Growth Hormone Disorders

Question 1

What are the three ways in which there can be GH deficiencies

Answer 1

GH insensitivity, No GH production (Secondary) and no GH production stimulation (tertiary) due to lack of upstream promoters

Question 2

How do you treat GH insensitivity

Answer 2

Via a IGF-1 injection

Question 3

How do you treat no GH

Answer 3

Via GH analogues (somatotrophins)

Question 4

How do you treat upstream deficiencies

Answer 4

Via GHRH and Ghrelin injections

Question 5

What are some of the causes of to much GH

Answer 5

Pituitary tumour

Question 6

What are some of the treatments for increased GH

Answer 6

Antagonists, Reduced secretion, tumour removal for Acromegaly

Question 7

What is the development of GH antagonist

Answer 7

Called pregvisimant and developed by removing lysine from position 120 to reduce binding at site 2. Then to increse half life PEGylate, yet to PEGYlate must add to lysine which is essential for binding at site 2. Hence modify 9 sites to mediate binding at site 1. Now has 28 less binding affinity yet 400 times increased in half life.

Question 8

What are the drugs to reduce GH secretion?

Answer 8

Somatostatin drugs with modified amino acids (D) to increase half life (Octreotide and Lanreotide) and also dopamine agonist (Bromocriptine and Cabergoline)

Question 9

How do you image tumours?

Answer 9

Use a labelled somatostatin analogue and they will be taken up into tumour cells