{"title":"The growth plate: Zonal architecture, plasticity, and endocrine control of linear growth","authors":"Carlos Barba Ostria , Shoshana Yakar","doi":"10.1016/j.ghir.2026.101679","DOIUrl":"10.1016/j.ghir.2026.101679","url":null,"abstract":"<div><div>The growth plate (physis) is a highly specialized cartilaginous organ that drives longitudinal bone growth and ultimately determines adult stature. Its zonal architecture, including the resting, proliferative, hypertrophic, and calcification zones, integrates stem-like progenitor activity, clonal chondrocyte expansion, matrix remodeling, vascular invasion, and replacement by bone. Here, we review how the structural organization of the growth plate emerges from the interplay among extracellular matrix composition, sulfation pathways, and canonical paracrine signaling pathways, including Ihh-PTHrP, BMP, Wnt, and FGF. We highlight advances in our understanding of chondrocyte fate, including lineage-tracing studies demonstrating that resting-zone PTHrP<sup>+</sup> cells function as skeletal stem cells and that hypertrophic chondrocytes can transdifferentiate into osteoblasts or dedifferentiate into progenitors rather than undergoing obligatory apoptosis. We also summarize how endocrine axes, including the GH/IGF-1, thyroid hormone, sex steroids, glucocorticoids, and vitamin D, coordinate the tempo of growth, the dynamics of growth plate senescence, and the timing of epiphyseal fusion, with emphasis on species differences between rodents and humans. Finally, we use monogenic skeletal dysplasias, endocrine disorders, and acquired conditions such as rickets and slipped capital femoral epiphysis as “experiments of nature” that illuminate how specific molecular perturbations disrupt growth plate physiology. Together, these converging lines of evidence reframe the growth plate as a dynamic stem-cell and progenitor niche whose fate is plastic, highly regulated, and increasingly targetable for therapy in disorders of linear growth.</div></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"83 ","pages":"Article 101679"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In search of Vitruvian man","authors":"Ron G. Rosenfeld , Alexandra Guevara","doi":"10.1016/j.ghir.2026.101681","DOIUrl":"10.1016/j.ghir.2026.101681","url":null,"abstract":"<div><div>Vitruvian Man, the iconic drawing by Leonardo Da Vinci, has long been regarded as a representation of the divine perfection of the human form. This emblematic drawing, inspired by the architectural treatise of Vitruvius, reflects the belief in the symmetry and proportionality of the human body. Influenced by the works of other artists and mathematicians of the Renaissance period, including Luca Pacioli and Albrecht Dürer, Leonardo da Vinci's depiction of the ideal human proportions has had a lasting impact on our concepts of beauty and functionality. While modern scientific understanding of human evolution and variation may challenge some aspects of Leonardo's portrayal, the Vitruvian Man continues to be relevant in contemporary discussions of stature and proportionality. The influence of this drawing on our perception of health, beauty, and therapeutic goals, particularly in the management of short stature, remains significant in the medical community.</div></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"83 ","pages":"Article 101681"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emilia Valdivieso-Andrade , Michael Hermanussen , Christiane Scheffler
{"title":"Growth patterns: Pathology vs. Normal variation","authors":"Emilia Valdivieso-Andrade , Michael Hermanussen , Christiane Scheffler","doi":"10.1016/j.ghir.2026.101682","DOIUrl":"10.1016/j.ghir.2026.101682","url":null,"abstract":"<div><div>Growth of children and adolescents follows a universal pattern with three distinct growth spurts. Common medical practice refers to normal child growth as a health and biological advantage, and considers “pathology in growth” as a deviation from the universal pattern.</div><div>Growth can differ in amplitude and tempo with considerable variation both within and between populations over time, and depending on geographic region. Local growth charts are necessary to adapt the universal pattern of growth to characteristics of a specific historic or modern population. Local charts can visualize the distinct ethnic and historic diversity of human growth and allow pathology to reference the local conditions.</div><div>Local charts are most appropriate for both “normality” as a statistical dimension and pathology as disease.</div><div>We illustrate the significance of local growth charts for an example pathology Turner syndrome (TS). TS-patients are “short”. However, short stature is relative, as it refers to local norms. For example, Swedish TS-women reach an average height of more than 3 SD below Swedish norms, a height of which would be considered “short normal” compared to healthy Indian women.