Tönshoff B, Mehls O
Division of Pediatric Nephrology, Heidelberg University Children's Hospital, Germany.
Pediatr Transplant. 1997 Nov;1(2):183-9.
Glucocorticoids in pharmacological doses interfere with the integrity of the somatotropics hormone axis. However, the apparent discrepancies between the in vitro and in vivo studies, short-term vs. long-term exposure, and species-specific changes complicate a clear assessment of these interactions. The growth-depressing effects of glucocorticoids are multifactorial and involve suppression of pituitary GH release by stimulating hypothalamic somatostatin tone, down-regulation of hepatic GH receptors, inhibition of GH bioactivity by the induction of IGF inhibitors, complex alteration of the IGFBP serum profile, and a direct suppressive effect on tissue matrix production and synthesis of local growth factors.
药理剂量的糖皮质激素会干扰生长激素轴的完整性。然而,体外研究与体内研究之间、短期暴露与长期暴露之间以及物种特异性变化之间明显的差异,使得对这些相互作用进行清晰评估变得复杂。糖皮质激素的生长抑制作用是多因素的,包括通过刺激下丘脑生长抑素分泌来抑制垂体生长激素释放、肝脏生长激素受体下调、通过诱导胰岛素样生长因子(IGF)抑制剂抑制生长激素生物活性、IGF结合蛋白血清谱的复杂改变,以及对组织基质产生和局部生长因子合成的直接抑制作用。