Recent research suggests that adult growth hormone (GH) deficiency, whether of pathological or physiological origin, is associated with a dis­ tinct syndrome that includes alterations in body composition, endocrine­ metabolic function, immune competence, and physical and psychosocial well-being. Not surprisingly, substantial investigative effort is currently focused on validating the above hypothesis and on determining whether restoration of a normal GH-IGF-I axis in various states of adult GH deficiency is clinically useful, safe, and cost-beneficial. This book contains the proceedings from the Symposium on GHRH, GH, and IGF-I: Basic and Clinical Advances, held December 9 to 12, 1993, in San Diego, California, and sponsored by Serono Symposia USA, Inc. The conference was meant to highlight selected novel and exciting clinical research developments related to possible therapeutic uses of recombinant human GH and IGF-I, GHRH, GH releasing peptides, and related GH secretagogues. This meeting occurred only one year after a similar Serono symposium that was somewhat more oriented to novel basic science discoveries, thus attesting to the current scientific and clinical interest in this area.

Inhalt

I. Overview of Physiology of the GHRH-Somatostatin-GH-IGF-I Axis.- 1. Physiology of the Growth Hormone Releasing Hormone-Somatostatin-Growth Hormone-Insulin-Like Growth Factor I Axis.- 2. Role of Somatostatin in the Regulation of Growth Hormone Secretion.- 3. Growth Hormone Releasing Hormone and Growth Hormone Releasing Peptides.- 4. GH Binding Protein, GH Receptors, and Domains Involved in Signal Transduction.- 5. Insulin-Like Growth Factors During Development.- II. Effects of Recombinant Human GH and/or IGF-I in Catabolic Illness.- 6. Anabolic Effects of Recombinant Human Growth Hormone and Insulin-Like Growth Factor I in Human Disease.- 7. Growth Hormone in Children with Chronic Renal Disease: Some Metabolic Considerations.- 8. Growth Hormone: The Visible Difference in Burn Care.- 9. Effects of Recombinant Human Growth Hormone on Body Composition and Metabolism in HIV-Associated Wasting.- 10. Administration of Growth Hormone as an Adjunct to Nutritional Support in Critical Illness.- 11. Strategies for the Use of Recombinant Human Growth Hormone and Insulin-Like Growth Factor I in Amyotrophic Lateral Sclerosis.- III. Contemporary Issues in Growth and Development.- 12. Contemporary Issues in Growth and Development: An Overview.- 13. Use of Recombinant IGF-I in Syndromes of GH Insensitivity.- 14. Use of Growth Hormone in Non-Growth-Hormone-Deficient Children: Physiologic, Pharmacologic, and Ethical Issues.- 15. Growth Hormone Treatment of Nonelderly Adults with GH Deficiency.- IV. Effects of rhGH and IGF-I on Intermediary and Bone Metabolism.- 16. Overview of Growth Hormone and IGF-I Effects on Intermediary Metabolism and Bone.- 17. Effects of rhGH on Glucose, Lipid, and Amino Acid Metabolism.- 18. Metabolic Effects of IGF-I: Implications for the Therapy of Diabetes Mellitus.- 19. Modulation of Responses to GH and IGF-I by Nutritional Variables.- 20. Growth Hormone Effects on the Adult Skeleton.- 21. Insulin-Like Growth Factors and Skeletal Remodeling.- V. Use of GHRH, rhGH, and rhIGF-I in Aging.- 22. Growth Hormone and Aging: A Brief Review.- 23. Potential Benefits and Risks in Treating the Hyposomatomedinemia and Hypogonadism of Elderly Men.- 24. Effects of Growth Hormone Releasing Hormone Administration in Healthy Aging Men.- 25. Effects of Recombinant Human Insulin-Like Growth Factor I in Aging.- 26. Growth Hormone and Immune Function in the Elderly.- 27. Treatment with Growth Hormone: Focus on Specificity with a View to the Future.- Author Index.