Growth hormone receptor gene polymorphism. Spontaneous catch up growth in small for gestational age patients / Polimorfismo del gen del receptor de la hormona de crecimiento. Crecimiento postnatal espontáneo en niños pequeños para la edad gestacional

Abstract The growth hormone receptor (GHR) mediates the effect of growth hormone (GH) on linear growth and metabolism. In humans, it exists as two isoforms differing by the retention or exclusion of exon 3; a full-length GHR isoform (GHRfl) and the exon 3-deleted isoform (GHRd3). The genotypic frequency of this polymorphism was analyzed in several studies and in different human populations. However scarce information in Argentinean population is available. Associations between GHRd3 and growth have been reported previously. Some studies have shown that the presence of GHRd3 polymorphism might be a potential variant that improves growth response to recombinant human GH (rhGH) therapy in patients born small for gestational age (SGA), among others. However, over the years the results have been controversial and inconclusive. Based on this, it would be proposed that variants at the genomic level are not completely reflected at the mRNA level. Our aim was to evaluate the genotypic frequencies (%) of the GHR gene polymorphism (GHRfl/GHRfl; GHRfl/GHRd3; GHRd3/GHRd3) in normal Argentinean population (n = 94) and SGA patients (n = 65), and the expression of these polymorphisms at mRNA level in the fetal side of placenta tissues was analyzed. In addition, their asso ciation with spontaneous postnatal catch-up growth in SGA patients was also evaluated. In this study, we show a significant increment of compensatory growth in small for gestational age children (SGA) associated to the presence of the GHRd3 allele polymorphism. In addition, the expression of GHR in healthy placentas revealed that no alternative splicing mechanism occurs.

Resumen El receptor de la hormona de creci miento (GHR) media la acción de la hormona de crecimiento (GH) en el crecimiento lineal y el metabolismo. En los seres humanos, existen dos isoformas que difieren en la retención (GHRfl) o exclusión del exón 3 (GHRd3). La frecuencia genotípica de este polimorfismo fue analizada en varios estudios y en diferentes poblaciones. Sin embargo, la información disponible en la población argentina es escasa. Se ha reportado anteriormente asociación entre el polimorfismo GHRd3 y el crecimiento. Varios estudios ha n demostrado que la presencia del polimorfismo GHRd3 podría mejorar, en pacientes nacidos pequeños para la edad gestacional, entre otros, la respuesta a la terapia con GH humana recombinante (rhGH). Sin embargo, a lo largo de los años los resultados han sido con trovertidos y no concluyentes. En base a esto, se propondría que las variantes a nivel genómico no se reflejan completamente a nivel del ARNm. Nuestro objetivo fue evaluar la frecuencia genotípica de los polimorfismos del gen del GHR (GHRfl/GHRfl; GHRfl/GHRd3; GHRd3/GHRd3) en la población argentina normal (n = 94) y en niños pequeños para la edad gestacional (n = 65), y se analizó la expresión de estos polimorfismos a nivel de ARNm en la porción fetal de placentas sanas. Además, se evaluó la asociación de este polimorfismo con el cre cimiento postnatal espontáneo en pacientes pequeños para la edad gestacional. En este estudio, mostramos un incremento significativo del crecimiento compensatorio en niños pequeños para la edad gestacional asociado a la presencia del polimorfismo del alelo GHRd3. Además, los ensayos de expresión de GHR en placentas sanas revelaron que no se produciría ningún mecanismo de splicing alternativo.

New insights of growth hormone (GH) actions from tissue-specific GH receptor knockouts in mice

ABSTRACT In order to provide new insights into the various activities of GH in specific tissues, recent advances have allowed for the generation of tissue-specific GHR knockout mice. To date, 21 distinct tissue-specific mouse lines have been created and reported in 28 publications. Targeted tissues include liver, muscle, fat, brain, bone, heart, intestine, macrophage, pancreatic beta cells, hematopoietic stem cells, and multi-tissue "global". In this review, we provide a brief history and description of the 21 tissue-specific GHR knockout mouse lines. Arch Endocrinol Metab. 2019;63(6):557-67

Expressão gênica de IGF-I e GHR no fígado e no músculo do peito de codornas de corte suplementadas com diferentes níveis de metionina em duas gerações sucessivas / IGF-I and GHR gene expression in liver and breast muscle of meat quails supplemented with different levels of methionine in two successive generations

