School of Pharmaceutical Sciences, University of Geneva & University of Lausanne, Geneva, Switzerland.
Eur J Pharm Biopharm. 2011 Jun;78(2):278-88. doi: 10.1016/j.ejpb.2011.01.006. Epub 2011 Feb 3.
The availability of recombinant human growth hormone (GH) has broadened its range of clinical applications. Approved indications for GH therapy include treatment of growth hormone deficiency (in children and in adults), Turner syndrome, Prader-Willi syndrome, chronic renal insufficiency and more recently, idiopathic short stature in children, AIDS-related wasting and fat accumulation associated with lipodystrophy in adults. Therapy with GH usually begins at a low dose and is gradually titrated to obtain optimal efficacy while minimizing side effects. It is usually administered on a daily basis by subcutaneous injection, since this was considered to impact upon patient compliance, extended-release GH preparations were developed and new delivery platforms - e.g., auto-injectors and needle-free devices - were introduced in order to improve not only compliance and convenience but also dosing accuracy. In addition, alternative less invasive modes of administration such as the nasal, pulmonary and transdermal routes have also been investigated. Here, we provide an overview of the different technologies and routes of GH administration and discuss the principles, limitations and pharmacological profiles for each approach.
重组人生长激素 (GH) 的出现拓宽了其临床应用范围。GH 治疗的批准适应症包括生长激素缺乏症（儿童和成人）、特纳综合征、普拉德-威利综合征、慢性肾功能不全，最近还包括儿童特发性身材矮小、艾滋病相关消瘦和脂肪堆积与脂肪营养不良相关。GH 治疗通常从低剂量开始，并逐渐滴定以获得最佳疗效，同时最大限度地减少副作用。由于考虑到对患者依从性的影响，通常通过皮下注射每日给药，因此开发了延长释放 GH 制剂，并引入了新的给药平台 - 例如自动注射器和无针装置 - 以提高不仅是合规性和便利性，而且是给药准确性。此外，还研究了替代的非侵入性给药方式，例如鼻内、肺部和透皮途径。在这里，我们概述了 GH 给药的不同技术和途径，并讨论了每种方法的原则、局限性和药理学特征。
