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Baxter RC. Endocrine and cellular physiology and pathology of the insulin-like growth factor acid-labile subunit. Nat Rev Endocrinol 2024; 20:414-425. [PMID: 38514815 DOI: 10.1038/s41574-024-00970-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 03/23/2024]
Abstract
The acid-labile subunit (ALS) of the insulin-like growth factor (IGF) binding protein (IGFBP) complex, encoded in humans by IGFALS, has a vital role in regulating the endocrine transport and bioavailability of IGF-1 and IGF-2. Accordingly, ALS has a considerable influence on postnatal growth and metabolism. ALS is a leucine-rich glycoprotein that forms high-affinity ternary complexes with IGFBP-3 or IGFBP-5 when they are occupied by either IGF-1 or IGF-2. These complexes constitute a stable reservoir of circulating IGFs, blocking the potentially hypoglycaemic activity of unbound IGFs. ALS is primarily synthesized by hepatocytes and its expression is lower in non-hepatic tissues. ALS synthesis is strongly induced by growth hormone and suppressed by IL-1β, thus potentially serving as a marker of growth hormone secretion and/or activity and of inflammation. IGFALS mutations in humans and Igfals deletion in mice cause modest growth retardation and pubertal delay, accompanied by decreased osteogenesis and enhanced adipogenesis. In hepatocellular carcinoma, IGFALS is described as a tumour suppressor; however, its contribution to other cancers is not well delineated. This Review addresses the endocrine physiology and pathology of ALS, discusses the latest cell and proteomic studies that suggest emerging cellular roles for ALS and outlines its involvement in other disease states.
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Affiliation(s)
- Robert C Baxter
- University of Sydney, Kolling Institute, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
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González Ildefonso P, Nieto Librero AB, Martín Alonso M, Hernández Cerceño ML, García Serrano E, Prieto-Matos P. Normal range for acid-labile subunit in paediatric patients in Spain and its association with age, sex, pubertal stage and other growth factors. An Pediatr (Barc) 2023; 98:329-337. [PMID: 37105787 DOI: 10.1016/j.anpede.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/18/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION The acid-labile subunit (ALS) plays an important role in the endocrine effects of insulin-like growth factors (IGFs) on target tissues. Historically, it has attracted limited attention. The aim of our study was to describe the normal range of ALS in healthy children and its association with other growth factors. PATIENTS AND METHODS We designed a cross-sectional descriptive study. We collected data on age, height, body mass index, gestational age, anthropometry at birth and serum levels of ALS, IGF1 and IGFBP3 in healthy children aged 2-15 years with a normal height. The levels of ALS, IGF1 and IGFBP3 were measured by ELISA. We fitted GAMLSS normalization models to standardize the variables. RESULTS Samples were collected from 446 children. In prepubertal children, the levels of ALS, IGF1 and IGFBP3 were positively correlated in both sexes and with age (P < .01). We found significant differences in the levels of ALS, IGF1 and IGFBP3 and the IGF1/IGFBP3 molar ratio between the sexes and higher levels in pubertal boys (P < .01). We generated normal probability plots for each sex for each of the components of the ternary complex and for the IGF1/IGFBP3 and IGFBP3/ALS molar ratios. In addition, we extracted equations from the models for the calculation of z-scores for age and sex. CONCLUSIONS This study may contribute age- and sex-specific reference values for IGF1, IGFBP3 and ALS levels and IGF1/IGFBP3 and IGFBP3/ALS ratios in Spanish children and suggests an association between age, sex, and pubertal stage.
