Clinical Note

Causes of Growth Hormone Deficiency

Defective hypothalamic production or secretion of GHRH may be a more common cause of GH deficiency than defects in the pituitary gland. GH concentrations in plasma are restored to normal in many GH-deficient individuals after treatment with GHRH, suggesting that their somatotropes are competent but not adequately stimulated. Defects in somatostatin synthesis or secretion are not known to be responsible for disease states, but long-acting analogs of somatostatin can be used to decrease GH secretion for treatment of acromegaly.

communicate with somatostatin-secreting neurons in the periventricular nuclei, either directly or through interneurons; conversely, somatostatinergic neurons communicate with GHRH neurons. However, understanding of how reciprocal changes in secretion of these two neurohormones are brought about is still incomplete. GHRH neurons express receptors for ghrelin, but the role of ghrelin in the regulation of GH secretion remains to be uncovered.

Actions of GHRH, Somatostatin, and IGF-I on the Somatotrope

Secretion of GH is under the direct control of at least three hormones: GHRH, somatostatin, and IGF-I.

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