Relationship of the adrenergic nervous systemand growth hormone release in normal adults and children with various growth disorders

The influence of alpha receptor stimulationduring beta blockade has been evaluated using epinephrine and propranolol in normal adults and patients with growth problems. These drugs were administered independently, together, and concurrently with arginine, insulin, and synthetic ACTH in a group of eight normal adults. Significant release of growth hormone accurred after arginine, insulin, ACTH, or simultaneous epinephrine and propranolol administration, as well as after administration of epinephrine and propranolol with arginine, insulin or ACTH. Significantly greater release occurred in normal adults and among the patients with familial short stature, intrauterine growth retardation, and constitutional delay after arginine-insulin-epinephrine-propranolol administration than with arginine-insulin alone. No release occurred after either test among idiopathic and organic hypopituitary patients except in three patients with idiopathic hypopituitarism with a partial but inadequate response to arginine and insulin. These patients released growth hormone after epinephrine and propranolol administration and to a greater extent after arginine-insulin-epinephrine-propranolol administration and hence may have a defect in adrenergic receptors. Epinephrine and propranolol also enhanced growth hormone release after insulin among the psychosocial dwarfs.