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Affiliation(s)
| | - Ana Belén Nieto Librero
- Departamento de Estadística, Facultad de Medicina de la Universidad de Salamanca, Salamanca, Spain
| | | | | | | | - Pablo Prieto-Matos
- Endocrinología Pediátrica, Hospital Universitario de Salamanca, Salamanca, Spain
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González Ildefonso P, Nieto Librero AB, Martín Alonso M, Hernández Cerceño ML, García Serrano E, Prieto-Matos P. Rango normal de subunidad ácido-lábil (ALS) en niños españoles y su relación con la edad, el sexo, el estadio puberal y otros factores de crecimiento. An Pediatr (Barc) 2023. [DOI: 10.1016/j.anpedi.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
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Schaupp A, Bidlingmaier M, Martini S, Reincke M, Schluessel S, Schmidmaier R, Drey M. Resistance training-induced improvement in physical function is not associated to changes in endocrine somatotropic activity in prefrail older adults. Arch Gerontol Geriatr 2022; 103:104792. [PMID: 36037722 DOI: 10.1016/j.archger.2022.104792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/02/2022] [Accepted: 08/13/2022] [Indexed: 11/02/2022]
Abstract
CONTEXT Resistance training improves muscle function in prefrail and frail elderly. The role of the somatotropic axis in this physiologic process remains unclear. Insulin-like growth factor I (IGF-I) and its associated proteins Insulin-like growth factor binding protein 3 (IGFBP3) and acid labile subunit (ALS) build a circulating ternary complex that mediates growth hormone (GH) effects on peripheral organs and can serve as a measure of endocrine somatotropic activity. OBJECTIVE The aim of this study was to assess the association between resistance training-induced changes in physical performance and basal levels of IGF-I, IGFBP-3 and ALS in prefrail older adults. METHODS 69 prefrail community-dwelling older adults, aged 65 to 94 years, were randomly assigned to a 12-week period of strength or power training or to a control group. The study was registered at clinicaltrials.gov as NCT00783159. Serum concentrations of IGF-I, IGFBP-3 and ALS were measured at rest before and after the intervention. Hormonal differences were examined in relation to changes in physical performance assessed by the Short Physical Performance Battery (SPPB). RESULTS While resistance training led to significant improvements in SPPB score it did not induce significant differences in somatotropic hormone concentrations. Pre- and post-intervention changes in IGF-I, IGFBP-3, ALS or IGF/IGFBP-3 molar ratio were not related to the intervention mode, even after adjustment for age, sex, nutritional status, as well as SPPB and hormone concentrations at baseline. CONCLUSION Training-induced improvements in physical performance in prefrail older adults were not associated with significant changes in endocrine somatotropic activity.
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Affiliation(s)
- Anna Schaupp
- Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität Munich, Ziemssenstraße 5, Munich 80336, Germany.
| | - Martin Bidlingmaier
- Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität Munich, Ziemssenstraße 5, Munich 80336, Germany
| | - Sebastian Martini
- Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität Munich, Ziemssenstraße 5, Munich 80336, Germany
| | - Martin Reincke
- Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität Munich, Ziemssenstraße 5, Munich 80336, Germany
| | - Sabine Schluessel
- Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität Munich, Ziemssenstraße 5, Munich 80336, Germany
| | - Ralf Schmidmaier
- Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität Munich, Ziemssenstraße 5, Munich 80336, Germany
| | - Michael Drey
- Department of Medicine IV, University Hospital, Ludwig-Maximilians-Universität Munich, Ziemssenstraße 5, Munich 80336, Germany
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Jarmusch S, Baber L, Bidlingmaier M, Ferrari U, Hofmeister F, Hintze S, Mehaffey S, Meinke P, Neuerburg C, Schoser B, Tanganelli F, Drey M. Influence of IGF-I serum concentration on muscular regeneration capacity in patients with sarcopenia. BMC Musculoskelet Disord 2021; 22:807. [PMID: 34544407 PMCID: PMC8454138 DOI: 10.1186/s12891-021-04699-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 09/10/2021] [Indexed: 02/01/2023] Open
Abstract
Background Previous research has described a neuroprotective effect of IGF-I, supporting neuronal survival, axon growth and proliferation of muscle cells. Therefore, the association between IGF-I concentration, muscle histology and electrophysiological markers in a cohort of patients with sarcopenia dares investigation. Methods Measurement of serum concentrations of IGF-I and binding partners, electromyographic measurements with the MUNIX (Motor Unit Number Index) method and muscle biopsies were performed in 31 patients with acute hip fracture older age 60 years. Molecular markers for denervation (neural cell adhesion molecule NCAM) and proliferation markers (Ki67) were assessed by immunofluorescence staining of muscle biopsy tissue. Skeletal muscle mass by bioelectrical impedance analysis and hand-grip strength were measured to assess sarcopenia status according to EWGSOP2 criteria. Results Thirty-one patients (20 women) with a mean age of 80.6 ± 7.4 years were included. Concentrations of IGF-I and its binding partners were significantly associated with sarcopenia (ß = − 0.360; p = 0.047) and MUNIX (ß = 0.512; p = 0.005). Further, expression of NCAM (ß = 0.380; p = 0.039) and Ki67 (ß = 0.424; p = 0.022) showed significant associations to IGF-I concentrations. Conclusions The findings suggest a pathogenetic role of IGF-I in sarcopenia based on muscle denervation. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04699-3.