Este estudo foi desenvolvido com o objetivo de avaliar a expressão gênica do fator de crescimento semelhante à insulina I (IGF-I) e do receptor do hormônio do crescimento (GHR) no fígado e no músculo do peito de codornas de corte, alimentadas com dietas contendo diferentes níveis de suplementação de metionina, em duas gerações sucessivas. Foram utilizadas codornas dos 22 aos 42 dias de idade, distribuídas em três e cinco tratamentos na primeira e na segunda geração, respectivamente. Ao final, as aves foram abatidas por deslocamento cervical, sendo coletados fígado e músculo do peito para extração de RNA total. O cDNA foi amplificado usando primers específicos para os genes analisados. Os resultados mostraram que a expressão dos genes GHR e IGF-I sofreu influência da suplementação. No quinto tratamento, em que apenas a primeira geração recebeu uma suplementação acima do padrão das exigências para o período, houve uma expressão significativamente maior do GHR tanto no músculo do peito como no fígado e igualmente do IGF-I no músculo, levando a concluir que o excesso de metionina na dieta torna-se tóxica para as aves. Apesar de a expressão dos genes ter sofrido influência da adição de metionina nos níveis estudados, não foi observada diferença no consumo alimentar, na conversão alimentar e no peso das aves.(AU)

This study was conducted to evaluate the gene expression of the insulin-like I growth factor (IGF-I) and growth hormone receptor (GHR), in the liver and chest muscle of slaughter quails fed with diets containing different levels of methionine supplementation, in two successive generations. Twenty-two to 42 day-old quails were used, distributed in three and five treatments in the first and second generation, respectively. At the end, the birds were killed by cervical dislocation, and their liver and chest muscle were collected for total RNA extraction. The cDNA was amplified using specific primers for the genes analyzed. The results showed that the expression of GHR gene and IGF-I were influenced by the supplementation. In the fifth treatment, where only the first generation received supplementation above the standard requirements for the period, there was a significantly higher expression of GHR both in muscle chest and in the liver, and also IGF-I on muscle, leading to the conclusion that the excess dietary methionine becomes toxic to birds. Despite the gene´s expression seeming to be influenced by the addition of methionine levels in the study, there was no difference in feed intake, feed conversion and weight of the birds.(AU)

Polimorfismo GHRD3 del gen del receptor de la hormona de crecimiento en niños peruanos con talla baja idiopática / GHRD3 polymorphism of growth hormone receptor gen in peruvian children with idiopathic short stature

Describir la estandarización de la detección molecular y la frecuencia del polimorfismo de GHRd3 del gen del receptor de la hormona de crecimiento en una población de niños peruanos con talla baja idiopática. Materiales y métodos. Se estudiaron 64 muestras de sangre periférica de pacientes con diagnóstico de talla baja idiopática atendidos en el servicio de endocrinología del Instituto Nacional de Salud del Niño en Lima, Perú. La amplificación del exón 3 se llevó a cabo empleando los cebadores G1, G2 y G3 optimizándose las condiciones de PCR, como la temperatura de hibridización y las concentraciones de magnesio. Resultados. Se determinó la especificidad de los cebadores a 67 °C y no se obtuvo diferencias entre las concentraciones de magnesio probadas. El 67% de los pacientes fueron homocigotos para GHRfl, 28% fueron heterocigotos y 5% fueron homocigotos para GHRd3. Conclusiones. La técnica permitió establecer los genotipos de los pacientes con talla baja idiopática, determinándose que solo el 5% de ellos presenta el genotipo susceptible de mejor respuesta al tratamiento con rhGH, lo cual puede ser considerado en la decisión de iniciar la terapia...

To describe the standardization of molecular detection and frequency of a growth hormone receptor gene deleted for exon three (GHRd3) polymorphism in a population of Peruvian children with idiopathic short stature. Materials and methods. Peripheral blood samples were used from patients (N=64) who were diagnosed with idiopathic short stature and were treated at the endocrinology unit of the National Institute of Child Health in Peru The amplification of exon 3 was carried out using G1, G2, and G3 primers by optimizing PCR conditions, such as annealing temperature and magnesium concentration. Results. The specificity of primers was maximized at 67 °C and there were no differences between magnesium concentration tests. Two-thirds (67%) of patients were GHRfl homozygous, 28% were heterozygous, and 5% were GHRd3 homozygous. Conclusions. The test was useful in determining the genotypes of patients with idiopathic short stature and revealed that only 5% had a genotype that would respond better to rhGH treatment. Thus, molecular assays may be useful when considering the decision to start drug therapy...

