The Pathophysiology Of Daily Growth Hormone Versus Long-Acting Growth Hormone: A Review

Abstract

Long-acting growth hormone analogues with lower injection frequency may aid in reducing treatment non-adherence and, as a result, potentially improve therapeutic efficacy. LAGH analogues can be taken on a weekly, biweekly, or monthly basis. There are conceptual reasons to believe that LAGH analogues are weaker compared to daily recombinant human (rh)GH administration. The physiologic secretory pattern of GH is episodic and pulsatile, with several peaks throughout the day and a higher number in the second half of the night while sleeping. Questions have been voiced that elevated and non-pulsatile GH exposure may downregulate or desensitize GH receptor signaling. Hence, it is critical to investigate the pathophysiology of both hormones' actions, including their growth enhancing effects as well as their role in hyperglycemia (the commonest side effect of growth hormone administration). GH can stimulate chondrocyte proliferation, type II collagen synthesis, and extracellular matrix formation via the phosphorylated STAT3 protein. The degree of activation by daily GH and LAGH must be compared. This type of research could shed light on the pathogenicity of daily versus long-acting growth hormone.