Growth hormone enhances thymic function in HIV-1–infected adults
Laura A. Napolitano, … , Peter Bacchetti, Joseph M. McCune
Laura A. Napolitano, … , Peter Bacchetti, Joseph M. McCune
Published February 21, 2008
Citation Information: J Clin Invest. 2008;118(3):1085-1098. https://doi.org/10.1172/JCI32830.
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Growth hormone enhances thymic function in HIV-1–infected adults

Abstract

Growth hormone (GH) is an underappreciated but important regulator of T cell development that can reverse age-related declines in thymopoiesis in rodents. Here, we report findings of a prospective randomized study examining the effects of GH on the immune system of HIV-1–infected adults. GH treatment was associated with increased thymic mass. In addition, GH treatment enhanced thymic output, as measured by both the frequency of T cell receptor rearrangement excision circles in circulating T cells and the numbers of circulating naive and total CD4+ T cells. These findings provide compelling evidence that GH induces de novo T cell production and may, accordingly, facilitate CD4+ T cell recovery in HIV-1–infected adults. Further, these randomized, prospective data have shown that thymic involution can be pharmacologically reversed in humans, suggesting that immune-based therapies could be used to enhance thymopoiesis in immunodeficient individuals.

Authors

Laura A. Napolitano, Diane Schmidt, Michael B. Gotway, Niloufar Ameli, Erin L. Filbert, Myra M. Ng, Julie L. Clor, Lorrie Epling, Elizabeth Sinclair, Paul D. Baum, Kai Li, Marisela Lua Killian, Peter Bacchetti, Joseph M. McCune

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Figure 1

Study design: prospective, randomized, open-label crossover study.

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Study design: prospective, randomized, open-label crossover study. The t...
The two-year study design is depicted. Eleven participants each were randomized either to receive GH for 1 year (3.0 mg GH subcutaneous injection daily for 6 months, then 1.5 mg daily for 6 months) while continuing their usual ARV (GH Arm); or to continue usual ARV for 1 year and then cross over to GH treatment and ARV in the second year (Control Arm). Unscheduled changes in GH treatment (premature dose reduction, temporary interruption, or permanent discontinuation) were made by the study investigators as indicated for management of AEs. Major time points, number of participants, and details of dropped participant data from the indicated arm are shown. Additional details of study design and data exclusion can be found in Methods. ATwo GH arm participants who terminated GH early (after month 6) were followed for 1 year after GH. These data are included in 1-year-post-GH follow-up.