Serum IGFBP4 concentration decreased in dairy heifers towards day 18 of pregnancy

This study was conducted to determine if the main components of the somatotropic axis change during the early phase of pregnancy in the maternal blood system and whether differences exist on day 18 after pregnancy recognition by the maternal organism. Blood samples of pregnant heifers (Holstein Friesian; n = 10 after embryo transfer) were obtained on the day of ovulation (day 0), as well as on days 7, 14, 16 and 18 and during pregnant, non-pregnant and negative control cycles. The oncentrations of progesterone (P4), oestrogen, growth hormone (GH), insulin-like growth factor-1 and -2 (IGF1, -2) and IGF-binding protein-2, -3 and -4 (IGFBP2, -3, -4) were measured. The mRNA expressions of growth hormone receptor 1A, IGF1, IGF2, IGFBP2, IGFBP3 and IGFBP4 were detected using RT-qPCR in liver biopsy specimens (day 18). In all groups, total serum IGF1 decreased from day 0 to 16. Notably, IGFBP4 maternal blood concentrations were lower during pregnancy than during non-pregnant cycles and synchronized control cycles. It can be speculated that the lower IGFBP4 in maternal blood may result in an increase of free IGF1 for local action. Further studies regarding IGFBP4 concentration and healthy early pregnancy are warranted.

Association between the Growth Hormone Receptor Exon 3 Polymorphism and Metabolic Factors in Korean Patients with Acromegaly

BACKGROUND: This study investigated the association between the frequency of growth hormone receptor (GHR) exon 3 polymorphism (exon 3 deletion; d3-GHR) and metabolic factors in patients with acromegaly in Korea. METHODS: DNA was extracted from the peripheral blood of 30 unrelated patients with acromegaly. GHR genotypes were evaluated by polymerase chain reaction and correlated with demographic data and laboratory parameters. RESULTS: No patient had the d3/d3 genotype, while four (13.3%) had the d3/fl genotype, and 26 (86.7%) had the fl/fl genotype. Body mass index (BMI) in patients with the d3/fl genotype was significantly higher than in those with the fl/fl genotype (P=0.001). Age, gender, blood pressure, insulin-like growth factor-1, growth hormone, fasting plasma glucose, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol levels showed no significant differences between the two genotypes. CONCLUSION: The d3-GHR polymorphism may be associated with high BMI but not with other demographic characteristics or laboratory parameters.

Fatores ambientais associados ao tempo de decisão para procura de atendimento no infarto do miocárdio / Environmental factors associated with the decision time for seeking care in myocardial infarction / Factores ambientales asociados con el tiempo de decisión para la búsqueda de atención en el infarto de miocardio

Objetivou-se estimar o tempo de decisão para procura de atendimento (TD) para homens e mulheres com infarto agudo do miocárdio (IAM); analisar a influência de variáveis ambientais no TD e a interação entre gênero e variáveis ambientais para o desfecho TD. Estudo transversal, envolvendo cem pacientes, entrevistados em hospitais de Salvador. Na análise dos dados empregou-se o Qui-quadrado ou Exato de Fisher e o Modelo de Regressão Linear Robusto. Predominou o IAM ocorrido no domicílio, familiares no entorno, e os pacientes sendo alvo de ações equivocadas. Observou-se TD elevado para mulheres (0,9h) e homens (1,4h). Aqueles em casa no início dos sintomas tiveram maior TD, comparados aos no trabalho e menor em relação aos em via pública (p=0,047). Houve interação estatisticamente significante entre gênero e viver acompanhado; e entre gênero e ter companheiro e filhos no entorno, para o desfecho TD. O cuidar em enfermagem focalizado nas especificidades de fatores ambientais e de gênero pode otimizar o atendimento precoce.

The purpose was to estimate the decision time (DT) for searching for attendance for men and women suffering from acute myocardial infarction (AMI); and to analyze the influence of surrounding variables in the DT. Transversal study, involving one hundred patients interviewed in hospitals of Salvador-BA, Brazil. For data analysis, it was used the chi-squared or Fisher’s exact test, and the Robust Linear Regression Model. AMI at the home predominated, with family members and patients receiving mistaken actions. A high DT was observed both, for women (0.9h) and men (1.4h). Those at home during the initial symptoms had higher DT, compared to those at work; and lower in relation to those in public spaces (p=0.047). Statistically significant interaction occurred among gender and the fact of living with company; and among gender and having a companion and children, for the outcome of the DT. Nursing care focused on the specificity of surrounding factors and gender can optimize early attendance.