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Affiliation(s)
- Stefanie Jarmusch
- Department of Medicine IV, Geriatrics, University Hospital of LMU Munich, Munich, Germany
| | - Lisa Baber
- Department of Medicine IV, Geriatrics, University Hospital of LMU Munich, Munich, Germany
| | - Martin Bidlingmaier
- Department of Medicine IV, Endocrinological Laboratory, University Hospital of LMU Munich, Munich, Germany
| | - Uta Ferrari
- Department of Medicine IV, Geriatrics, University Hospital of LMU Munich, Munich, Germany
| | - Fabian Hofmeister
- Department of Medicine IV, Geriatrics, University Hospital of LMU Munich, Munich, Germany
| | - Stefan Hintze
- Friedrich-Baur-Institute, Department of Neurology, University Hospital of LMU Munich, Munich, Germany
| | - Stefan Mehaffey
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital of LMU Munich, Munich, Germany
| | - Peter Meinke
- Friedrich-Baur-Institute, Department of Neurology, University Hospital of LMU Munich, Munich, Germany
| | - Carl Neuerburg
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital of LMU Munich, Munich, Germany
| | - Benedikt Schoser
- Friedrich-Baur-Institute, Department of Neurology, University Hospital of LMU Munich, Munich, Germany
| | - Fabiana Tanganelli
- Department of Medicine IV, Geriatrics, University Hospital of LMU Munich, Munich, Germany
| | - Michael Drey
- Department of Medicine IV, Geriatrics, University Hospital of LMU Munich, Munich, Germany.
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Cottrell E, Maharaj A, Williams J, Chatterjee S, Cirillo G, Miraglia del Giudice E, Festa A, Palumbo S, Capalbo D, Salerno M, Pignata C, Savage MO, Schilbach K, Bidlingmaier M, Hwa V, Metherell LA, Grandone A, Storr HL. Growth Hormone Receptor (Ghr) 6ω Pseudoexon Activation: A Novel Cause Of Severe Growth Hormone Insensitivity (Ghi). J Clin Endocrinol Metab 2021; 107:dgab550. [PMID: 34318893 PMCID: PMC8684449 DOI: 10.1210/clinem/dgab550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Indexed: 12/15/2022]
Abstract
CONTEXT Severe forms of Growth Hormone Insensitivity (GHI) are characterized by extreme short stature, dysmorphism and metabolic anomalies. OBJECTIVE Identification of the genetic cause of growth failure in 3 'classical' GHI subjects. DESIGN A novel intronic GHR variant was identified, and in vitro splicing assays confirmed aberrant splicing. A 6Ω pseudoexon GHR vector and patient fibroblast analysis assessed the consequences of the novel pseudoexon inclusion and the impact on GHR function. RESULTS We identified a novel homozygous intronic GHR variant (g.5:42700940T>G, c.618 + 836T> G), 44bp downstream of the previously recognized intronic 6Ψ GHR pseudoexon mutation in the index patient. Two siblings also harbored the novel intronic 6Ω pseudoexon GHR variant in compound heterozygosity with the known GHR c.181C>T (R43X) mutation. In vitro splicing analysis confirmed inclusion of a 151bp mutant 6Ω pseudoexon not identified in wild-type constructs. Inclusion of the 6Ω pseudoexon causes a frameshift resulting in a non-functional truncated GHR lacking the transmembrane and intracellular domains. The truncated 6Ω pseudoexon protein demonstrated extracellular accumulation and diminished activation of STAT5B signaling following growth hormone stimulation. CONCLUSION Novel GHR 6Ω pseudoexon inclusion results in loss of GHR function consistent with a severe GHI phenotype. This represents a novel mechanism of Laron syndrome and is the first deep intronic variant identified causing severe postnatal growth failure. The 2 kindreds originate from the same town in Campania, Southern Italy, implying common ancestry. Our findings highlight the importance of studying variation in deep intronic regions as a cause of monogenic disorders.