</div><div>We consider body height as a signal within the social group. Competitive growth and strategic growth adjustments in height reflect hope for a better life following political liberation, but also illusions of equity, freedom, justice, and the expectation of social advancement. Height is relative and only has value as a relative measure among family members, neighbors, and peers. Screening for pathology requires a concept of health that includes the local context.</div></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"83 ","pages":"Article 101682"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cognitive effects of growth hormone following traumatic brain injury and other disorders","authors":"Walter M. High","doi":"10.1016/j.ghir.2026.101685","DOIUrl":"10.1016/j.ghir.2026.101685","url":null,"abstract":"<div><div>Traumatic Brain Injury (TBI) is a leading cause of death and disability, with a significant percentage of patients experiencing pituitary dysfunction, including growth hormone (GH) deficiency. This manuscript examines the cognitive consequences of GH deficiency following TBI and other disorders and its implications for treatment. Despite advancements in understanding the cognitive impairments resulting from TBI—predominantly affecting memory, executive function, and processing speed—current interventions remain limited. Research indicates that GH deficiency, prevalent in 15–26% of TBI patients, correlates with substantial cognitive deficits. Notably, GH replacement therapy has demonstrated cognitive improvements in non-TBI populations, which raises the potential for similar benefits in TBI patients. Studies, including a double-blind, placebo-controlled trial, report significant enhancements in cognitive functions such as verbal memory and processing speed following GH replacement. However, the underutilization of GH screening and treatment in TBI patients persists due to confounding factors and assumptions about the origin of cognitive impairment. This review emphasizes the need for increased awareness and further research into GH/IGF-1 assessment as a therapeutic target for cognitive recovery in TBI, particularly for the approximately 80% of patients with mild TBI who are often overlooked. Addressing these gaps could lead to improved patient outcomes and quality of life for those affected by TBI-related cognitive impairments.</div></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"83 ","pages":"Article 101685"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pituitary hormone abnormalities following military-related traumatic brain injuries","authors":"Megan Herodes , Jose M. Garcia","doi":"10.1016/j.ghir.2026.101687","DOIUrl":"10.1016/j.ghir.2026.101687","url":null,"abstract":"<div><div>Pituitary hormone abnormalities are not uncommon among individuals who have sustained a traumatic brain injury (TBI), particularly among the military population which has a higher prevalence of lifetime TBI due to the risks associated with a military career. The diagnosis and treatment of these hormone abnormalities (also known as post-traumatic hypopituitarism or PTHP) is further complicated by numerous comorbidities (discussed below) endemic among individuals with a history of military service whose symptoms are similar to those of PTHP. This updated review discusses the unique pathophysiology of military-related TBI due to high frequency of blast TBI and multiple lifetime TBI, comorbidities within military and Veteran populations, and how these factors influence and are influenced by PTHP, including updated findings on military TBI incidence and PTHP prevalence. 0000-0002-9844-0375.</div></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"83 ","pages":"Article 101687"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A.B.M. Kamrul-Hasan , Lakshmi Nagendra , Ambika P. Ashraf , Subhankar Chatterjee , Deep Dutta , Joseph M. Pappachan