Se objetivó estimar el tiempo de decisión para buscar atendimiento (TD) para hombres y mujeres con infarto agudo de miocardio (IAM); analizar la influencia de variables ambientales en TD y la interacción entre genero y variables ambientales para el desfecho del TD. Estudio transversal, envolviendo cien pacientes entrevistados en hospitales de Salvador-BA, Brasil. En el análisis se utilizó el chi-cuadrado o el Teste Exacto de Fisher y el Modelo de Regresión Linear Robusto. Predominó el IAM en el domicilio, familiares en el entorno y con pacientes siendo objeto de acciones equivocadas. Se observó TD elevados para mujeres (0,9h) y hombres (1,4h). Aquellos en sus casas en el inicio de los síntomas tuvieron mayor TD, comparados a los en el trabajo, y menor en relación aquellos en vía pública (p=0,047). Hubo interacción estadísticamente significante entre genero y vivir acompañado y entre genero y tener compañero e hijos en el entorno, para el desfecho del TD. El cuidar en enfermería focalizado en especificidades de factores ambientales y de géneros puede optimizar el atendimiento precoce.

Single-nucleotide polymorphism analysis of GH, GHR, and IGF-1 genes in minipigs

Tibetan (TB) and Bama (BM) miniature pigs are two popular pig breeds that are used as experimental animals in China due to their small body size. Here, we analyzed single-nucleotide polymorphisms (SNPs) in gene fragments that are closely related to growth traits [growth hormone (GH), growth hormone receptor (GHR), and insulin-like growth factor (IGF)-1)] in these pig breeds and a large white (LW) control pig breed. On the basis of the analysis of 100 BMs, 108 TBs, and 50 LWs, the polymorphic distribution levels of GH, GHR, and IGF-1 were significantly different among these three pig breeds. According to correlation analyses between SNPs and five growth traits - body weight (BW), body length (BL), withers height (WH), chest circumference (CC), and abdomen circumference (AC) - three SNP loci in BMs and four SNP loci in TBs significantly affected growth traits. Three SNP sites in BMs and four SNP sites in TBs significantly affected growth traits. SNPs located in the GH gene fragment significantly affected BL and CC at locus 12 and BL at locus 45 in BMs, and also BW, WH, CC, and AC at locus 45 and WH and CC at locus 93 in TBs. One SNP at locus 85 in the BM GHR gene fragment significantly affected all growth traits. All indices were significantly reduced with a mixture of alleles at locus 85. These results provide more information regarding the genetic background of these minipig species and indicate useful selection markers for pig breeding programs.

Growth hormone receptor inhibition decreases the growth and metastasis of pancreatic ductal adenocarcinoma

Pancreatic cancer is the only major cancer with very low survival rates (1%). It is the fourth leading cause of cancer-related death. Hyperactivated growth hormone receptor (GHR) levels have been shown to increase the risk of cancer in general and this pathway is a master regulator of key cellular functions like proliferation, apoptosis, differentiation, metastasis, etc. However, to date there is no available data on how GHR promotes pancreatic cancer pathogenesis. Here, we used an RNA interference approach targeted to GHR to determine whether targeting GHR is an effective method for controlling pancreatic cancer growth and metastasis. For this, we used an in vitro model system consisting of HPAC and PANC-1 pancreatic cancer cells lines. GHR is upregulated in both of these cell lines and silencing GHR significantly reduced cell proliferation and viability. Inhibition of GHR also reduced the metastatic potential of pancreatic cancer cells, which was aided through decreased colony-forming ability and reduced invasiveness. Flow cytometric and western blot analyses revealed the induction of apoptosis in GHR silenced cells. GHR silencing affected phosphatidylinositol 3 kinase/AKT, mitogen extracellular signal-regulated kinase/extracellular signal-regulated kinase, Janus kinase/signal transducers and activators of transcription and mammalian target of rapamycin signaling, as well as, epithelial to mesenchymal transition. Interestingly, silencing GHR also suppressed the expression of insulin receptor-beta and cyclo-oxygenease-2. Altogether, GHR silencing controls the growth and metastasis of pancreatic cancer and reveals its importance in pancreatic cancer pathogenesis.

