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Highlights of the
30th International Symposium on Growth Hormone and Growth Factors in Endocrinology and Metabolism

E-Newsletter No. 12

Monte Carlo, Monaco

The 30th International Symposium on Growth Hormone and Growth Factors in Endocrinology and Metabolism took place overlooking the beautiful Mediterranean coastline of Monte Carlo, Monaco, on October 6-7, 2000. Over 600 delegates attended the Symposium.

The Monte Carlo Symposium began with a Highlights session on the fifth analysis of KIMS (Pharmacia International Metabolic Database). The topics covered in this session included health economic aspects of growth hormone (GH) replacement therapy, safety of GH replacement, and the beneficial effects of GH therapy on lipid metabolism. One of the most striking conclusions from this session was that GH replacement can significantly improve quality of life and reduce healthcare costs in adults with GH deficiency (GHD).

The first main session of the Monte Carlo Symposium looked at the pulsatility of endocrine signals. The wide range of different hormone systems in which pulsatile signaling is seen was clearly demonstrated. While the clinical significance of pulsatile hormone secretion is not yet fully understood, it seems clear that pulsatility has a role to play in the diagnosis and management of hormone deficiencies such as GHD.

An examination of the role of insulin-like growth factor I (IGF-I) in physiology and pathology was the subject of the second main session. Many of the actions of GH are mediated via circulating IGF-I, while local IGF-I production in tissues appears to be important for somatic growth. The role of IGF-I in diseases such as diabetic retinopathy and acromegaly was also discussed, and the session ended with a look at the potential therapeutic impact of IGF-I in specific disorders.

Two entertaining plenary lectures were given at the Monte Carlo Symposium. In the first, the question of whether there are genuine differences between males and females in terms of their presentation of GHD and their response to therapy was addressed with a comprehensive review of the literature. In the second plenary lecture, the abuse of GH in certain reports was described. GH abuse has been reported in body builders and in endurance athletes such as swimmers and cyclists. Large amounts of GH are injected in the belief that it will increase muscle mass and performance. Work is underway to develop an accurate means of detecting such abuse.

The Symposium also included four parallel workshops. The first addressed the growing health problem of obesity, reviewing early work on the roles of leptin, GH and the hypothalamic-pituitary-adrenal axis. It is possible that treatment of obesity may be a useful means of improving insulin resistance in individuals with type 2 diabetes mellitus.

Some of the potential clinical uses of pegvisomant, the newly developed GH receptor antagonist, were discussed in a second workshop. The ability of pegvisomant to selectively block the GH receptor makes it a candidate for treatment of acromegaly, and the possibility that it can be used to reverse the renal hypertrophy and glomerular enlargement seen in diabetic nephropathy was reported. The role of pegvisomant in the treatment of certain types of cancer, such as meningioma, and carcinomas of the colon and breast, was also discussed.

A third workshop was an interactive session in which delegates were presented with a range of different case studies of patients with pituitary disease. This led to a lively debate regarding the best diagnosis and treatment for these patients.

New pharmacogenetic techniques in endocrinology and metabolism were the subject of a fourth workshop. Recent advances in genetics may lead to improvements in numerous aspects of drug therapy, including identification of non-responders, prevention of adverse reactions, and improvements in risk-benefit profiles.

Finally, more than 50 posters were presented in Monte Carlo.

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