{"title":"Safety and efficacy of somapacitan in adults with growth hormone deficiency who were switched from daily growth hormone therapy: A systematic review and meta-analysis","authors":"A.B.M. Kamrul-Hasan , Lakshmi Nagendra , Ambika P. Ashraf , Subhankar Chatterjee , Deep Dutta , Joseph M. Pappachan","doi":"10.1016/j.ghir.2025.101677","DOIUrl":"10.1016/j.ghir.2025.101677","url":null,"abstract":"<div><h3>Background</h3><div>The safety and efficacy of somapacitan, a novel long-acting growth hormone (GH) formulation, in adults with GH deficiency (GHD) remain insufficiently explored in systematic reviews and meta-analyses (SR/MA). We aimed to fill this knowledge gap.</div></div><div><h3>Methods</h3><div>Databases were searched to identify RCTs and real-world studies involving adults with GHD who had previously been treated with daily GH and switched to once-weekly somapacitan. The primary outcome was the risk of adverse events (AEs); additional outcomes included treatment satisfaction, body composition measures, and insulin-like growth factor-1 standard deviation scores (IGF-1 SDS).</div></div><div><h3>Results</h3><div>This SR/MA included five studies (<em>N</em> = 297); four RCTs (<em>n</em> = 286) with a daily GH comparator group were meta-analyzed. Compared to daily GH, somapacitan increased the risk of all AEs (RR 1.31, 95 % CI [1.07, 1.61], <em>P</em> = 0.01), but not the risk of serious AEs or other specific AEs. Glucose homeostasis was less affected by somapacitan, indicated by a lesser increment in HbA1c in the somapacitan group and larger increases in fasting insulin and HOMA-IR in the daily GH group. The convenience score increased more with somapacitan, while effectiveness and satisfaction scores changed similarly in both groups. No differences in body composition changes were observed, but somapacitan improved lumbar spine bone mineral content and density in one study. By the end, IGF-1 SDS values were comparable (MD -0.05 [−0.24, 0.15], <em>P</em> = 0.64).</div></div><div><h3>Conclusion</h3><div>Somapacitan is as effective as daily GH in treating adults with GHD, with a reasonable safety profile and modest benefits for glucose homeostasis, as well as treatment convenience.</div></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"83 ","pages":"Article 101677"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145536864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
María Belén Tite Haro , Christiane Scheffler , Michael Hermanussen
{"title":"Auxology – an update 2025","authors":"María Belén Tite Haro , Christiane Scheffler , Michael Hermanussen","doi":"10.1016/j.ghir.2026.101680","DOIUrl":"10.1016/j.ghir.2026.101680","url":null,"abstract":"<div><div>Growth is a dynamic process and a mirror of health. Documenting child and adolescent growth includes careful, and if possible, longitudinal recordings of height, weight, and indicators of the state of maturity. Measurements should be translated into centiles or z-scores. Changes in height z-scores are related to the progress in maturation, and sensitive to growth arrests and catch-up growth.</div><div>Heritability studies and genome-wide association studies have traditionally been applied to assess the intrinsic regulators of growth. Nutritional, environmental and socio-economic factors are usually considered the major extrinsic regulators of growth.</div><div>Human growth is not a target seeking process, but a process that unfolds within a frame shaped and regulated primarily by the social community of family, peers, and neighbors. Community effects on height protect against being “too tall” or “too short” within a given social group.</div><div>In the healthy individual, height is a social signal which is strongly conserved in evolution. Height refers to social status among members of the same group, and is strategically regulated through neuroendocrine signals. Strategic adjustments of growth are part of social interactions. Being taller signals supremacy and dominance, being shorter signals inferiority.</div><div>Global growth charts are insufficient to reflect the social and historic plasticity of human growth, and can lead to misclassification of “normal” and “abnormal” growth within a given population.</div></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"83 ","pages":"Article 101680"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Signe Graungaard , Mai Christiansen Arlien-Søborg , Niels Henrik Bruun , Erlend Gjersdal , Jens Otto Lunde Jørgensen , Jakob Dal
{"title":"Assessment of body composition in active and controlled acromegaly by bioelectrical impedance analysis and dual-energy x-ray absorptiometry","authors":"Signe Graungaard , Mai Christiansen Arlien-Søborg , Niels Henrik Bruun , Erlend Gjersdal , Jens Otto Lunde Jørgensen , Jakob Dal","doi":"10.1016/j.ghir.2025.101678","DOIUrl":"10.1016/j.ghir.2025.101678","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the accuracy of bioimpedance analysis (BIA) compared to dual-energy x-ray absorptiometry (DXA) measurements of body composition in patients with active and controlled acromegaly.</div></div><div><h3>Methods</h3><div>BIA and DXA methods were applied to estimate body composition in patients with active acromegaly and again after disease control.