Pegvisomanto para o tratamento da acromegalia / Pegvisomanto for the treatment of acromegaly

CONTEXTO: A acromegalia é uma doença rara, debilitante e desfigurante, decorrente do excesso de produção do hormônio do crescimento (GH) e, consequentemente, do fator de crescimento semelhante à insulina (insulin-like growth factor I - IGF-I), que leva a um crescimento excessivo do esqueleto e dos tecidos moles. Está associada com um aumento da mortalidade e redução da qualidade de vida dos pacientes. A acromegalia está associada com um aumento da mortalidade e redução da qualidade de vida. A morbidade e mortalidade da doença estão correlacionadas com os níveis de GH e, desta forma, a utilização de terapias eficientes é importante. O tratamento pode ser feito por meio de cirurgia, radioterapia ou uso de medicamentos. É chamado de tratamento primário aquele usado como primeiro tratamento (em geral com o intuito de controlar a doença em longo prazo). O tratamento secundário tem como objetivo o controle da doença naqueles pacientes não compensados após realização de tratamento primário. Somavert® (pegvisomanto) é indicado para o tratamento da acromegalia em pacientes que apresentaram resposta inadequada à cirurgia e/ou à radioterapia e para aqueles pacientes cujo tratamento médico com análogos da somatostatina não normalizou as concentrações séricas de IGF-I ou não foi tolerado. EVIDÊNCIAS CIENTÍFICAS: Além da análise dos estudos apresentados pelo demandante, a Secretaria-Executiva da CONITEC realizou busca na literatura por artigos científicos, com o objetivo de encontrar Revisões Sistemáticas e Ensaios Clínicos Randomizados (ECR), considerados a melhor evidência para avaliar a eficácia de uma tecnologia usada para tratamento. As bases pesquisadas foram Medline® (via PubMed), The Cochrane Library (via Bireme) e CRD (Centre for Reviews and Dissemination). RECOMENDAÇÃO DA CONITEC: em decorrência da limitação de dados que demonstrem a efetividade e a segurança do medicamento por períodos mais prolongados e, principalmente, por uma relação de custo-efetividade bastante desfavorável, os membros da CONITEC, presentes na reunião do plenário do dia 02/08/2012, não recomendaram a incorporação do medicamento pegvisomanto para o tratamento da acromegalia no SUS. CONSULTA PÚBLICA: A consulta pública foi realizada do dia 13/08/2012 ao dia 22/08/2012. Foram recebidas 16 contribuições. Delas, a maioria foi encaminhada por especialistas de instituições de saúde/hospitais, seguido de contribuições de instituições de ensino, empresa e de sociedades médicas. As contribuições apresentadas na consulta pública não acrescentaram novas evidências científicas sobre a utilidade do medicamento, além daquelas já apresentadas pelo demandante e avaliadas pela CONITEC. Desta forma, as conclusões do relatório da CONITEC são mantidas no sentido de que as evidências existentes são limitadas para a incorporação do medicamento no SUS. Além disso, algumas das contribuições trazem a preocupação sobre o uso incorreto deste medicamento caro no SUS, uma vez que as alternativas terapêuticas atualmente oferecidas (Cirurgia, Radioterpaia e Medicamentos) são utilizadas de maneira inadequada, o que poderá levar a que este medicamento seja prescrito de maneira desnecessária para muitos pacientes. Desta forma, antes da incorporação do pegvisomanto é necessário que se garanta que as atuais terapias oferecidas, que já são bastante onerosas para SUS, sejam utilizadas de maneira otimizada. Ao contrário, estaremos em risco de aumentar ainda mais os custos do tratamento da acromegalia com utilização inadequada do Pegvisomanto. Neste sentido, devemos considerar que os valores bastante elevados de custo por QALY (ao redor de 230 mil reais) e por ano de vida ganho (ao redor de 820 mil reais) para a utilização do Pegvisomanto, podem ficar ainda muito mais elevados se a medicação for utilizada de maneira inadequada. DELIBERAÇÃO FINAL: Os membros da CONITEC presentes na 9ª reunião do plenário do dia 11/10/2012, por unanimidade, ratificaram a decisão de não recomendar a incorporação do medicamento pegvisomanto para o tratamento da Acromegalia. DECISÃO: PORTARIA SCTIE-MS N.º 1 de 17 de janeiro de 2013 - Torna pública a decisão de não incorporar o medicamento pegvisomanto para o tratamento da acromegalia no Sistema Único de Saúde (SUS).

