Recombinant human growth hormone: a medical miracle or cause for concern?
DOI:
https://doi.org/10.30574/gscbps.2018.5.1.0090Keywords:
Growth hormone, Growth hormone deficiency, Adverse effects, Anti-aging, CancerAbstract
The availability of recombinant human growth hormone (GH) has expanded the use beyond growth hormone deficiency (GHD) to conditions that include, use in anti-aging formula and in sports to enhance athletic performance. The long-term safety and efficacy of GH use for these conditions has not been demonstrated. The objective of this review is to explore evidence from clinical and epidemiological studies to determine the safety of GH and current updates on any adverse effects including cancer risk. The primary concern with GH use for healthy adults without proven GHD is the lack of long-term studies evaluating its safety and efficacy. An association with cancer has been shown in limited studies that highlight the need for caution on long term use in healthy adults without GHD. GHD efficacy has not been established in anti-aging or enhancing athletic performance but adverse effects have been documented in these uses.
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References
Strobl JS and Thomas MJ. (1994). Human growth hormone. Pharmacological Reviews, 46, 1-34.
Laron Z. (1996). Short stature due to genetic defects affecting growth hormone activity. New England Journal of Medicine, 334(7), 463-465.
Gupta V. (2011). Adult growth hormone deficiency. Indian Journal of Endocrinology and Metabolism, 15(l3), S197–S202.
Reed ML, Merriam GR and Kargi AY. (2013). Adult growth hormone deficiency – benefits, side effects, and risks of growth hormone replacement. Frontiers in Endocrinology, 4, 64.
Fradkin JE, Schonberger LB, Mills JL, Gunn WJ, Piper JM, Wysowski DK, Thomson R, Durako S and Brown P. (1991). Creutzfeldt-Jakob disease in pituitary growth hormone recipients in the United States. Journal of the American Medical Association, 265(7), 880-884.
Swerdlow AJ, Higgins CD, Adlard P, Jones ME and Preece MA. (2003). Creutzfeldt-Jakob disease in United Kingdom patients treated with human pituitary growth hormone. Neurology, 61(6), 783-91.
Wiren L, Bengtsson BA and Johannsson G. (1998). Beneficial effects of long-term GH replacement therapy on quality of life in adults with GH deficiency. Clinical Endocrinology (Oxford), 48, 613-620.
López-Siguero J, Borrás Pérez MV, Balser S, Sigrid and Khan-Boluki, J. (2011). Long-term safety and efficacy of the recombinant human growth hormone Omnitrope® in the treatment of Spanish growth hormone deficient children: results of a phase III study. Advances in therapy, 28, 879-893.
Nass R, Huber RM, Klauss V, Muller OA, Schopohl J and Strasburger CJ. (1995). Effect of growth hormone (hGH) replacement therapy on physical work capacity and cardiac and pulmonary function in patients with hGH deficiency acquired in adulthood. The Journal of Endocrinology and Metabolism, 80, 552-557.
Bengtsson BA, Johannsson G, Shalet SM, Simpson H and Sonken PH. (2000).Treatment of growth hormone deficiency in adults. The Journal of Clinical Endocrinology and Metabolism, 85, 933-942.
Fürstenberger G and Senn HJ. (2002). Insulin-like growth factors and cancer. Lancet Oncology, 3, 298– 302.
Cohen P, Clemmons DR and Rosenfeld RG. (2000). Does the GH-IGF axis play a role in cancer pathogenesis? Growth Hormone and IGF Research, 10, 297– 305.
Swerdlow AJ, Reddingius RE and Higgins CD, Spoudeas HA, Phipps K, Qiao Z, Ryder WDJ, Brada M, Hayward RD, Brook CGD, Hindmarsh PC and Shalet SM. (2000). Growth hormone treatment of children with brain tumors and risk of tumor reccurrence. The Journal of Clinical Endocrinology and Metabolism, 85, 4444–4449.
Monson JP. (2000). Growth hormone (GH) replacement therapy: cancer in adults treated with GH. Growth Hormone and IGF Research. 10, S50–S51.
Yu H and Rohan T. (2000). Role of the insulin-like growth factor family in cancer development and progression. Journal of the National Cancer Institute, 92 (18), 1471-1489.
Baserga R. (1995).The insulin-like growth factor I receptor: a key to tumor growth? Cancer Research, 5, 249–252.
Vance ML. (2003). Can growth hormone prevent aging? New England Journal of Medicine, 348, 779-780.
Blethen Sl, Allen DB, Graves D, August G, Moshang T and Rosenfeld R. (1996). Extensive personal experience safety of recombinant deoxyribonucleic acid-derived growth hormone: the national cooperative growth study experience. Journal of Clinical Endocrinology and Metabolism, 81, 1704-1710.
Bolar K, Hoffman AR, Maneatis T and Lippe B. (2008) Long-term safety of rhGH in Turner syndrome. The Journal of Clinical Endocrinology and Metabolism, 93, 344-351.
Howell SJ, Wilton P, Linberg A and Shalet SM. (1998). Growth hormone replacement and risk of malignancy in children with neurofibromatosis. Journal of Pediatrics, 133, 201-205.
