ABSTRACT
The newly described peptidergic (1-4) and nonpeptidergic growth hormone (GH) secretagogues (GHSs; 5) that enhance endogenous GH secretion are of special interest to the pediatricians and pediatric endocrinologists who, in their practice, encounter many diseases and conditions that are benefited by GH administration. The GHSs act through a receptor that is independent from that of growth hormone-releasing hormone (GHRH; 6,7). The GHSs act synergetically with GHRH (8,9) amplifying the pulsatile GH release and increasing the insulin-like growth factor-! (IGF-1) secretion. These actions are most probably induced by suppressing somatostatin secretion (10). A major advantage of these substances over GHRH, human GH (hGH) and IGF-1 is that they are active not only when injected, but also by the oral and intranasal routes. The number of reports on the use of the GHSs in the pediatric clinic is limited, involving almost exclusively the peptidergic substances. Most reports deal with bolus effects. This chapter presents a review of published data on the use of this new class of hormone-like drugs in children and adolescents, with a discussion on their future possible role in pediatric endocrinology.