Effect of rhGH on JAK2-STAT3 signal pathway after GHR was down-regulated by siRNA in gastric cancer cell / 药学学报

To investigate the effect of recombinant human growth hormone (rhGH) on JAK2-STAT3 pathway and the growth of gastric cancer cell lines at different GHR expression status, the eukaryotic expression vector targeting human GHR (pGPU6/GFP/Neo-shGHR and pGPU6/GFP/Neo-scramble) was constructed and transfected into MGC803 cells by Lipofectamine 2000. Stable expressive cell lines were obtained by G418 screening. The expression of GHR was analyzed by Western blotting. After being stimulated with rhGH, cell growth was detected by MTT assay. Cell cycle and apoptosis were examined by flow cytometry. The components of JAK2/STAT3 signaling pathway were detected by Western blotting. There is no significant difference of GHR expression between MGC803 and pGPU6/GFP/Neo-scramble-transfected cells (named as MGC803-NC) (P > 0.05). Compared with MGC803, the GHR expression in pGPU6/GFP/Neo-shGHR-transfected cells (named as MGC803-shGHR) decreased significantly (protein decreased 50%). The cells were treated with rhGH at 0, 150 and 300 ng x mL(-1), the growth rate of MGC803 and MGC803-NC increased significantly, PI and the number of G2/M phase cells all increased significantly, and apoptosis decreased significantly. Western blotting revealed that the expression of pJAK2 and pSTAT3 was up-regulated after being treated with rhGH in MGC803 and MGC803-NC cells. In contrast, similar change was not observed in MGC803-shGHR cells. Knockdown of GHR gene may decrease the sensitivity of gastric cancer cells to rhGH, and down-regulating of components of the expression of JAK2/STAT3 signaling pathway may be the potential mechanisms.

The effect of polymorphism F279Y of GHR gene on milk production trait in Chinese Holstein cattle / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To study the effect of the polymorphism F279Y of the growth hormone receptor (GHR) gene on milk yield and composition in Chinese Holstein cattle.</p><p><b>METHODS</b>Hundred thirty two Chinese Holstein cattle were selected as study materials, according to DHI production performance method to get the data of milk yield and composition; PCR- SSCP and sequencing method were used to detect the genotypes; least square method was used to acquire correlation analysis.</p><p><b>RESULTS</b>Chinese Holstein cattle F279Y of GHR gene loci A and T allele frequency were 0.68 and 0.32, respectively, the experimental group significantly deviated from Hardy Weinberg equilibrium (P < 0.01); 305 d milk yield of AA genotype was significantly higher than AT type (P < 0.05), 305 d milk fat yield, 305 d milk protein yield and 305 d lactose of AT type had better trend than those of AA type in numeric; Therefore, allele A was dominant gene of high milk yield, allele T has positive effect on milk composition.</p><p><b>CONCLUSION</b>Mutation F279Y of GHR gene can be used as genetic markers in Chinese Holstein milk production traits of marker assisted selection (MAS) breeding.</p>

Analysis of clinical manifestations and genetic mutations in a child with Laron syndrome / 中华儿科杂志

<p><b>OBJECTIVE</b>To analyze clinical manifestations and gene mutations in a child with severe short stature, explore its molecular mechanism and further clarify the diagnostic procedure for short stature.</p><p><b>METHOD</b>We observed clinical characteristics of a patient with short stature and did diagnostic examinations, assessed the function of GH-IGF-1 axis, and surveyed its family members.Genomic DNA was extracted from peripheral blood, GHR, IGFALS, STAT5b and GH1 gene were amplified by PCR for sequencing, including exons and splicing areas.</p><p><b>RESULT</b>The patient presented symmetrical short stature (height -8.2 SDS) and facial features, and other congenital abnormalities.It displayed non-growth hormone deficiency. The baseline value of GH was 21 µg/L, and the peak was 57.9 µg/L. The value of IGF-1 was less than 25 µg/L, and the IGFBP-3 less than 50 µg/L. And IGF-1 generation test showed no response. There was no similar patients in the family members.Sequencing of GHR in the patient revealed a homozygous point mutation (c.Ivs6+1G>A), and her father and mother had the same heterozygous mutation. The same mutation was not identified for her sister.No other candidate gene was found.</p><p><b>CONCLUSION</b>As the result of combined clinical characteristics and lab examinations, as well as gene detection, the case was diagnosed with Laron syndrome and GHR gene mutation is the molecular mechanism.We should explicit the etiological diagnosis for short stature, and avoid missed diagnosis and misdiagnosis.</p>