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Affiliation(s)
- Emily Cottrell
- Centre for Endocrinology, William Harvey Research Institute: Barts and The London School of Medicine and Dentistry William Harvey Research Institute, London EC1M 6BQ, UK
| | - Avinaash Maharaj
- Centre for Endocrinology, William Harvey Research Institute: Barts and The London School of Medicine and Dentistry William Harvey Research Institute, London EC1M 6BQ, UK
| | - Jack Williams
- Centre for Endocrinology, William Harvey Research Institute: Barts and The London School of Medicine and Dentistry William Harvey Research Institute, London EC1M 6BQ, UK
| | - Sumana Chatterjee
- Centre for Endocrinology, William Harvey Research Institute: Barts and The London School of Medicine and Dentistry William Harvey Research Institute, London EC1M 6BQ, UK
| | - Grazia Cirillo
- Studies of Campania Luigi Vanvitelli, Department of Woman, Child, General and Specialized Surgery, Naples 80138, Italy
| | - Emanuele Miraglia del Giudice
- Studies of Campania Luigi Vanvitelli, Department of Woman, Child, General and Specialized Surgery, Naples 80138, Italy
| | - Adalgisa Festa
- Studies of Campania Luigi Vanvitelli, Department of Woman, Child, General and Specialized Surgery, Naples 80138, Italy
| | - Stefania Palumbo
- Studies of Campania Luigi Vanvitelli, Department of Woman, Child, General and Specialized Surgery, Naples 80138, Italy
| | - Donatella Capalbo
- Federico II University Hospital: Azienda Ospedaliera Universitaria Federico II, Naples 80131, Italy
| | - Mariacarolina Salerno
- University of Naples Federico II Department of Translational Medical Sciences: Universita degli Studi di Napoli Federico II Dipartimento di Scienze Mediche Traslazionali, Naples 80138, Italy
| | - Claudio Pignata
- University of Naples Federico II Department of Translational Medical Sciences: Universita degli Studi di Napoli Federico II Dipartimento di Scienze Mediche Traslazionali, Naples 80138, Italy
| | - Martin O Savage
- Centre for Endocrinology, William Harvey Research Institute: Barts and The London School of Medicine and Dentistry William Harvey Research Institute, London EC1M 6BQ, UK
| | | | | | - Vivian Hwa
- Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, USA
| | - Louise A Metherell
- Centre for Endocrinology, William Harvey Research Institute: Barts and The London School of Medicine and Dentistry William Harvey Research Institute, London EC1M 6BQ, UK
| | - Anna Grandone
- Studies of Campania Luigi Vanvitelli, Department of Woman, Child, General and Specialized Surgery, Naples 80138, Italy
| | - Helen L Storr
- Centre for Endocrinology, William Harvey Research Institute: Barts and The London School of Medicine and Dentistry William Harvey Research Institute, London EC1M 6BQ, UK
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Ferrari U, Schmidmaier R, Jung T, Reincke M, Martini S, Schoser B, Bidlingmaier M, Drey M. IGF-I/IGFBP3/ALS Deficiency in Sarcopenia: Low GHBP Suggests GH Resistance in a Subgroup of Geriatric Patients. J Clin Endocrinol Metab 2021; 106:e1698-e1707. [PMID: 33378445 DOI: 10.1210/clinem/dgaa972] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Definition of etiological subgroups of sarcopenia may help to develop targeted treatments. insulin like growth factor-I (IGF-I), Insulinlike growth factor binding protein 3 (IGFBP3), and acid labile subunit (ALS) build a ternary complex that mediates growth hormone (GH) effects on peripheral organs, such as muscle. Low GH binding protein (GHBP) as a marker of GH receptor number would hint toward GH resistance. OBJECTIVE We aimed to analyze the association of IGF-I, IGFBP3, and ALS with sarcopenia. STUDY PARTICIPANTS AND SETTING A total of 131 consecutively recruited patients of a geriatric ward were included in a single-center cross-sectional analysis; the nonsarcopenic patients served as controls. METHODS Measures included sarcopenia status by hand-grip strength measurement and Skeletal Muscle Index (SMI); IGF-I, IGFBP3, ALS, GH, GHBP; body mass index (BMI); Activity of Daily Living (ADL); Mini-Mental State Examination (MMSE); routine laboratory parameters; and statistical regression modeling. RESULTS Compared with controls, sarcopenic patients did not differ regarding age, sex, ADL, MMSE, C-reactive protein, glomerular filtration rate, and albumin serum concentrations. However, sarcopenic patients had significantly lower IGF-I, IGFBP3, and ALS. IGF-I and ALS associated significantly with sarcopenia and low hand-grip strength, even after adjustment for age, sex, BMI, and albumin, but not with low SMI. GHBP serum was low in sarcopenic patients, but normal in geriatric patients without sarcopenia. Over 60% of patients with IGF-I/ALS deficiency patients showed GH resistance. CONCLUSIONS Our data suggest that in geriatric patients, low IGF-I/IGFBP3/ALS could be evaluated for causative connection of the sarcopenia spectrum. Low GHBP points toward potential GH resistance as one possible explanation of this deficiency.
