Peptide hormone analogues and novel clinical applications.

Clinical application of peptide hormone analogues is rapidly expanding. Peculiar aminoacid residues, conformational turns and the degree of molecular flexibility may represent critical keys for differential interaction with the receptor sites, hence for specific biological effects. Broadly different biological responses may be elicited as a function of dose and timing of administration. The clinical use of the heptadecapeptide analogue ACTH 1-17 (Synchrodyn 1-17) has provided new diagnostic information about subtle alterations of the adrenal function and has been valuable to presenting the rhythmic ordering of several functions, especially of those which are more dependent on the glucocorticoid modulation. In this sense, the use of a synthetic hormone analogue presenting a wide range of programmable effects appears essential for a better medicine. A large body of evidence indicates that the same concept applies to most actions of the gonadotropin-releasing hormone (LH-RH) related analogues. The availability of small computerized instruments for data collection and analysis of the endogenous rhythmicities, on the one hand, and for programmable administration of the analogues, on the other hand, is already providing new approaches to heretofore unsuccessful therapies.