Therapeutic use of human growth hormone.

A great deal is known about the therapeutic effect of human growth hormone (HGH) on short stature. Raben (1958) reported the acceleration of growth in hypopituitary subjects given HGH 18 years ago. The species specificity of growth hormone means that we must rely on hormone extracted from human pituitaries. It is likely to be a long time before HGH is synthesised and various 'soups' of digested ox pituitary have been of no avail. The only immediate hope for an alternative to HGH is the isolation and synthesis of the growth hormone releasing hormone. If the syndrome of isolated growth hormone deficiency is due to a lack of this hypothalamic hormone rather than an inability of the pituitary itself to secrete growth hormone the logical therapy is obvious. The amount of 'clinical grade' HGH available from human pituitaries obtained at necropsy will depend largely on the efficiency of the extraction procedures. Raben's (1959) method using acetonedried pituitaries yielded 4-4 IU per gland. The modification of Wilhelmi's method by Mills et al. (1969) obtained about 7-2 IU per gland. Methods using fresh frozen pituitaries vary from that of Roos et al. (1963) to the modern development by Lowry (1977) that produced monomer growth hormone at a yield of 16-0 IU per gland. The antigenicity of these products is of importance. The Raben preparation, widely used, promoted antibody formation in a number of patients. The preparations from frozen pituitaries seem less antigenic. The biological potency of each batch of HGH has to be assayed, because it varies considerably, and the potency of the finally ampouled material has to be checked.