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Affiliation(s)
- Uta Ferrari
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Ralf Schmidmaier
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Theresa Jung
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Martin Reincke
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Sebastian Martini
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
| | - Benedikt Schoser
- Friedrich-Baur-Institute, Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | | | - Michael Drey
- Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
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Trainer PJ, Newell-Price JDC, Ayuk J, Aylwin SJB, Rees A, Drake W, Chanson P, Brue T, Webb SM, Fajardo C, Aller J, McCormack AI, Torpy DJ, Tachas G, Atley L, Ryder D, Bidlingmaier M. A randomised, open-label, parallel group phase 2 study of antisense oligonucleotide therapy in acromegaly. Eur J Endocrinol 2018; 179:97-108. [PMID: 29789410 PMCID: PMC6063983 DOI: 10.1530/eje-18-0138] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/22/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE ATL1103 is a second-generation antisense oligomer targeting the human growth hormone (GH) receptor. This phase 2 randomised, open-label, parallel-group study assessed the potential of ATL1103 as a treatment for acromegaly. DESIGN Twenty-six patients with active acromegaly (IGF-I >130% upper limit of normal) were randomised to subcutaneous ATL1103 200 mg either once or twice weekly for 13 weeks and monitored for a further 8-week washout period. METHODS The primary efficacy measures were change in IGF-I at week 14, compared to baseline and between cohorts. For secondary endpoints (IGFBP3, acid labile subunit (ALS), GH, growth hormone-binding protein (GHBP)), comparison was between baseline and week 14. Safety was assessed by reported adverse events. RESULTS AND CONCLUSIONS Baseline median IGF-I was 447 and 649 ng/mL in the once- and twice-weekly groups respectively. Compared to baseline, at week 14, twice-weekly ATL1103 resulted in a median fall in IGF-I of 27.8% (P = 0.0002). Between cohort comparison at week 14 demonstrated the median fall in IGF-I to be 25.8% (P = 0.0012) greater with twice-weekly dosing. In the twice-weekly cohort, IGF-I was still declining at week 14, and remained lower at week 21 than at baseline by a median of 18.7% (P = 0.0005). Compared to baseline, by week 14, IGFBP3 and ALS had declined by a median of 8.9% (P = 0.027) and 16.7% (P = 0.017) with twice-weekly ATL1103; GH had increased by a median of 46% at week 14 (P = 0.001). IGFBP3, ALS and GH did not change with weekly ATL1103. GHBP fell by a median of 23.6% and 48.8% in the once- and twice-weekly cohorts (P = 0.027 and P = 0.005) respectively. ATL1103 was well tolerated, although 84.6% of patients experienced mild-to-moderate injection-site reactions. This study provides proof of concept that ATL1103 is able to significantly lower IGF-I in patients with acromegaly.
