Growth hormone treatment combined with physical therapy over six months significantly improved sensory function in patients with complete spinal injuries.
This research, presented at the European Congress of Endocrinology in Lisbon, is the first human study to investigate the link between spinal injuries and growth hormone deficiency (GHD). These findings could lead to life-improving treatments for patients with spinal injuries.
Although the cause is unknown, over 70 per cent of patients with spinal injuries also produce less growth hormone from the pituitary gland, but few studies have investigated how this impacts recovery. Cell-based studies have shown that growth hormone is involved in regenerative and adaptive processes in neurons and only preliminary studies have examined this in animals or humans. Given the proposed role of growth hormone in neuronal growth and regeneration and that many spinal injury patients exhibit growth hormone deficiency (GHD), therapies restoring growth hormone levels during rehabilitation could enhance recovery.
In this study conducted at the Hospital Quiron-Teknon and Guttmann Institute in Barcelona, 18 patients with complete spinal injury and GHD were treated with growth hormone or placebo over a six month period. Growth hormone dosage was individually tailored to comparable levels and all subjects participated in physical exercise for two hours per day during the study. Motor and sensory recovery was assessed at three and six months, using standard tests of sensory and motor function for spinal injury.
Although only a small patient group was assessed, the results showed those treated with growth hormone had significant improvements in the measures of self-care and respiration and sphincter control at both three and six months. The growth hormone group also regained far more feeling below the site of spinal injury after six months of treatment compared with the placebo group.
Further work, with larger patient numbers, is required to confirm and extend these findings; to examine differences between acute, sub-acute and chronic spinal injuries, and to investigate treatment with different doses of growth hormone.
Dr Guillem Cuatrecasas, who led the study, said, “It is possible that optimisation of the therapy could improve recovery, at least for sensory perception, in the future.”
Dr Guillem Cuatrecasas continued, “We need to challenge the well-established concept in medicine, that an axon once injured cannot be repaired. Sensory recovery is critical for quality of life in these patients, for example to avoid pressure ulcers from wheelchair use, and funding will be critical to further this work.”
Reference: Cuatrecasas et al., Recombinant Growth Hormone added to physical therapy in GH-deficient adults with complete (ASIA A) Spine Injury (EudraCT 2011-005377-23). Endocrine Abstracts (2017) 49 OC12.3 DOI:10.1530/endoabs.49.OC12.3