Abstract | OBJECTIVE: To report a novel mutation in GHR and to characterize a novel mechanism of nonclassical growth hormone insensitivity. CONTEXT: DESIGN: Case presentation with in vitro functional studies. PATIENTS: A young male Caucasian child with short stature was found to have growth hormone insensitivity manifested by elevated levels of GH and GHBP. MEASUREMENTS:
Growth hormone stimulation tests revealed baseline GH level of 20.9 µg/L and maximum stimulated GH level of 52.7 µg/L and GHBP level of 4868 pmol/L. GHR gene sequencing revealed a novel heterozygous nonsense mutation (c.800G > A, p.Trp267*) in the transmembrane domain of the receptor. Immunoblot analysis of transfected GHR p.Trp267* in HEK293 revealed inhibition of GH-induced STAT5 signalling that was overcome with increasing doses of recombinant human GH. RESULTS: Using an in vitro model, we show that elevated levels of GHBP inhibit the action of GH. Furthermore, our studies demonstrate that this inhibition by GHBP can be overcome by increasing doses of recombinant human GH. CONCLUSIONS: To our knowledge, this is the first study to demonstrate in vitro that elevated levels of GHBP attenuate the effect of GH and inhibit GH-induced signalling, thereby leading to short stature. Though this inhibition was overcome in vitro with supraphysiologic doses of GH, significantly above endogenously available GH, it remains to be seen whether such an effect can be replicated in vivo.
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Authors | Ankur Rughani, Dongsheng Zhang, Kanimozhi Vairamani, Andrew Dauber, Vivian Hwa, Sowmya Krishnan |
Journal | Clinical endocrinology
(Clin Endocrinol (Oxf))
Vol. 92
Issue 4
Pg. 331-337
(04 2020)
ISSN: 1365-2265 [Electronic] England |
PMID | 31883394
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | © 2019 John Wiley & Sons Ltd. |
Chemical References |
- Carrier Proteins
- Codon, Nonsense
- Receptors, Somatotropin
- Human Growth Hormone
- Insulin-Like Growth Factor I
- Growth Hormone
- somatotropin-binding protein
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Topics |
- Carrier Proteins
(genetics)
- Child
- Codon, Nonsense
(genetics)
- Growth Hormone
- HEK293 Cells
- Human Growth Hormone
(genetics)
- Humans
- Insulin-Like Growth Factor I
(genetics, metabolism)
- Male
- Receptors, Somatotropin
(genetics)
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