Growth Hormone Related Diseases and Therapy: A Molecular and Physiological Perspective for the Clinician (Contemporary Endocrinology)

The molecular era ushered in the cloning of the growth hormone (GH) gene and the production of unlimited amounts of GH through recombinant technology. The continuing momentum of research from basic science to clinical evaluation has brought unprecedented advances to the understanding of GH biology for the clinical endocrinologist. Growth Hormone Related Diseases and Therapy: A Molecular and Physiological Perspective for the Clinician distills all the new information of relevance to the endocrinologist over the last 20 years by offering five sections: physiology, molecular genetics, GH deficiency, acromegaly and pharmacotherapy. The first section on physiology focuses on GH action. A review on the structure and function of the GH receptor is followed by a perspective on the regulatory role of ghrelin on GH secretion. The second section on genetics covers pituitary function and adenomas, including new and fascinating information on familial pituitary adenomas, their genotype and phenotype. The adult GH deficiency section spans the epidemiology and diagnosis of GH deficiency with a strong reminder for the clinician that the transition period represents a critical time of somatic maturation, which continues for years after cessation of liner growth. The section on acromegaly focuses on management, giving practical guides to the value of GH and IGF-1 measurements, the place of somatostatin analogues and of radiotherapy while reminding the reader as to why evaluating quality of life is an important part of management. Finally, the section on GH pharmacology takes the reader through innovative developments of long-acting GH formulations with some products on the threshold of clinical use. This section provides a balanced evidence based review of the effects of GH supplementation in aging and in sports where recent data indicates an enhancing effect on a selective aspect of performance. Growth Hormone Related Diseases and Therapy: A Molecular and Physiological Perspective for the Clinician integrates a wealth of information and will prove an invaluable reference for pediatric endocrinologists, adult endocrinologists, endocrine scientists and internists interested in the human biology of GH. Front Matter....Pages i-xiv Front Matter....Pages 1-1 Growth Hormone Receptor in Growth....Pages 3-16 Ghrelin in the Regulation of GH Secretion and Other Pituitary Hormones....Pages 17-31 Growth Hormone Pulsatility and its Impact on Growth and Metabolism in Humans....Pages 33-56 Metabolic Actions of Growth Hormone....Pages 57-79 Front Matter....Pages 81-81 Molecular Genetics of Congenital Growth Hormone Deficiency....Pages 83-102 Structural Abnormalities in Congenital Growth Hormone Deficiency....Pages 103-135 Genetic Causes of Familial Pituitary Adenomas....Pages 137-150 Front Matter....Pages 151-151 The Epidemiology of Growth Hormone Deficiency....Pages 153-167 Diagnosis of Growth Hormone Deficiency in Adults....Pages 169-186 Transition from Puberty to Adulthood....Pages 187-210 Issues in Long-Term Management of Adults with Growth Hormone Deficiency....Pages 211-236 Quality of Life in Acromegaly and Growth Hormone Deficiency....Pages 237-250 Front Matter....Pages 251-251 The Value of GH and IGF-I Measurements in the Management of Acromegaly....Pages 253-270 The Role of Somatostatin Analogues in Treatment of Acromegaly....Pages 271-302 The Role of External Beam Radiation Therapy and Stereotactic Radiosurgery in Acromegaly....Pages 303-315 Mortality and Morbidity in Acromegaly: Impact of Disease Control....Pages 317-338 GHR Antagonist: Efficacy and Safety....Pages 339-357 Front Matter....Pages 359-359 Long-Acting Growth Hormone Analogues....Pages 361-373 Growth Hormone Supplementation in the Elderly....Pages 375-387 Growth Hormone in Sports: Is There Evidence of Benefit?....Pages 389-404 Back Matter....Pages 405-411