Pharmacokinetics of radioiodinated human and ovine growth hormones in transgenic mice expressing bovine growth hormone

Low IGF-I Bioavailability Impairs Growth and Glucose Metabolism in a Mouse Model of Human PAPPA2 p.Ala1033Val Mutation

Bioactive free IGF-I is critically important for growth. The bioavailability of IGF-I is modulated by the IGF-binding proteins (IGFBPs) and their proteases, such as pregnancy-associated plasma protein-A2 (PAPP-A2). We have created a mouse model with a specific mutation in PAPPA2 identified in a human with PAPP-A2 deficiency. The human mutation was introduced to the mouse genome via a knock-in strategy, creating knock-in mice with detectable protein levels of Papp-a2 but without protease activities. We found that the Pappa2 mutation led to significant reductions in body length (10%), body weight (10% and 20% in males and females, respectively), and relative lean mass in mice. Micro-CT analyses of Pappa2 knock-in femurs from adult mice showed inhibited periosteal bone expansion leading to more slender bones in both male and female mice. Furthermore, in the Pappa2 knock-in mice, insulin resistance correlated with decreased serum free IGF-I and increased intact IGFBP-3 concentrations. Interestingly, mice heterozygous for the knock-in mutation demonstrated a growth rate for body weight and length as well as a biochemical phenotype that was intermediate between wild-type and homozygous mice. This study models a human PAPPA2 mutation in mice. The mouse phenotype closely resembles that of the human patients, and it provides further evidence that the regulation of IGF-I bioavailability by PAPP-A2 is critical for human growth and for glucose and bone metabolism.

Insulin-like growth factor 1 mediates negative feedback to somatotroph GH expression via POU1F1/CREB binding protein interactions

Circulating insulin-like growth factor 1 (IGF-1) has been shown to act as a negative feedback regulator of growth hormone (GH) gene expression; however, the mechanism of this negative feedback is poorly understood. Activation and regulation of GH gene expression require the binding of the transcription factor POU1F1 to the GH promoter along with cyclic AMP (cAMP) response element binding protein (CREB) binding protein (CBP). We investigate the role of CBP as a target of IGF-1 somatotroph regulation using the MtT/S somatotroph cell line. IGF-1 significantly inhibits basal GH mRNA levels but not POU1F1 levels. Chromatin immunoprecipitation assays demonstrate inhibition of CBP binding to the GH promoter after IGF-1 treatment. We hypothesized that IGF-1 receptor (IGF-1R) signaling disrupts the POU1F1/CBP complex to inhibit gene expression. In support, the use of a mutant CBP (S436A) construct, which lacks a critical phosphorylation site, leads to the loss of IGF-1 inhibition. The studies of CBP (S436A) knock-in mice show elevated serum GH levels, a greater response to GH releasing hormone (GHRH) stimulation along with lower weight gain, and decreased body fat. Our data confirm the inhibitory effects of IGF-1 on GH expression at the level of the promoter and provide evidence of CBP's role as a target of IGF-1R signaling.

Review--the use of immunosuppressive agents to prevent neutralizing antibodies against a transgene product

A potential obstacle to successful gene therapy for some patients is the in vivo production of neutralizing antibodies against the recombinant therapeutic product delivered. This is a problem inherent to all gene therapy methods, regardless of the vector used to deliver the protein. This clinical situation can be mimicked in animal models by delivering a foreign protein (i.e., a human protein) to the animal to provoke anti-human protein antibody production. The efficacy of different immunosuppressive treatments to inhibit the development of neutralizing antibodies can then be investigated. The immunosuppressive agents examined here include drugs (e.g., cyclophosphamide, FK506), cytokines (e.g., interferon-gamma, interleukin-12), and monoclonal antibodies (e.g., anti-CD4, anti-gp39, CTLA4-Ig). It has been found that a high level of antibody suppression is necessary to allow prolonged delivery of a foreign protein. Immunosuppressive agents capable of this high level of suppression will be important adjuncts to prevent treatment failures in situations where patients are at risk of developing neutralizing antibodies.

Pharmacokinetics of radioiodinated growth hormones in the turtle Chrysemys dorbigni