</div></div><div><h3>Results</h3><div>16 patients with active acromegaly were included and followed until after disease control. GH nadir decreased from 5.5 ± 5.7 μg/L to 0.2 ± 0.3 μg/L, and IGF-1 levels from 565 ± 189 ng/L to 191 ± 137 ng/L after treatment. Body weight remained stable (95.4 ± 30.0 kg and 95.5 ± 26.7 kg) throughout the study period although fat mass increased by 3.2 kg (from 34.1 ± 15.2 kg to 37.5 ± 14.6 kg) or 4.5 kg (31.5 ± 14.6 kg to 36.0 ± 16.0 kg) measured by DXA or BIA, respectively. Lean body mass measured by DXA decreased by 2.2 kg (61.6 ± 16.9 kg to 59.4 ± 14.5 kg), while fat free mass decreased by 4.2 kg (63.4 ± 19.0 kg to 59.2 ± 15.7 kg) and total body water (L) decreased by 3.1 kg (46.4 ± 13.9 kg to 43.3 ± 11.5 kg) estimated by BIA. Using Bland–Altman analysis the bias in estimates for lean mass was −1.7 kg (LOA:−10.0–6.6 kg) in active acromegaly and 0.2 kg (LOA:−10.1–10.5 kg) with hormonal control. For fat mass, bias was 2.6 kg (LOA:−3.8–9.0 kg) in active disease and 1.5 kg (LOA:−5.0–8.1 kg) in controlled disease.</div></div><div><h3>Conclusions</h3><div>A high conformity between BIA predictions and DXA scan measurements was observed in patients with acromegaly during both active disease and hormonal control. BIA provides additional important estimations of body water content.</div></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"83 ","pages":"Article 101678"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145836778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Administration study of somapacitan, a long-acting growth hormone derivative, in horse for doping control purpose","authors":"Yoshibumi Shimizu , Michiko Sugai-Bannai , Haruka Tanabe , Kazunobu Saito , Hiroki Ito , Hirotaka Tokushige , Kazuhiro Kamiya , Misato Hirano-Kodaira , Masayuki Yamada , Gary Ngai-Wa Leung","doi":"10.1016/j.ghir.2025.101662","DOIUrl":"10.1016/j.ghir.2025.101662","url":null,"abstract":"<div><div>Somapacitan is the second generation of recombinant human growth hormone (rhGH) medication that retains the pharmacological effects of rhGH but exhibits a longer duration of action due to its reversible albumin-binding in the body. In general, the use of all recombinant growth hormone (rGH) analogues is banned by the human and animal sports regulatory authorities due to their anabolic and lipolytic effects. However, little is known about the elimination kinetics and biological effects of the newly introduced long-acting rhGH, somapacitan, in horses. This paper describes the administration study of somapacitan and its elimination in horses, its correlation with plasma insulin-like growth factor-1 (IGF-1) levels, an established indicator for rGH abuse, and the evaluation of the detection capability of our recently developed liquid chromatography high-resolution mass spectrometry (LC-HRMS) method in equine plasma after extraction and trypsin digestion specifically designed for controlling the misuse or abuse of somapacitan. Three thoroughbred mares were each administered 90 mg somapacitan subcutaneously. Plasma IGF-1 concentration significantly increased in all horses after administration of somapacitan. The somapacitan-specific T10 peptide fragment that allows discriminative identification of somapacitan and rhGH was detected up to 14 days and confirmed in post-administration samples collected up to 10 days. Several shared peptide fragments between somapacitan and rhGH were also detected and confirmed in plasma samples collected 14 days post-administration, supporting the applicability of the test strategy for the analysis of authentic doping control samples in horses.</div></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"82 ","pages":"Article 101662"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Growth hormone - releasing hormone antagonists induce autophagy in cancer cells","authors":"Madan Sigdel , Saikat Fakir , Md Matiur Rahman Sarker, Nektarios Barabutis","doi":"10.1016/j.ghir.2025.101668","DOIUrl":"10.1016/j.ghir.2025.101668","url":null,"abstract":"<div><div>GHRH antagonists (GHRHAnt) were developed to suppress cancers and have been associated with robust anti-inflammatory and anti-oxidative activities. The mechanisms involved in those effects are not completely understood. MDA-MB-468 and A549 cancer cells, which express GHRH receptors, were treated with GHRHAnt JV-1-36, to evaluate the effects of that compound in autophagy. JV-1-36 induces autophagy in MDA-MB-468 and A549 cells since exposure to the aforementioned peptide elevated the expression levels of the autophagy-related protein (ATG) – 5, ATG – 3, ATG – 7, and ATG-16L1. In contrast, MCF-7 cells - which do not express GHRH receptors – did not respond to GHRHAnt. Our findings suggest that the beneficial effects of GHRHAnt in cancers may involve autophagy. Further studies will attempt to delineate the underlying mechanisms.</div></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":"82 ","pages":"Article 101668"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}