Child CJ, Zimmermann AG, Jia N, Robison LL, Brämswig JH and Blum WF. (2016). Assessment of primary cancer incidence in growth hormone-treated children: Comparison of a multinational prospective observational study with population databases. Hormone Research in Paediatrics, 85, 198–206
Wilton P, MD, Mattsson AF and Darendeliler F. (2010). Growth hormone treatment in children is not associated with an increase in the incidence of cancer: experience from KIGS (Pfizer International Growth Database). Journal of Pediatrics,157, 265-270
Swerdlow AJ, Cooke R, Beckers D, Borgström B, Butler G, Caret JC, Cianfarani S, Clayton P, Coste J, Deodati A, Ecosse E, Gausche R, Giacornozzi C, Hokken-Koelega ACS, Khan AJ, Kiess W, Kuehni CE, Mullis PE, Pfaffle R, Savendahl L, Sommer G, Thomas M, Tidblad A, Tollerfield S, Van Eycken L and Zandwijken GRJ. (2017). Cancer risks in patients treated with growth hormone in childhood: The SAGhE European cohort study. The Journal of Clinical Endocrinology and Metabolism, 102, 1661–1672
Sklar CA. Mertens AC, Mitby P, Occhiogrosso G, Qin J, Heller G, Yasui Y and Robison LL. (2002). Risk of disease recurrence and second neoplasms in survivors of childhood cancer treated with growth hormone: A report from the childhood cancer survivor study. The Journal of Clinical Endocrinology and Metabolism, 87(7), 3136–3141
Ergun-Longmire B, Mertens AC, Mitby P, Qin J, Heller G, Shi W, Yasui Y, Robison LL and Sklar CA. (2006). Growth hormone treatment and risk of second neoplasms in the childhood cancer survivor. The Journal of Clinical Endocrinology & Metabolism, 91(9), 3494–3498
Yu H and Rohan T. (2000). Role of the insulin-like growth factor family in cancer development and progression. Journal of National Cancer Institute, 92: 1472–1489
Shevah O and Laron Z. (2007). Patients with congenital deficiency of IGF-I seem protected from the development of malignancies: a preliminary report. Growth Hormone and IGF Research, 17(1), 54-57.
Steuerman, R., Shevah, O., and Laron, Z. (2011). Congenital IGF1 deficiency tends to confer protection against post-natal development of malignancies. European Journal of Endocrinology, 164 485–489.
Allen NE, Roddam AW, Allen DS, Fentiman IS, Santos Silva I, Peto J, Holly JMP and Key TJ. (2005). A prospective study of serum insulin-like growth factor-I (IGF-I), IGF-II, IGF-binding protein-3 and breast cancer risk British Journal of Cancer, 92, 1283–1287.
Stattin P, Bylund A, Rinaldi S, Biessy C, Déchaud H, Stenman UH, Egevad L, Riboli E, Hallmans G and Kaaks R. (2000). Plasma insulin-like growth factor-I, insulin-like growth factor-binding proteins, and prostate cancer risk: a prospective study. Journal of National Cancer Institute, 92(23), 1910-1917.
Enriori PJ, Fischer CR, Gori JR, Etkin AE, Calandra RS and Luthy IA. (2003). Augmented serum levels of the IGF-I/IGF-binding protein-3 ratio in pre-menopausal patients with type I breast cysts. European Journal of Endocrinology, 148, 177–184.
Giovannucci E, Pollak MN, Platz EA, Willett WC, Stampfer MJ, Majeed N, Colditz GA, Speizer FE and Hankinson SE. (2000). A prospective study of plasma insulin-like growth factor-1 and binding protein-3 and risk of colorectal neoplasia in women. Cancer Epidemiology, Biomarkers and Prevention, 9, 345–349
Larijani B, Aliannejad R, Khaleghnejad-Tabari N, Baradar-Jalili R, Ansari R, Tavangar SM and Bandarian F. (2007). The prevalence of Polyp in colon of patients with acromegaly. Archives of Iranian Medicine, 10 (2), 236 – 238.
Stochholm K, Gravholt CH, Laursen T, Laurberg P, Andersen M, Kristensen LØ, Feldt-Rasmussen U, Christiansen JS, Frydenberg M and Green A. (2007). Mortality and GH deficiency: a nationwide study. European Journal of Endocrinology, 157, 9-18.
Rudman D, Feller AG, Cohn L, Shetty KR, Rudman IW and Draper MW. (1991). Effects of human growth hormone on body composition in elderly men. Hormone Research, 36 (1), 73-81.
Liu H, Bravata DM, Olkin I, Nayak S, Roberts B, Garber AM and Hoffman AR. (2007). Systematic review: the safety and efficacy of growth hormone in the healthy elderly. Annals of Internal Medicine, 146, 104–115.
Liu H, Bravata DM, Olkin I, Nayak S, Roberts B, Garber AM and Hoffman AR. (2007). Systematic review: the effects of growth hormone on athletic performance. Annals of Internal Medicine, 148, 747-758.
Melmed, GY, Devlin SM, Vlotides G, Dhall D, Ross S, Yu R and Melmed S. (2008). Anti-aging therapy with human growth hormone associated with metastatic colon cancer in a patient with Crohn’s colitis. Clinical Gastroenterology and Hepatology, 6, 360–363.
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