Growth hormone excess and the development of growth hormone receptor antagonists.
AffiliationDepartment of Endocrinology, Christie Hospital, Manchester M20 4BX, UK.
MetadataShow full item record
AbstractIn 1990, a single amino acid substitution in the growth hormone (GH) gene at position 119 was found to transform the consequent protein from an agonist to an antagonist at the growth hormone receptor (GHR). Further amino acid substitutions plus prolongation of the half-life of the protein by pegylation resulted in the first clinically effective GHR antagonist, pegvisomant. Following extensive clinical trials, this medication has emerged as the most efficacious therapy for treatment-resistant acromegaly. Subsequent advances in our understanding of GH-GHR interactions and downstream GH signalling pathways suggest that pegvisomant binds to preformed GHR dimers and prevents rotational changes within the receptor-GH complex necessary for intracellular signalling to occur. This article reviews the discovery of pegvisomant, from initial experimental data to successful licensing of the drug for treatment-resistant acromegaly, and discusses its other potential therapeutic uses in diseases with abnormalities in the GH-IGF-I axis.
CitationGrowth hormone excess and the development of growth hormone receptor antagonists. 2008, 93 (11):1157-69 Exp. Physiol.
- Growth hormone receptor antagonists: discovery, development, and use in patients with acromegaly.
- Authors: Kopchick JJ, Parkinson C, Stevens EC, Trainer PJ
- Issue date: 2002 Oct
- Pegvisomant: current and potential novel therapeutic applications.
- Authors: Thankamony GN, Dunger DB, Acerini CL
- Issue date: 2009 Dec
- Growth hormone receptor antagonists.
- Authors: Kohn DT, Kopchick JJ
- Issue date: 2002 Dec
- Cotreatment of acromegaly with a somatostatin analog and a growth hormone receptor antagonist.
- Authors: Jørgensen JO, Feldt-Rasmussen U, Frystyk J, Chen JW, Kristensen LØ, Hagen C, Ørskov H
- Issue date: 2005 Oct
- Growth hormone receptor antagonists therapy for acromegaly.
- Authors: Parkinson C, Trainer PJ
- Issue date: 1999 Oct