Cardiopulmonary Support and Physiology
Growth hormone prevents acute liver injury induced by cardiopulmonary bypass in a rat model
Yong An, MD, Ying-Bin Xiao, MD*
Department of Cardiovascular Surgery, Xin-Qiao Hospital, Third Military Medical University, Chongqing, China.
Received for publication November 13, 2006; revisions received February 7, 2007; accepted for publication February 14, 2007.
* Address for reprints: Ying-Bin Xiao, MD, Department of Cardiovascular Surgery, Xin-Qiao Hospital, Third Military Medical University, ShaPingBa District, Chongqing 400037, China. (Email:
anyongsmcvs@163.com).
Objective: Cardiopulmonary bypass***8211;induced acute liver injury is a life-threatening complication thought to be associated with the inflammatory response and the acute-phase response. Recombinant human growth hormone can modulate the acute-phase response and inflammatory response. We tested the protective effect of growth hormone on cardiopulmonary bypass***8211;induced liver injury in the rat.
Methods: Adult male Sprague***8211;Dawley rats (group G received 2.5 mg/kg recombinant human growth hormone intramuscularly at 8 AM every 24 hours for 3 days and just before the initiation of cardiopulmonary bypass; group C served as a control group) underwent cardiopulmonary bypass (120 minutes, 120 mL · kg***8211;1 · min***8211;1, 34°C) and were killed 3 hours after the termination of cardiopulmonary bypass.
Results: Administration of recombinant human growth hormone markedly increased serum insulin-like growth factor and insulin-like growth factor***8211;binding protein 3 levels compared with those seen in group C. Group G showed significantly lower serum concentrations of alanine aminotransferase and total bilirubin after cardiopulmonary bypass termination. Those receiving recombinant human growth hormone demonstrated a significant increase in serum prealbumin and transferrin levels and a marked decrease in serum amyloid A and C-reactive protein levels. Recombinant human growth hormone significantly decreased serum tumor necrosis factor and interleukin 1ß levels, whereas no changes were found for serum interleukin 6 and interleukin 10 levels. Recombinant human growth hormone significantly increased total liver protein content and hepatocyte proliferation and decreased hepatocyte apoptosis versus values seen in group C.
Conclusions: These results suggest that growth hormone prevents cardiopulmonary bypass***8211;induced acute liver injury in a rat model through decreases in acute-phase proteins, proinflammatory cytokines tumor necrosis factor and interleukin 1ß, and hepatocyte apoptosis, which is associated with increases in constitutive hepatic proteins, total liver protein content, and hepatocyte proliferation. This strategy of pretreatment with growth hormone might be a prospective management for preventing acute liver injury when major cardiac surgery with cardiopulmonary bypass is performed.
Dig Liver Dis. 2008 Jul;40(7):554-9. Epub 2008 Mar 4. Links
Recombinant human growth hormone increases albumin and prolongs survival in patients with chronic liver failure: a pilot open, randomized, and controlled clinical trial.Li N, Zhou L, Zhang B, Dong P, Lin W, Wang H, Xu R, Ding H.
Department of GI and Hepatology, Beijing You'an Hospital Affiliated to Capital Medical University, China.
OBJECTIVE: To evaluate the efficacy and safety of recombinant human growth hormone (rhGH) in the treatment of patients with chronic liver failure. SUBJECTS AND METHODS: One hundred and fourteen patients with chronic liver failure were randomly divided into two groups: (1) 56 patients in the rhGH treatment group received 4.5IU of rhGH intramuscularly daily for 4 weeks and (2) 58 patients in the control-treatment group. Fifteen healthy subjects served as normal controls. Symptoms and complications were recorded. The prognosis was analysed by Kaplan-Meier survival analysis. The serum GH, IGF-1, IGFBP-3, and insulin levels were determined using ELISA. RESULTS: The efficacy of rhGH treatment was 87.5% (vs. 38.1% in the controls-treatment group, p<0.01). The serum GH, IGF-1, IGFBP-3, and insulin levels in patients with chronic liver failure were significantly different than the levels in the normal controls (5.50+/-4.21 vs. 1.57+/-1.27, 80.45+/-69.99 vs. 172.97+/-78.12, 109.93+/-87.53 vs. 373.41+/-119.07, and 31.99+/-49.87 vs. 6.72+/-1.09, respectively, p<0.05-0.001). The serum IGF-1, IGFBP-3, albumin, proalbumin, and cholesterol levels were significantly increased after rhGH treatment; however, the serum GH and insulin levels were decreased. The survival rate of the rhGH treatment and control-treatment groups after 2 weeks, 1 month, 3 months, and 6 months of treatment was 98.21% vs.75.86%, 91.07% vs.62.07%, 66.07% vs.22.41%, and 55.36% vs.13.79%, respectively. Cox regression analysis showed that rhGH was an independent factor in predicting the survival of patients after 3 and 6 months of treatment with rhGH. CONCLUSIONS: rhGH replacement therapy increased albumin and tended to improve survival in adult patients with chronic liver failure.
Hunan Yi Ke Da Xue Xue Bao. 2003 Aug;28(4):398-400.Links
[Clinical observation of recombinant growth hormone therapy for liver cirrhosis with hypoproteinemia][Article in Chinese]
Liu SJ, Tang WL, Shen SR.
Department of Gastroenterology, Third Xiangya Hospital, Central South University, Changsha 410013, China.
OBJECTIVE: To assess the effect of recombinant growth hormone (rhGH) therapy for liver cirrhosis patients with hypoproteinemia. METHODS: Fifteen patients with liver cirrhosis were treated with rhGH (4 U per day) for 7 days and 15 controls were given human albumin (10 g) for every other day (altogether 3 times). Albumin was measured one day before the treatment, and on day 1, 10, 14, and 28 after the treatment. RESULTS: After 7 days of rhGH administration, the albumin level of the patients was significantly higher and the function lasted longer than those of patients treated with human albumin (P < 0.05). CONCLUSION: Exogenous rhGH in treating hypoproteinemia in patients with liver