Benfield M R, Kohaut E C
Department of Pediatrics, University of Alabama at Birmingham 36233, USA.
J Pediatr. 1997 Jul;131(1 Pt 2):S28-31. doi: 10.1016/s0022-3476(97)70007-6.
With the availability of an easily produced and safely administered form of recombinant human growth hormone (GH), the clinical indications for its use have increased. Recent studies have shown that GH therapy is both safe and effective in the treatment of growth failure in children with chronic renal insufficiency. Similarly, GH has been used to treat growth failure in children after renal transplantation. GH therapy increases growth in these patients, but in some of them increased organ rejection or worsening of kidney function occurs. GH is a neuroendocrine peptide that is important to somatic growth, but it has also been shown to have pleiotropic effects on many cells and organ systems including the immune system. We have shown that GH in vitro augments the responses during a mixed leukocyte culture in normal adult volunteers. GH also augments the responses to donor-specific alloantigens in some patients. We conclude that if in vitro assays such as these can successfully identify those patients who are at risk for organ rejection and worsening kidney function, then GH therapy is safe in children with growth failure after renal transplantation.
随着易于生产且安全施用的重组人生长激素（GH）的出现，其临床应用指征有所增加。近期研究表明，GH疗法在治疗慢性肾功能不全儿童的生长障碍方面既安全又有效。同样，GH已被用于治疗肾移植后儿童的生长障碍。GH疗法可促进这些患者的生长，但其中一些患者会出现器官排斥增加或肾功能恶化的情况。GH是一种对体细胞生长很重要的神经内分泌肽，但也已显示其对包括免疫系统在内的许多细胞和器官系统具有多效性作用。我们已经表明，在正常成年志愿者中，体外GH可增强混合淋巴细胞培养期间的反应。在一些患者中，GH还可增强对供体特异性同种异体抗原的反应。我们得出结论，如果像这样的体外试验能够成功识别出有器官排斥和肾功能恶化风险的患者，那么GH疗法对于肾移植后生长障碍的儿童是安全的。
