Bartolotta E, Bellone J, Aimaretti G, Arvat E, Benso L, Deghenghi R, Camanni F, Ghigo E
Division of Pediatrics, Hospital of Recanati, Macerata, Italy.
J Pediatr Endocrinol Metab. 1997 Sep-Oct;10(5):491-7. doi: 10.1515/jpem.1997.10.5.491.
The aim of the present study was to verify the GH-releasing effect of Hexarelin, a synthetic hexapeptide, in newborns who are known to have GH hypersecretion likely due to hyperactivity of GHRH-secreting neurons while somatostatinergic activity seems not fully operative. We studied in 6 newborns (NB, 2.5 +/- 2.1 days), 12 prepubertal children (PC, 9.8 +/- 0.45 yr) and 12 young adults (YA, 28.2 +/- 0.2 yr) the GH response to Hexarelin (HEX, 2 micrograms/kg i.v.) compared to that observed after GHRH (1 microgram/kg i.v.) in 6 NB (4.2 +/- 0.4 days), 12 PC (9.9 +/- 0.6 yr) and 12 YA (31.0 +/- 1.3 yr). GH levels were assayed basally and 30 and 60 min after drug administration. In NB, mean (+/- SEM) basal GH levels were higher while IGF-I levels were lower than those recorded in PC and YA (GH: 34.8 +/- 1.9 vs 2.8 +/- 0.4 vs 1.4 +/- 0.4 micrograms/l, p < 0.0006; IGF-I: 36.3 +/- 1.9 vs 152.0 +/- 11.5 vs 175.8 +/- 15.3 micrograms/l, p < 0.0007); in the last two groups GH and IGF-I levels were similar. The mean delta GH peak after HEX in NB (32.8 +/- 4.7 micrograms/l) was similar to that in PC (34.6 +/- 4.3 micrograms/l) and lower (p < 0.01) than that in YA (56.2 +/- 7.4 micrograms/l). Delta GH peak after GHRH in NB (60.1 +/- 1.5) was higher than those in PC and YA (20.8 +/- 4.8 and 22.8 +/- 3.4 micrograms/l) (p < 0.005 and < 0.002, respectively). In NB, the GH response to HEX was lower (p < 0.005) than to GHRH while in PC and YA the somatotrope response to HEX was higher (p < 0.03 and 0.0004, respectively) than to GHRH. These data demonstrate that the GH-releasing effect of Hexarelin undergoes age-dependent variation being lower in newborns than in young adults, opposite to that observed after GHRH administration. The evidence that Hexarelin releases less GH than GHRH in newborns but not in prepubertal children and in young adults makes unlikely the hypothesis that the GH-releasing effect of this hexapeptide is mediated via endogenous GHRH release.
本研究的目的是验证一种合成六肽——六氢瑞林对新生儿的生长激素释放作用。已知这些新生儿生长激素分泌过多,可能是由于分泌生长激素释放激素(GHRH)的神经元活动亢进,而生长抑素能活性似乎未完全发挥作用。我们研究了6名新生儿(NB,2.5±2.1天)、12名青春期前儿童(PC,9.8±0.45岁)和12名青年成人(YA,28.2±0.2岁)对六氢瑞林(HEX,2微克/千克静脉注射)的生长激素反应,并与6名新生儿(4.2±0.4天)、12名青春期前儿童(9.9±0.6岁)和12名青年成人(31.0±1.3岁)注射生长激素释放激素(GHRH,1微克/千克静脉注射)后的反应进行比较。在给药前及给药后30分钟和60分钟测定生长激素水平。在新生儿中,平均(±标准误)基础生长激素水平较高,而胰岛素样生长因子-I(IGF-I)水平低于青春期前儿童和青年成人(生长激素:34.8±1.9 vs 2.8±0.4 vs 1.4±0.4微克/升,p<0.0006;IGF-I:36.3±1.9 vs 152.0±11.5 vs 175.8±15.3微克/升,p<0.0007);在后两组中,生长激素和IGF-I水平相似。六氢瑞林给药后新生儿的平均生长激素峰值增量(32.8±4.7微克/升)与青春期前儿童(34.6±4.3微克/升)相似,且低于青年成人(56.2±7.4微克/升)(p<0.01)。生长激素释放激素给药后新生儿的生长激素峰值增量(60.1±1.5)高于青春期前儿童和青年成人(20.8±4.8和22.8±3.4微克/升)(分别为p<0.005和<0.002)。在新生儿中,对六氢瑞林的生长激素反应低于对生长激素释放激素的反应(p<0.005),而在青春期前儿童和青年成人中,对六氢瑞林的生长激素反应高于对生长激素释放激素的反应(分别为p<0.03和0.0004)。这些数据表明,六氢瑞林的生长激素释放作用存在年龄依赖性变化,在新生儿中低于青年成人,这与注射生长激素释放激素后的情况相反。六氢瑞林在新生儿中释放的生长激素比生长激素释放激素少,但在青春期前儿童和青年成人中并非如此,这使得该六肽的生长激素释放作用是通过内源性生长激素释放激素释放介导的这一假设不太可能成立。