Polimorfismo GHRd3 e suas implicações na prática clínica / GHRd3 polymorphisms and their implications in clinical practice

O hormônio do crescimento (GH), ou somatotropina, é um hormônio secretado pela glândula hipófise anterior, cuja função é promover e controlar o crescimento corporal. Polimorfismos em receptores de hormônios têm sido apontados como importantes no desenvolvimento de muitas doenças e, entre os polimorfismos do gene GHR, o polimorfismo representado pela deleção do éxon 3 do gene GHR (GHRd3) tem sido o mais estudado. Este polimorfismo tem influência sobre a expressão e/ou responsividade do GHR, afetando sua ligação ao GH. O objetivo deste trabalho é realizar uma revisão sobre o polimorfismo GHRd3 e suas implicações na prática clínica

Growth hormone (GH) or somatotropin is a hormone secreted by the anterior pituitary gland, whose function is to promote and control the body growth. Polymorphisms in hormone receptors have been identified as important in the development of many diseases, and, among the GHR gene polymorphisms, the polymorphism represented by the deletion of exon 3 of the GHR gene (GHRd3) has been the most studied. This polymorphism influences the expression and/or responsiveness of GHR, affecting its binding to GH. The aim of this study is to perform a review of GHRd3 polymorphism and its implications for clinical practice

Relationship between the polymorphism of growth hormone receptor Ex3 and the efficacy of rhGH treatment in children with idiopathic short stature / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To assess the influence of growth hormone receptor (GHR) Ex3 genotype on the short-term response to recombinant human growth hormone (rhGH) therapy in children with idiopathic short stature (ISS).</p><p><b>METHODS</b>Thirty prepubertal children with ISS receiving rhGH treatment [0.116±0.02 IU/(kg/d)] were randomly recruited. The GHR Ex3 locus was genotyped using a PCR multiplex assay. The growth data including growth velocity, height SDS for chronological age (HtSDSCA), height SDS for bone age (HtSDSBA) and predict final height were compared in children with different GHR genotypes 6 months after rhGH treatment.</p><p><b>RESULTS</b>After 6 months of rhGH treatment, the children with ISS carrying d3/d3 alleles showed a significantly higher increment in growth velocity than those carrying fl/fl alleles (6.3±1.6 cm/year vs 3.4±0.5 cm/year; P<0.05).</p><p><b>CONCLUSIONS</b>The polymorphism in GHR Ex3 is associated with the responsiveness to rhGH treatment, showing that the growth velocity in ISS children with d3/d3 genotype is significantly higher than those with fl/fl genotype.</p>

Asociación de la variante GHRd3 del receptor de la hormona de crecimiento con autoinmunidad en la diabetes tipo 1 / Association of GHRd3 variant of growth hormone receptor gene with autoimmunity in type 1 diabetes

Background: Growth Hormone Receptor (GRH) is expressed in the liver, pancreas, stomach and small intestine. A high expression of GHR mRNA in the mucosal gut suggests a possible role of this receptor on digestive and immune functions. Aim: To investigate the putative effects of the GHRd3 variants on the cytokine profile and distribution of auto-antibodies in children with type 1 diabetes (T1D). Material and Methods: Unrelated unaffected controls (n =192) and incident cases of children with T1D (n =127) were analyzed for GHRd3 polymorphism, cytokine profile and a panel of auto-antibodies. Results: The allele frequency for d3 was 24.8 percent in type 1 diabetics and 34.1 percent in controls (p =NS). Among type 1 diabetic children, the carriers of the GHRd3 polymorphism had significantly higher levels of interleukin-lB than homozygous for the wild type genotype (5.7 and 17.7, pg/ml respectively p <0.015). Carriers of d3 variant had a higher frequency of positive anti-insulin antibodies (anti-IAA) than children without this variant (39.6 and 17.7 percent respectively, p <0.01). Conclusions: The observed frequency of the GHR d3/d3 genotype was comparable to other reports. A relationship between d3 variant and anti-IAA antibodies and interleukin-1ß was observed.