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Affiliation(s)
- Peter J Trainer
- Department of EndocrinologyThe Christie NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Correspondence should be addressed to P J Trainer;
| | - John D C Newell-Price
- Department of Oncology and MetabolismThe Medical School, University of Sheffield, Sheffield, UK
- Royal Hallamshire HospitalSheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - John Ayuk
- Medicine EndocrinologyQueen Elizabeth Hospital Birmingham, Edgbaston, UK
| | | | - Aled Rees
- Neuroscience and Mental Health Research InstituteSchool of Medicine, Cardiff University, Hadyn Ellis Building, Cardiff, UK
| | - William Drake
- Department of EndocrinologySt Bartholomew’s Hospital, London, UK
| | - Philippe Chanson
- Assistance Publique-Hôpitaux de ParisHôpitaux Universitaires Paris-Sud, Hôpital de Bicêtre, Service d’Endocrinologie et des Maladies de la Reproduction, Le Kremlin-Bicêtre, France
- Inserm 1185Fac Med Paris Sud, Univ Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Thierry Brue
- Aix-Marseille UniversitéCNRS, CRN2M UMR 7286, Marseille, France
- APHMHôpital Conception, Service d’Endocrinologie, Diabète et Maladies Métaboliques, Centre de Référence des Maladies Rares d’Origine Hypophysaire, Marseille, France
| | - Susan M Webb
- Department of EndocrinologyCIBERER Group 747, IIB-S Pau, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Carmen Fajardo
- Servicio de EndocrinologíaHospital Universitario de La Ribera, Alzira, Valencia, Spain
| | - Javier Aller
- Endocrinology DepartmentHospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - Ann I McCormack
- Garvan Institute of Medical Research and St Vincent’s HospitalDarlinghurst Sydney, New South Wales, Australia
| | - David J Torpy
- Royal Adelaide HospitalNorth Terrace, Adelaide, Australia
| | - George Tachas
- Antisense Therapeutics LimitedToorak, Victoria, Australia
| | - Lynne Atley
- Antisense Therapeutics LimitedToorak, Victoria, Australia
| | - David Ryder
- Manchester Academic Health Science Centre (MAHSC) Clinical Trials UnitThe Christie NHS Foundation Trust, University of Manchester, Manchester, UK
| | - Martin Bidlingmaier
- Endocrine LaboratoryMedizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany
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Sundström K, Cedervall T, Ohlsson C, Camacho-Hübner C, Sävendahl L. Combined treatment with GH and IGF-I: additive effect on cortical bone mass but not on linear bone growth in female rats. Endocrinology 2014; 155:4798-807. [PMID: 25243853 DOI: 10.1210/en.2014-1160] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The growth-promoting effect of combined therapy with GH and IGF-I in normal rats is not known. We therefore investigated the efficacy of treatment with recombinant human (rh)GH and/or rhIGF-I on longitudinal bone growth and bone mass in intact, prepubertal, female Sprague-Dawley rats. rhGH was injected twice daily sc (5 mg/kg·d) and rhIGF-I continuously infused sc (2.2 or 4.4 mg/kg·d) for 28 days. Longitudinal bone growth was monitored by weekly x-rays of tibiae and nose-anus length measurements, and tibial growth plate histomorphology was analyzed. Bone mass was evaluated by peripheral quantitative computed tomography. In addition, serum levels of IGF-I, rat GH, acid labile subunit, IGF binding protein-3, 150-kDa ternary complex formation, and markers of bone formation and degradation were measured. Monotherapy with rhGH was more effective than rhIGF-I (4.4 mg/kg·d) to increase tibia and nose-anus length, whereas combined therapy did not further increase tibia, or nose-anus, lengths or growth plate height. In contrast, combined rhGH and rhIGF-I (4.4 mg/kg·d) therapy had an additive stimulatory effect on cortical bone mass vs rhGH alone. Combined treatment with rhGH and rhIGF-I resulted in markedly higher serum IGF-I concentrations vs rhGH alone but did not compromise the endogenous secretion of GH. We conclude that rhIGF-I treatment augments cortical bone mass but does not further improve bone growth in rhGH-treated young, intact, female rats.
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Affiliation(s)
- Katja Sundström
- Pediatric Endocrinology Unit (K.S., T.C., C.C.-H., L.S.), Department of Women's and Children's Health, Karolinska Institutet, SE-17176 Stockholm, Sweden; and Centre for Bone and Arthritis Research (C.O.), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden
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Roemmler J, Bidlingmaier M, Schopohl J. Endogenous estradiol may influence IGF-I levels in acromegalic women treated with pegvisomant. Pituitary 2010; 13:89-93. [PMID: 18498055 DOI: 10.1007/s11102-008-0131-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We present the case of a 46-year-old woman with acromegaly currently being treated with the growth hormone (GH) receptor antagonist pegvisomant showing strongly fluctuating IGF-I levels. We prospectively measured estradiol, IGF-I, IGF-I binding protein, acid labile subunit, basal endogenous GH, binding protein and pegvisomant levels for 6 months every week. Estradiol levels showed a strongly negative correlation with IGF-I (r = -0.733, P < 0.001), and less so with ALS (r = -0.433, P < 0.05) and IGFBP3 (r = -0.590, P < 0.01). Estradiol was not significantly correlated with endogenous GH or pegvisomant levels. Likewise, IGF-I did not correlate with endogenous GH or pegvisomant levels. In our patient, endogenous estradiol levels have a significant influence on IGF-I levels. When female acromegalic patients on permanent pegvisomant treatment show fluctuating IGF-I levels, estradiol levels should be taken into consideration.
