human Growth Hormone and Insulin-Like Growth Factor-I for Catabolic Conditions in Humans

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          Abstract

          Patients with a variety of catabolic illnesses or conditions are subjected to protein catabolic losses which we attempt to address with traditional enteral or parenteral nutritional support. Accelerated protein catabolism and energy requirements together with inadequate intake or assimilation of exogenous amino acids are all contributing causes. Circulating glucocorticosteroids may play a significant contributing role in the redistribution and loss of body protein in acute, and possibly chronic, catabolic illnesses but such complex metabolic conditions are not easily studied. Short-term, high-dose glucocorticosteroid administration, a model for such protein catabolic condition, increases rates of whole-body proteolysis, increase amino acid oxidation, and decrease the effectiveness insulin in suppressing proteolysis. Recombinant human growth hormone (rhGH) administration alone in humans decreases amino acid oxidation and increases the estimated rate of whole body protein synthesis. The exact proteins affected by rhGH and the nutritional implications of this, remain to be determined. rhGH when given in combination with high-dose glucocorticosteroids offsets the protein catabolic effects of steroids alone. Thus, rhGH might provide a means to manipulate protein homeostasis in acute and possibly chronic catabolic conditions. Current data with the use of IGF-I is less clear and will require further investigation to clarify its potential role in such conditions. Finally, clear clinical utility of adjunctive rhGH and/or rhIGF-I therapy must be demonstrated to justify its wide applicability in specific clinical settings as a standard care.

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          Author and article information

          Journal
          HRE
          Horm Res Paediatr
          10.1159/issn.1663-2818
          Hormone Research in Paediatrics
          S. Karger AG
          978-3-8055-6432-8
          978-3-318-00112-9
          1663-2818
          1663-2826
          1996
          1996
          09 December 2008
          : 46
          : 4-5
          : 202-207
          Affiliations
          Nemours Children’s Clinic Jacksonville, Fla., USA
          Article
          185024 Horm Res 1996;46:202–207
          10.1159/000185024
          8950622
          © 1996 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 6
          Categories
          Session 2: GH, IGF-I and Metabolism

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