Amil B, Fernández-Fuente M, Santos F, Rodríguez J, Díaz-Tejón L, García E, Carbajo E
Area de Pediatría y Anatomía, Facultad de Medicina, Hospital Central de Asturias, Universidad de Oviedo y SESPA, Oviedo, Asturias.
Nefrologia. 2003;23 Suppl 2:23-6.
This study analyzed the modifications induced by growth hormone (GH) and/or calcitriol treatments in the growth plate of growth retarded uremic rats. Four groups of 5/6 nephrectomized rats were studied: untreated (U), treated with GH (U + GH), treated with calcitriol (U + D), treated with GH and calcitriol (U + GH + D). Treatments were given intraperitoneally during the second week of renal failure. Uremic groups were compared with sham-operated rats fed ad libitum (C) or pair-fed with U (CP). In comparison with C and CP, histomorphometric analysis of tibial proximal ends of U group showed decreased bone formation, as estimated by osseous front advance (OFA), elongation of growth cartilage and its hypertrophic zone, and decreased size of most distal chondrocytes. The U + D group tended to normalize growth cartilage height, and that of its hypertrophic zone, as well as the size of chondrocytes. In U + GH group OFA improved and chondrocyte size became normal, but growth cartilage remained elongated. Similar results were found in the U + GH + D group. These findings indicate that, in chronic renal insufficiency, the beneficial effect of GH on growth is not associated with normalization of growth cartilage morphology and that calcitriol facilitates chondrocyte maturation. When given together the effect of GH prevails.
本研究分析了生长激素(GH)和/或骨化三醇治疗对生长迟缓的尿毒症大鼠生长板的影响。研究了四组5/6肾切除大鼠:未治疗组(U)、生长激素治疗组(U + GH)、骨化三醇治疗组(U + D)、生长激素和骨化三醇联合治疗组(U + GH + D)。在肾衰竭第二周进行腹腔内给药。将尿毒症组与随意进食的假手术大鼠(C)或与U组配对喂养的大鼠(CP)进行比较。与C组和CP组相比,U组胫骨近端的组织形态计量学分析显示骨形成减少,通过骨前沿推进(OFA)、生长软骨及其肥大区的伸长来估计,并且大多数远端软骨细胞的大小减小。U + D组的生长软骨高度及其肥大区的高度以及软骨细胞大小趋于正常。在U + GH组中,OFA改善,软骨细胞大小恢复正常,但生长软骨仍伸长。在U + GH + D组中也发现了类似结果。这些发现表明,在慢性肾功能不全中,GH对生长的有益作用与生长软骨形态的正常化无关,骨化三醇促进软骨细胞成熟。当联合使用时,GH的作用占主导。