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Affiliation(s)
- J Roemmler
- Endocrinology, Medizinische Klinik-Innenstadt, University of Munich, Ziemssenstr. 1, 80336, München, Germany.
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Weiss S, Henle P, Bidlingmaier M, Moghaddam A, Kasten P, Zimmermann G. Systemic response of the GH/IGF-I axis in timely versus delayed fracture healing. Growth Horm IGF Res 2008; 18:205-212. [PMID: 17936052 DOI: 10.1016/j.ghir.2007.09.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2007] [Revised: 08/27/2007] [Accepted: 09/04/2007] [Indexed: 11/24/2022]
Abstract
The GH-IGF axis has profound effects on the local and systemic regulation of bone metabolism and may be important for quality of fracture healing. To test the hypothesis that deficiency of the GH/IGF axis may play a role in the pathogenesis of fracture non-union we investigated whether alterations of serum concentrations of the GH-IGF axis could be related to failed fracture healing compared to timely fracture healing in trauma patients. Serum probes were prospectively collected from 186 patients with surgical treatment of long bone fractures up to 6 months after surgery. Samples from 14 patients with atrophic type of non-union have been compared to 14 matched patients with normal bone healing. Postoperative time courses of serum concentrations have been analyzed using commercially available chemiluminescence sandwich assays (GH), fully automated assay systems (IGF-I, IGFBP-3) or sandwich immunometric assays (ALS). Comparison between both collectives revealed significantly lower serum concentrations of GH dependent ALS during early (1st week after surgery) and of both IGFBP-3 and ALS during late stages of fracture healing (6 and 8 weeks after surgery) in non-union patients, coinciding clinically with failed fracture healing. Tendentially lower serum levels of IGF-I in the non-union group over the entire investigation period were statistically not significant. We have been able to show time courses of serum concentrations of the GH/IGF-I axis during normal and failed fracture healing in humans. An impairment of the GH/IGF-I axis might be involved in the biochemical mechanisms determining delayed or failed fracture healing.
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Affiliation(s)
- Stefan Weiss
- Stiftung Orthopädische Universitätsklinik, University of Heidelberg, Germany
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Hwang DL, Lee PD, Cohen P. Quantitative ontogeny of murine insulin-like growth factor (IGF)-I, IGF-binding protein-3 and the IGF-related acid-labile subunit. Growth Horm IGF Res 2008; 18:65-74. [PMID: 17719253 PMCID: PMC2276237 DOI: 10.1016/j.ghir.2007.07.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2007] [Revised: 07/05/2007] [Accepted: 07/10/2007] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The mouse serves as an important model for insulin-like (IGF)-related research. However, lack of homologous mouse assays has prevented studies of the normal ontology of the murine IGF system. Therefore, we developed and validated immunoaassays for murine IGF-I, IGFBP-3 and ALS and studied levels of these analytes in mice. METHODS Using commercially available reagents, we developed and validated specific enzyme-linked immunosorbent assays (ELISAs) for murine IGF-I, IGFBP-3, and ALS. Levels of these analytes were measured in sera from CD-1 mice, male and female, sampled at 1, 2, 4, 8, 20 and 32 weeks of age. In addition, sera from pregnant and postpartum CD-1 mice were also studied. RESULTS Validation of specific ELISAs for murine IGF-I, IGFBP-3 and ALS are described; all 3 assays were highly sensitive, precise and accurate. As measured by our homologous ELISA, IGF-I levels (ng/mL, mean+/-SD) in male mice were relatively low at 1 week (53+/-8), rising sharply to peak at 8 weeks of age (636+/-48), and gradually declining thereafter, reaching 395+/-64 at 32 weeks. IGF-I levels in non-pregnant female mice peaked at 4 weeks of age (548+/-77) declined at 8 weeks (417+/-61), then recovered to plateau at 539+/-78 and 535+/-88 at 20 and 32 weeks, respectively. In male mice, trends in IGFBP-3 were similar to the patterns of IGF-I. However, in non-pregnant female mice, the IGFBP-3 levels declined relatively slowly