A detailed account of the past and present of human growth hormone

With the continuous improvement of living standards, more and more parents are beginning to pay attention to their children's height. We are often consulted by parents about growth hormone. Let us learn about growth hormone together today.

Growth hormone is a peptide hormone secreted by the anterior pituitary gland, composed of 191 amino acids, which can promote bone growth, protein synthesis, affect fat and mineral metabolism, and play an important role in human growth and development. Since the first human pituitary-derived growth hormone was used in clinical practice in 1958, growth hormone has been updated to the fifth generation, and its stability and safety have been greatly improved.

The first generation of growth hormone (1950s-1970s), also known as human pituitary growth hormone, was extracted from the human pituitary gland and was mainly used for dwarfism in children. Due to limited sources, high prices, and susceptibility to viral contamination, it was banned by the US FDA in 1985.

Second generation growth hormone (early 1980s), in the early 1980s, scientists used E. coli inclusion bodies to develop a recombinant human growth hormone with 192 amino acids, which has one more methionine residue than natural growth hormone. This drug has complex production process, is easy to pollute, has high rejection, and poor clinical effect, and has now been eliminated from the market.

The third generation of growth hormone (mid-1980s). In the mid-1980s, scientists used Escherichia coli gene expression technology to synthesize growth hormone. Although it has the same amino acid as natural GH, its three-dimensional structure is slightly different, and the antibody production rate is still high. It is no longer used.

The fourth generation of growth hormone (late 1980s) is synthesized by recombinant DNA in mammalian cells and is closer to natural growth hormone. However, due to its high cell culture requirements, low yield and susceptibility to viral contamination, it is currently only used by a few manufacturers.

The fifth generation of growth hormone (since the 1990s) is produced by secretory expression of E. coli, and the product is directly secreted outside the bacteria. The amino acid sequence and protein structure are completely consistent with the growth hormone produced by the pituitary gland, and the biological activity is greatly improved compared with the previous one. It is currently used by most manufacturers.

The current clinically used growth hormone dosage forms mainly include growth hormone freeze-dried powder, growth hormone injection, and long-acting growth hormone (polyethylene glycol recombinant human growth hormone), all of which are fifth-generation products.

Growth hormone powder injection and water injection are both administered once a day, and long-acting growth hormone is administered once a week, which greatly improves the medication compliance of children. However, the clinical effects of the three dosage forms are basically the same, and doctors can choose the medication according to the condition of the child.

In the clinical field, in addition to the treatment of growth hormone deficiency, growth hormone is also widely used in the fields of reproduction, burns and anti-aging.

Although growth hormone does not produce side effects like steroid hormones, it also has its own side effects. The more common ones include redness and swelling at the injection site, fat atrophy, transient hyperglycemia, etc., which usually disappear after stopping the drug; uncommon adverse reactions include papilledema, intracranial hypertension, femoral head slippage and necrosis, etc.

In summary, growth hormone should be used under the guidance of an endocrinologist or pharmacist, should not be self-injected, and relevant biochemical indicators need to be closely monitored during use.

(Zhang Miao, Henan Children's Hospital)