Growth hormone binding proteins (GHBP) have been identified in the blood of many species. The aim of the present work is to study the physiological role of the GHBP in the turtle serum which we recently described. Binding studies were carried out using in vivo pharmacokinetic and chromatographic techniques as well as in vitro methods. When (125)I-GH was injected in physiological concentration into Chrysemys dorbigni turtles, the first step of pharmacokinetics was the binding of a significant fraction of the labeled GH by the GHBPs present in serum. The decay curve followed a three compartments model and gave the equation: Ae(-alphat) + Be(-betat) + Ce(-gammat). The fast compartment with t(1/2) of 14.4 min or 25.2 min, for hGH and bGH represents 30.3% and 18.9% of total radioactivity, respectively, at hypothetical time zero (not experi mental). Chromatographic studies reveal that this rapid compartment represents free GH. The second and third compartments represent complex forms between GH and GHBPs present in the turtle serum, and represent 70% and 80% of total radioactivity for hGH and bGH, respectively. In vitro chromatographic studies showed direct evidence of the presence of GHBPs in the turtle serum. The presence of these GHBPs changed the pharmacokinetics of labeled GH in plasma and the subsequent liver uptake of GH. The labeled hGH or bGH binds to turtle serum in similar proportion, but maximal liver uptake of these hormones are completely different (L/B ratio of 9.2 +/- 0.6 (n = 5) for ( 125)I-hGH and 4.8 +/- 0.3 (n = 7) for (125)I-bGH). The reasons for these differences could be that human GH binds to lactogenic and somatotropic receptors and bovine GH binds only to somatotropic receptors.

Delivery of recombinant gene products to the central nervous system with nonautologous cells in alginate microcapsules

Somatic gene therapy using nonautologous recombinant cells immunologically protected with alginate microcapsules has been successfully used to treat rodent genetic diseases. We now report the delivery of recombinant gene products to the brain in rodents by implanting microencapsulated cells for the purpose of eventually treating neurodegenerative diseases with this technology. Alginate-poly-L-lysine-alginate microcapsules enclosing mouse C2C12 myoblasts expressing the marker gene human growth hormone (hGH) at 95+/-20 ng/million cells/hr were implanted into the right lateral ventricles of mice under stereotaxic guidance. Control mice were implanted similarly with nontransfected but encapsulated cells. Delivery of hGH to the different regions of the brain at various times postimplantation was examined. At 7, 28, 56, and 112 days postimplantation, hGH was detected at high levels around the implantation site and also at lower levels in the surrounding regions, while control mice showed no signal. Immunohistochemical staining of the implanted brains showed that on days 7, 56, and 112 postimplantation, hGH was localized in the tissues around the implantation site. Mice implanted with encapsulated but nontransfected cells showed no signal. Hence, the feasibility of using encapsulated nonautologous cells to deliver recombinant gene products to the brain for extended periods may allow the application of this technology to the treatment of neurodegenerative genetic disorders.

Specific interactions of growth hormone (GH) with GH-receptors and GH-binding proteins in vivo in genetically GH-deficient Ames dwarf mice

The fate of exogenous radiolabeled growth hormone (125I-hGH) was studied in Ames dwarf mice, which do not express growth hormone (GH) or prolactin (PRL) genes. Labeled GH was injected in low amounts that did not exceed the normal physiological GH concentration in mice. Binding of most of the injected 125I-hGH by the GH-binding proteins (GHBPs) present in plasma represents the first step in the handling of this material in vivo. The decay curve followed a two-compartment model and gave the equation: Conc = 2.807e-0067t + 15301e-0.0647t (coefficient of determination 0.9986+/-0.0019), while in normal mice, GH decay followed a three-compartment model as we have previously reported. The fast compartment with t1/2 of 1-2 min was virtually absent in dwarf mice, and chromatographic studies revealed the disappearance of free GH in these mice. We also present evidence of the labeled GH-forming complexes, presumably with GHBPs under in vivo conditions. The second step of processing labeled GH in vivo is the uptake by the liver, which was slower in dwarf than in normal mice (30-45 vs 15 min). Moreover, a lower GH uptake was found in dwarf than in normal mice (UB ratio of 1.75+/-0.29 [30 min] vs L/B ratio of 3.68+/-0.33 [15 min], respectively) due to lower concentration of free GH in plasma and to the reduced number of GH-receptors (GHRs). The radioactive material present in the liver was compatible with 125I-hGH-GHR complexes with Stokes radius of 59A. In summary, we provide evidence that plasma of dwarf mice contains proteins capable of binding GH in vivo and probably representing GHBPs not complexed with GH. The presence of these proteins modified the pharmacokinetics of 125I-hGH in plasma and its subsequent uptake by the liver. The presence of these binding proteins in the absence of endogenous GH suggests that a fraction of total GHBPs (one class?) is independent of GH concentration.

