Structure

Molecular Composition

  • 191-amino acid, single-chain, nonglycosylated polypeptide.
  • Molecular weight: 22-kDa.
  • Core comprised of four alpha-helices in parallel/antiparallel orientation.
  • Structure stabilized by two disulfide bonds located between cysteines 53-165 and 182-189.
  • Derived from 217-amino-acid precursor; signal peptide cleaved before secretion.

Isoforms

  • 22-kDa form constitutes 75% to 90% of total pituitary growth hormone.
  • 20-kDa form, resulting from alternative splicing, accounts for <10%.
  • Remaining fraction includes desamidated, N-acetylated, oligomeric, and 17.5-kDa variant forms.

Genetic Basis

  • Encoded by GH1 gene.
  • Gene located on long arm of chromosome 17 (17q22-24).
  • Located within cluster of five highly homologous genes.

Mechanism of Action

Receptor Characteristics

  • Binds Growth Hormone Receptor (GHR) on target cell surfaces.
  • GHR is 620-amino acid, single-chain transmembrane molecule.
  • Member of class 1 hematopoietic cytokine receptor family.
  • Comprises extracellular hormone-binding domain, single membrane-spanning domain, and intracellular signaling domain.

Receptor Activation

  • Preformed GHR dimers exist on cell surface.
  • Single growth hormone molecule binds sequentially to two GHR molecules (initially to stronger site 1, followed by weaker site 2).
  • Binding induces receptor dimerization and conformational change.

Intracellular Signaling (JAK-STAT Pathway)

  • Receptor dimerization repositions intracellular domains and associated Janus Kinase 2 (JAK2).
  • JAK2 undergoes autophosphorylation and activation.
  • Activated JAK2 cross-phosphorylates distal tyrosine residues on GHR.
  • Phosphorylated sites recruit SH2-domain molecules, specifically Signal Transducer and Activator of Transcription (STAT) 5a and 5b.
  • STAT molecules undergo phosphorylation, dimerization, and nuclear translocation.
  • STAT dimers/tetramers bind DNA, activating transcription of target genes (e.g., Insulin-Like Growth Factor 1 [IGF-1]).

Biological Effects

  • Stimulates hepatic synthesis of IGF-1.
  • Promotes linear growth, bone thickness, soft tissue growth, and protein synthesis.
  • Stimulates lipolysis and induces cellular insulin resistance.

Pattern of Secretion

Secretory Dynamics

  • Synthesized, stored, and secreted by anterior pituitary somatotropes.
  • Highly pulsatile secretion pattern.
  • Normal young men average 12 secretory bursts per 24 hours.
  • Between secretory bursts, baseline serum concentration remains < 0.2 ng/mL.

Circadian Rhythm

  • Peak secretion occurs during night.
  • Maximal secretion coincides with onset of first slow-wave sleep (stages III/IV).
  • Rapid-eye-movement (REM) sleep associated with low secretion.

Regulatory Control

  • Stimulated by hypothalamic Growth Hormone-Releasing Hormone (GHRH).
  • Inhibited by hypothalamic somatostatin.
  • Secretory peaks occur when GHRH peaks coincide with somatostatin troughs.
  • Ghrelin (gastric enteroendocrine peptide) directly stimulates secretion via specific secretagogue receptors.
  • Physiologic stimulators: sleep, exercise, physical stress, trauma, fasting, and hypoglycemia.
  • Physiologic inhibitors: hyperglycemia, hypothyroidism, free fatty acids, glucocorticoids, and obesity.