What is Somatropin?
Somatropin, also known as human growth hormone (HGH), is a peptide hormone that stimulates growth, cell reproduction, and cell regeneration in humans and other animals. It is a 191 amino acid, single-chain polypeptide hormone that is produced by the anterior pituitary gland which is located at the base of the brain. It plays a key role in stimulating growth and cell regeneration.
Production and Release
The synthesis and secretion of it is regulated by the hypothalamus located in the brain. The hypothalamus secretes growth hormone-releasing hormone (GHRH) and growth hormone-inhibiting hormone (GHIH) or somatostatin, which respectively stimulate and inhibit the release of it from the anterior pituitary gland in a pulsatile manner. It is produced and stored in somatotrope cells within the anterior pituitary and is released in a diurnal pattern with highest levels typically occurring between midnight and dawn.
Functions
Some of the important functions of it include:
- Stimulating linear growth and skeletal growth - Somatropin promotes the differentiation and proliferation of chondrocytes and osteoblasts which leads to bone growth and extension. It is essential for normal skeletal growth during childhood and adolescence.
- Protein synthesis - Somatropin stimulates protein synthesis and inhibits protein breakdown leading to positive nitrogen balance and growth.
- Lipolysis - It stimulates the breakdown of fats and increases fat metabolism. This leads to decreased fat mass.
- Cell reproduction - It stimulates stem cells, and proliferation and regeneration of other cells such as skeletal, liver and kidney cells.
- Insulin antagonism - It increases blood glucose through antagonizing many of insulin's effects on carbohydrate and lipid metabolism.
- Immune function - It stimulates the immune system and increases antibody production.
Deficiency and Uses
Somatropin deficiency can result in dwarfism and short stature when it occurs during childhood and adolescence. Growth hormone therapy is the most common use of it in children not growing at a normal rate and having a low level of growth hormone. It is also used to treat Prader-Willi syndrome, Turner syndrome, chronic renal failure and short bowel syndrome when growth is compromised.
Some other uses of it include treatment of HIV/AIDS wasting, cachexia, short bowel syndrome, aging/anti-aging and muscle wasting disorders like sarcopenia and osteoporosis. Bodybuilders and athletes sometimes abuse Somatropin to aid muscle growth and fat loss to enhance performance. However, its use by healthy individuals remains controversial due to potential safety issues.
Regulation and Delivery
As it has potent anabolic effects, its use is regulated by government agencies and requires a prescription from an endocrinologist. It is available as a daily injection since oral delivery is not effective due to rapid breakdown in the stomach. Recombinant DNA technology allows production of biosynthetic human growth hormone which is identical to natural endogenous HGH.
Long-acting somatropin formulations have been developed that only need weekly or monthly injections instead of a daily injection. These include pegylated somatropin and miniature osmotic pump delivery systems that provide sustained release. New delivery methods under investigation include transdermal patches and pulmonary powders for non-injectable delivery options. Proper use under medical guidance helps optimize benefits and minimize any potential risks associated with its therapy.
Side Effects and Safety Considerations
Some common minor side effects associated with its replacement therapy include edema, joint or muscle pain and sensitivity at the injection site. Higher doses can increase risks of Slipped Capital Femoral Epiphysis (SCFE) in children and mortality in critically ill hospitalized patients. Carpal Tunnel Syndrome may occur or worsen as fluid retention increases.
Rare severe side effects include pseudotumor cerebri arising from excess fluid retention and proliferation of pituitary tumors, especially in acromegaly patients receiving high exogenous doses. Its therapy should not be started in presence of active tumors, diabetes or severe obesity. Precautions also need addressing insulin needs in diabetics to avoid hypoglycemia.
Long term safety data especially with new sustained release delivery systems still requires more research. So prescribed dosage should be individualized balancing benefits versus potential risks based on patient’s health condition, risk factors and endocrinologist's advice to maximize therapeutic benefits. Overall it when used appropriately under medical guidance provides an important medical therapy.
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