Glucocorticoid therapy suppresses abnormal secretion of big IGF-II by non-islet cell tumours inducing hypoglycaemia (NICTH)

• Published in: Clinical endocrinology (Oxford) Vol. 49; no. 4; pp. 491 - 498
• Main Authors: Teale, J. D., Marks, V.
• Format: Journal Article
• Language: English
• Published: Oxford BSL Blackwell Science Ltd 01.10.1998; Blackwell
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Depression, Chemical; Drug Therapy, Combination; Female; Glucocorticoids - therapeutic use; Hormones. Endocrine system; Human Growth Hormone - therapeutic use; Humans; Hypoglycemia - drug therapy; Hypoglycemia - etiology; Hypoglycemia - metabolism; Insulin-Like Growth Factor Binding Protein 3 - analysis; Insulin-Like Growth Factor II - analysis; Insulin-Like Growth Factor II - metabolism; Male; Medical sciences; Middle Aged; Neoplasms - complications; Neoplasms - metabolism; Pharmacology. Drug treatments; Protein Precursors - analysis; Protein Precursors - metabolism; Syndrome; United Kingdom; Europe; Antineoplastic agent; Endocrinopathy; STH; Glucose; Blood plasma; Insulin like growth factor binding protein; Secretory tumor; Protein hormone; Etiology; Tumor; Adult; Recombinant protein; Prednisolone; Human; Corticosteroid; Dexamethasone; Steroid hormone; Treatment efficiency; Antiinflammatory agent; Hypoglycemia; Insulin like growth factor 2; Chemotherapy; Treatment; Adenohypophyseal hormone; Adrenal hormone; Immunosuppressive agent; Elderly; Comparative study
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1046/j.1365-2265.1998.00564.x

OBJECTIVE To assess the relative efficacy of hGH and glucocorticoids in the treatment of non‐islet cell tumour hypoglycaemia (NICTH) by examination of their influence on the composition of the various molecular species involving tumour and mature forms of IGF‐II in association with IGFBP‐3. DESIGN Two groups each of 4 patients, all diagnosed as cases of NICTH, were treated with either hGH or glucocorticoids. Through the use of acidic size exclusion chromatography serum levels of tumour (big) and mature IGF‐II were evaluated. Neutral size exclusion chromatography was used in the separation of molecular species before assay for immunoreactive IGF‐II and IGFBP‐3 content. RESULTS High‐dose hGH treatment produced increases in serum levels of big and mature IGF‐II and IGFBP‐3 but without generation of high molecular weight complexes. Glucocorticoid treatment suppressed big IGF‐II permitting re‐establishment of normal IGF/IGFBP association patterns. CONCLUSION Glucocorticoid therapy has been demonstrated to consistently reverse the biochemical abnormalities caused by tumour‐derived big IGF‐II compared with the potentially adverse stimulatory effects of hGH treatment in causing increases in serum levels of big IGF‐II.