Investigação de baixa estatura: aspectos clínicos, laboratoriais e moleculares da insensibilidade ao hormônio de crescimento / Short stature investigation: clinical, laboratorial and genetic aspects concerning the trowth hormone insensitivity (GHI)

Neste artigo são descritos os aspectos clínicos, laboratoriais e genéticos da investigação da baixa estatura, dando ênfase para o diagnóstico da insensibilidade ao hormônio de crescimento (IGH). O paciente apresentado possuía características clínicas típicas de pacientes com IGH e em idade pré-púbere seus achados laboratoriais eram compatíveis com este diagnóstico (IGF-1 e IGFBP3 baixos, GH basal e pós-estímulo elevados). No entanto, quando avaliado durante a puberdade, as dosagens de IGF-1 e IGFBP-3 foram normais, dificultando o diagnóstico. O estudo molecular identificou mutação no exon 7 do gene do receptor do hormônio de crescimento (S226I). Discutiram-se os passos realizados para identificar a mutação e demonstrar que ela é responsável pelo fenótipo observado no paciente. Também será feita revisão dos casos de IGH descritos no Brasil e dos novos defeitos moleculares descritos nesta doença.

It is reported in this study the clinical, laboratory and genetic aspects of short stature investigation with emphasis to the diagnostic approach of growth hormone insensitivity (GHI). This patient in case presented typical clinical features of GHI and his laboratory findings at prepubertal age were typical of those observed in GHI patients (low IGF-1 and IGFBP-3 levels, with high basal and stimulated GH levels). However, during the puberty, he presented normal IGFBP-3 and IGF-1 levels that hindered the diagnosis. The molecular study disclosed a mutation in exon 7 of growth hormone receptor gene (S226I). The steps that demonstrated the causative effect of this mutation are shown here, and also a review of Brazilian GHI cases is given and new molecular defects in this field are discussed as well.

Identification of growth hormone receptor in plexiform neurofibromas of patients with neurofibromatosis type 1

OBJECTIVE: The aim of this study was to investigate the presence of growth hormone receptor in plexiform neurofibromas of neurofibromatosis type 1 patients. INTRODUCTION: The development of multiple neurofibromas is one of the major features of neurofibromatosis type 1. Since neurofibromas commonly grow during periods of hormonal change, especially during puberty and pregnancy, it has been suggested that hormones may influence neurofibromatosis type 1 neurofibromas. A recent study showed that the majority of localized neurofibromas from neurofibromatosis type 1 patients have growth hormone receptor. METHODS: Growth hormone receptor expression was investigated in 5 plexiform neurofibromas using immunohistochemistry. RESULTS: Four of the 5 plexiform neurofibromas were immunopositive for growth hormone receptor. CONCLUSION: This study suggests that growth hormone may influence the development of plexiform neurofibromas in patients with neurofibromatosis type 1.

The effects of recombinant human growth hormone on the proliferation of Bel-7402 human hepatic carcinoma cell lines in vitro and its regulation on growth hormone receptors / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the role of recombinant human growth hormone (rhGH) in the growth of Bel-7402 human hepatic carcinoma cell line (Bel-7402 line) in vitro and its effects on GHR expression.</p><p><b>METHODS</b>Tumor cell count, MT assay and colony forming test were performed to determine the responses of Bel-7402 to different concentrations of rhGH (0, 1, 10, 100, 1000, 10 000 ng/ml). Metabolism of DNA in tumor cells was analyzed with the method of mixture of 3H-TdR. Radioreceptor assay was used to detect the GHR expression of the hepatic carcinoma cell lines and its relation to different rhGH concentrations.</p><p><b>RESULTS</b>rhGH accelerated the proliferation of the Bel-7402 line when the concentration of rhGH was over 100 ng/ml (P < 0.05). Other rhGH concentrations had also positive effects, but with reduced effect as compared with that of 100 ng/ml. After 24 h of rhGH addition of concentration of 10 ng/ml and 100 ng/ml, GHR site number was significantly higher than that in control group, while the 10,000 ng/ml group showed a significantly lower GHR site number.</p><p><b>CONCLUSIONS</b>Different concentrations of rhGH might result in variable effects on the growth of Bel-7402 hepatic carcinoma cell line. Certain concentrations of rhGH might stimulate the growth of the cell line. rhGH can regulate the expression of GHR in the cell line.</p>