after peaking at 4-weeks of age, unlike IGF-I levels during this period. ALS levels followed the same pattern as IGF-I in both sexes. IGF-I to IGFBP-3 molar ratios (percent) were similar between sexes, rising continuously with age: approximately 30% at 1 week, 80% at 4 weeks, 135% at 32 weeks. IGF-I was reduced in 8 week old mice in mid-pregnancy (354+/-75 vs 417+/-61 in non-pregnant 8 week females), reaching a nadir in late-term (146+/-40), and only partially recovering in the postpartum period (239+/-23). IGFBP-3 was also lower in late-pregnancy (1245+/-100 vs 1925+/-439) and remained depressed postpartum. In contrast to IGF-I and IGFBP-3, ALS increased more than threefold in mid-pregnancy (12180+/-1641 vs 3741+/-910), followed by a 4-fold decrease in late-pregnancy (2964+/-489), recovering postpartum (6104+/-1178). CONCLUSIONS We report the first ontological studies of IGF-I, IGFBP-3 and ALS in mice using newly-characterized sensitive, homologous immunoassays. Our results indicate that mice have a generally similar pattern in IGF-related axis components, with low levels early in life, increasing to peak during sexual maturation and declining thereafter. Significant gender differences in non-pregnant levels and dramatic changes during pregnancy were also found. Knowledge of the normal developmental changes in the murine IGF system and accurate tools for investigations of this system are a necessary foundation for research in this field.
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Affiliation(s)
- David L. Hwang
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1752
| | | | - Pinchas Cohen
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1752
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Murray RD, Bidlingmaier M, Strasburger CJ, Shalet SM. The diagnosis of partial growth hormone deficiency in adults with a putative insult to the hypothalamo-pituitary axis. J Clin Endocrinol Metab 2007; 92:1705-9. [PMID: 17327383 DOI: 10.1210/jc.2006-2055] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT Similar to patients with severe GH deficiency (GHD), those with a more moderate impairment of GH secretion [GH insufficiency (GHI)] have abnormal body composition, dyslipidemia, and insulin resistance. Given the inherent problems in the diagnosis of severe GHD, the situation is likely to be even more difficult in individuals with GHI. OBJECTIVE The objective of the study was to examine the utility of GH stimulation tests and GH-dependent proteins in the diagnosis of GHI. DESIGN The study was a cross-sectional, case-controlled study. PATIENTS The study included 31 patients with GHD, 23 with GHI [peak GH 3-7 microg/liter (9-21 mU/liter)], and 30 age- and sex-matched controls. MAIN OUTCOME MEASURES Demographic and biochemical markers of GH status were measured. RESULTS Nineteen of the patients with GHI (83%) had no additional anterior pituitary hormone deficits. Ten GHI patients showed discordant GH status based on the two GH stimulation tests performed. GH status was defined by the highest peak GH value achieved; in four this was to the insulin tolerance test (ITT), four the arginine test, and two the GHRH-arginine test. In five of the six patients in whom GH status was not defined by the ITT, peak GH levels to the ITT were in the range 2.4-2.9 microg/liter. IGF-I values for the GHI adults were significantly lower than the control subjects (121 +/- 48 vs. 162 +/- 75 microg/liter; P < 0.05); however, only six (26%) had values below the 10th percentile of levels seen in the control group. IGF binding protein-3 and acid labile subunit levels of the GHI adults were not significantly different from the controls. CONCLUSION The diagnosis of GHI in an individual is extremely difficult because the patients rarely exhibit additional pituitary hormone deficits, and levels of GH-dependent proteins are normal in the majority. Diagnosis relies heavily on GH stimulation tests and requires two tests in all patients to define GHI; obesity when present is potentially a major confounder.
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Affiliation(s)
- Robert D Murray
- Department of Endocrinology, Christie Hospital National Health Service Trust, Wilmslow Road, Manchester, United Kingdom
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