A novel treatment option for HIV lipodystrophy will be one of the highlights of Saturday’s plenary session “Disordered Growth Hormone Secretion in HIV-Mechanisms and Novel Therapeutic Strategies” at 11:45 am in Ballroom A of the Music City Center.
Steven K. Grinspoon, MD, will discuss his research covering the relationship of growth hormone secretion in obesity and the physiological consequences of perturbation of growth hormone secretion in obesity with respect to cardiovascular disease risk factors.
Dr. Grinspoon, Director, Massachussetts General Hospital Program in Nutritional Metabolism and Co-Director, Nutrition Obesity Research Center, Harvard, said that using a specific disease syndrome as a model – HIV lipodystrophy – researchers were able to develop a new therapy to augment growth hormone secretion and significantly reduce abdominal fat in those patients and improve cardiovascular disease risk parameters.
Patients with more abdominal fat have more reduced growth hormone secretion. Dr. Grinspoon calls it a vicious cycle whereby, you have reduced growth hormone that can lead to increased visceral fat; the more increased visceral fat leads to reduced growth hormone.
“It’s a cycle that needs to be broken,” he said.
Researchers came up with a strategy using a hypothalamic peptide called growth hormone releasing hormone, which is the precursor to growth hormone.
It’s a peptide from the brain that we give once a day subcutaneously and it augments growth hormone in a physiological way,” he explained. “It does it in a pulsatile fashion so it recapitulates the pulsatility of growth hormone naturally and that led to a very significant reduction in abdominal visceral fat and lipids in HIV patients.”
He will also describe an extension of the research to regular obesity, non HIV, in which patients were given the same drug and showed a marked reduction in abdominal fat and improvement in carotid IMT and lipids.
“It’s a story in which we link the physiological consequences of abdominal fat to perturbed growth hormone, with a focus on the consequences of growth hormone and then come up with a strategy to augment growth hormone, which is not growth hormone, that has led to significant improvements,” said Dr. Grinspoon.
He noted that the model of HIV improvement was substantial enough to lead to FDA approval of the drug, tesamorelin, which is the first and only drug approved for HIV lipodystrophy and the first and only drug approved that selectively reduces abdominal fat.