Increased growth hormone response to growth hormone releasing hormone induced by erythropoietin in uraemic patient

This study was designed to assess the response of growth hormone (GH) to growth hormone releasing hormone (GHRH) and the possible interaction of acutely administered recombinant human erythropoietin (rhEPO) on GH response to GHRH in a group of uraemic patients. Eight patients on maintenance haemodialysis, not previously treated with rhEPO, and six healthy controls were tested with GHRH (100 micrograms i.v. in bolus), and with GHRH (100 micrograms i.v. in bolus) plus rhEPO (40 U/kg in constant infusion for 30 min) on different days. GHRH injection provoked a GH release in five out of eight uraemic patients; the overall mean response did not differ significantly from the GH response obtained in controls (P = 0.30). Erythropoietin infusion significantly increased GH release after GHRH (P less than 0.01 at 15, 30, 45, 60 min after GHRH injection) in uraemic patients; in controls, on the contrary, stimulation with GHRH plus rhEPO did not induce a greater increase of GH release compared with that observed after GHRH alone (mean GH peak 37.66 +/- 7.68 mU/l after GHRH; and 38.0 +/- 9.18 mU/l after GHRH plus rhEPO; P greater than 0.5). In this study acutely administered rhEPO significantly potentiated the GH response to GHRH in uraemic patients whereas the same effect was not demonstrable in subjects with normal renal function

Recombinant human erythropoietin (rhEPO)treatment potentiates growth hormone (GH)response to growth hormone releasing hormone (GHRH) stimulation in hemodialysis in patients

On the basis of previously described effects of recombinant human erythropoietin (rhEPO) treatment on endocrine abnormalities present in uremia, we assessed the possible effect of treatment with rhEPO on growth hormone (GH) response to growth hormone releasing hormone (GHRH) in a group of uremic patients. Eight patients on maintenance hemodialysis for 12 to 228 months, not previously treated with rhEPO, were tested with 100 micrograms of GHRH i.v. in bolus before and after three months of rhEPO treatment (40 U/kg i.v. three times a week). Before treatment, the GH response to GHRH was characterized, in uremic patients, by remarkable differences in plasma GH values and in the pattern of response curve in single patients. The variability of GH response was not modified after rhEPO treatment; however, an overall potentiation of GH response with a significant increase of plasma GH (p = 0.017 at 15 min, p = 0.035 at 30 min after GHRH injection) was observed in the tests performed after treatment. rhEPO administration induced an evident improvement of anemia, blood hemoglobin concentration being 5.3-7.6 g/dl before and 9.1-11.3 g/dl after treatment; however a demonstrable correlation between the potentiation of GH response to GHRH and the increase of hemoglobin concentration was not observed

Potentiating effect of galanin on GHRH-induced GH release : comparison between old and young subjects

The aim of our study was to investigate the effect of galanin on basal and GHRH-stimulated GH secretion in a healthy group of elderly subjects and in a healthy group of young subjects for comparison. Ten old subjects (mean age 75 +/- 1.15 years) and an equal number of healthy young volunteers (mean age 26 +/- 0.71 years) underwent three stimulation tests in random order. Galanin infusion for 60 minutes (10 micrograms/kg in 100 ml saline) failed to provoke an appreciable release of circulating GH in old subjects, while it induced a significant increase of plasma GH in the young adults; GHRH administration i.v. in bolus (100 micrograms in 1 ml saline) elicited a significant GH response in both groups; however, in the older group GH response was significantly (p < 0.05) lower than in the young adults. The administration of galanin (10 micrograms/kg in 100 ml saline as an i.v. infusion for 60 min) plus GHRH (100 micrograms in 1 ml saline i.v. in bolus), potentiated GH response in old and young subjects. The combined administration of two peptides was able to elicit a clear GH release even in the older subjects who were hyporesponsive/unresponsive to galanin and/or GHRH alone. In the elderly, plasma GH values observed after the combined stimuli overlapped with GH values observed after GHRH alone in the young adults. In conclusion, our study confirms that galanin has a synergic effect with GHRH on GH release both in younger and elderly subjects. Moreover, our data confirm an impaired responsivity to GHRH in the elderly and demonstrate that galanin is able to normalize response of somatotrophs to GHRH in old people

The impact of long-term hemodialysis on pituitary-adrenocortical function

The activity of the hypothalamic-pituitary-adrenal axis in hemodialyzed (HD) patients has been investigated, with conflicting results. Different results are reported concerning both basal ACTH and cortisol concentration and the responses to different stimulating agents, in chronic hemodialyzed patients. The present study was performed in order to assess whether the length of the hemodialytic treatment may affect the pituitary and adrenocortical response to stimulation with ovine CRH (oCRH) and with exogenous ACTH in a group of patients on chronic HD for more than 10 years. Ten uremic patients (aged 3871, 6 males and 4 females) on chronic hemodialysis for at least 10 years and 7 healthy subjects matched for age and sex were studied. The patients were tested on the day preceding dialysis session. Each subject received on different non-consecutive days oCRH (100 μg i.v. in bolus) and ACTH (Synacthen 0.25 mg i.v. in bolus), and blood samples were obtained at appropriate intervals. Basal ACTH and cortisol levels of HD patients were in the upper limit of normal range (ACTH 39.21 ± 11.11 pg/mL in HD patients vs. 26.88 ± 14.12 pg/mL in controls; cortisol 19.96 ± 5.07 in HD patients rs. 12.66 ± 4.44 in controls); however, the means were not significantly different compared with controls. Following oCRH administration a net increase of ACTH and cortisol was observed in every patient tested (ACTH peak 83.81 ±28.49 in HD vs. 78.73 ± 22.87 pg/mL in controls; cortisol peak 30.73 ± 19.31 in HD vs. 20.05 ± 3.19 μg/dL in controls). Comparing the ACTH and cortisol responses to oCRH obtained in HD pts and in controls, a mild delay in the maximum response peak of ACTH (peak at 60 min vs. 30 min) and a prolonged cortisol dismission was observed. Exogenous A CTH administration elicited a normal cortisol response in both HD patients and control groups. In conclusion, our results show that the responsiveness of the pituitary-adrenal axis is maintained in uremic patients, even after more than 10 years of chronic hemodialysis; the delayed ACTH response to oCRH might be considered a further manifestation of the disordered hypothalamic regulation described in uremia and/or it is probably due to a maladaptative response to chronic stress

Neuropeptides in anterior pituitary development

Recent studies using biotechnological methods have achieved significant advances in our knowledge of molecular mechanisms underlying pituitary gland development and the differentiation of pituitary cytotypes. A large number of neuropeptides have been reported in the adult pituitary gland as well as in the central and peripheral nervous system. The early presence of neuropeptides during pituitary development is reviewed here. Neuromedin U (NmU), galanin and the polypeptide 7B2 have been localised to different endocrine cells of the gland. Their expression seems to be manifold even though it is temporally and spatially regulated. There is now firm immunocytochemical evidence that neuropeptides are present during morphogenesis of the pituitary and can be present simultaneously with all pituitary hormones. © 2003 ISDN. Published by Elsevier Ltd. All rights reserved