Suppression of immunological response against a transgene product delivered from microencapsulated cells

A potential obstacle to successful gene therapy for some patients is the in vivo production of neutralizing antibodies against the recombinant therapeutic product delivered. To mimic this clinical situation, we implanted microencapsulated recombinant cells producing human growth hormone into C57B1/6 mice to provoke antihuman growth hormone antibody production. We then investigated the efficacy of different immunosuppressive treatments to inhibit the development of neutralizing antibodies. The experimental mice were treated with either an immunosuppressive drug (FK506 or cyclophosphamide), a cytokine (interferon-gamma [IFN-gamma] or interleukin-12 [IL-12], or a monoclonal antibody (anti-CD4, anti-gp39, or CTLA4-Ig). Serum human growth hormone and mouse anti-human growth hormone antibody levels were measured by enzyme-linked immunosorbent assay (ELISA) for 4 weeks. There were three patterns of response noted among the seven treatment groups. First, the mice receiving IFN-gamma, IL-12, anti-gp39, or CTLA4-Ig were similar to the untreated controls-no suppression of anti-hGH antibodies and no improvement in delivery of hGH. Next, the mice receiving FK506 or cyclosphosphamide showed > or = 90% suppression of antibodies but also no improvement in product delivery. Last, the mice receiving anti-CD4 showed almost complete antibody suppression over 1 month postimplantation. Furthermore, only anti-CD4 permitted a sustained level of human growth hormone delivery to day 28, in contrast to the controls whose human growth hormone delivery was undetectable by day 14 postimplantation. Hence, the use of anti-CD4 inhibited formation of neutralizing antibodies against a recombinant gene product delivered in vivo, and allowed prolonged delivery of a foreign protein. Its role as adjunct treatment for appropriate patients receiving gene therapy should be examined further.

Growth hormone (GH) substitution for one year normalizes elevated GH-binding protein levels in GH-deficient adults secondary to a reduction in body fat. A placebo-controlled trial

The high affinity growth hormone binding protein (GHBP) in human serum derives from the extracellular domain of the GH receptor. It is well known that fat mass correlates positively to GHBP levels, but it is uncertain whether GH secretory status influences GHBP levels. Since body composition is known to change during GH substitution in adult GHD patients, we determined the relation between GHBP and body composition during GH substitution in GHD adults. Twenty-five GHD adults aged 45.0 +/- 1.8 years, were examined before and after 12 months of placebo-controlled GH substitution (2 IU/m2) in a parallel design. A group of 27 healthy age- and gender-matched normal-weight adults provided reference data. The participants underwent anthropometric measurements [body mass index (BMI), waist/hip ratio (W/H)], computer-tomography (CT-scan) of femoral and abdominal regions, dual-energy X-ray absorptiometry (DEXA-scan), and bioimpedance (BIA), as well as blood sampling. At baseline, the GHBP levels were increased compared to controls (1.63 +/- 0.14 nmol/l vs 1.12 +/- 0.1 nmol/l, P = 0.01). During 12 months of GH substitution, GHBP levels decreased to the levels of the control subjects. GHBP correlated positively to indices of adiposity in GHD patients at baseline: intra-abdominal fat (r = 0.54, P = 0.005), subcutaneous abdominal fat (r = 0.59, P < 0.002), body fat (BIA) (r= 0.41, P= 0.044), BMI (r= 0.58, P = 0.002), and total body fat (DEXA scan) (r= 0.61, P < 0.001). After 12 months of GH substitution, different estimates of body fat were significantly decreased in the GH treated group, but the positive relationship between GHBP and these estimates of body fat was maintained. In multiple linear regression analyses, fasting insulin levels were also a significant determinant of GHBP levels. We conclude that GHBP levels are increased in GHD patients and decrease to normal levels during 12 months of GH substitution. Furthermore, GHBP is predominantly correlated to indices of adiposity also in GHD patients.

Growth hormone-binding protein in normal mice and in transgenic mice expressing bovine growth hormone gene

The levels and characteristics of growth hormone (GH)-binding protein (GHBP) and the distribution of GH in peripheral circulation between the free and the bound fractions were studied in three lines of transgenic mice with various degrees of overexpression of bovine (b) GH gene. Two serum fractions bound GH specifically: one with low affinity and high capacity (GHBPI) and one with high affinity and low capacity (GHBPII). The GHBP binding capacity in normal mice (both sexes), transgenic male mice that express the metallothionein-I-hybrid bGH genes, transgenic female mice that express phosphoenolpyruvate carboxykinase (PEPCK)-bGH hybrid genes (PEPCK-bGH-1), and transgenic PEPCK-bGH-5 animals was 1.1 +/- 0.2, 2.0 +/- 0.1, 3.0 +/- 0.1, and 3.9 +/- 0.6 pmol/ml serum, respectively. The amount of GH bound to GHBP in transgenic animals vs. normal siblings was increased 1.8-, 2.5-, and 3.9-fold in these three lines. Consequently, the levels of GH-GHBP complexes in the circulation of PEPCK-bGH-1 transgenic mice were increased approximately 10-fold. Specific GHBP radioimmunoassay confirmed a threefold increase in GHBP in PEPCK-bGH-1 transgenic animals. The levels of GHBP were not significantly correlated to serum GH within or between lines, perhaps due to elevation of serum GH in PEPCK-bGH mice above the level producing maximal response. From these and previous studies, we conclude that life-long exposure to supranormal GH levels leads to major shifts in GH binding in the circulation and in the GH target organs.