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Włodarczyk L, Cichoń N, Karbownik MS, Saso L, Saluk J, Miller E. Circulating Serum VEGF, IGF-1 and MMP-9 and Expression of Their Genes as Potential Prognostic Markers of Recovery in Post-Stroke Rehabilitation-A Prospective Observational Study. Brain Sci 2023; 13:846. [PMID: 37371326 DOI: 10.3390/brainsci13060846] [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: 04/03/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/29/2023] Open
Abstract
The key period in post-stroke recovery is the first three months due to the high activity of spontaneous and therapeutic-induced processes related to neuroplasticity, angiogenesis and reperfusion. Therefore, the present study examines the expression of VEGF, IGF-1 and MMP-9 proteins and their genes to identify biomarkers that can prognose brain repair ability and thus estimate the outcome of stroke. It also identifies possible associations with clinical scales, including cognitive assessment and depression scales. The study group comprised 32 patients with moderate ischemic stroke severity, three to four weeks after incident. The results obtained after three-week hospitalization indicate a statistically significant change in clinical parameter estimations, as well as in MMP9 and VEGF protein and mRNA expression, over the rehabilitation process. Our findings indicate that combined MMP9 protein and mRNA expression might be a useful biomarker for cognitive improvement in post-stroke patients, demonstrating 87% sensitivity and 71% specificity (p < 0.0001).
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Affiliation(s)
- Lidia Włodarczyk
- Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa 14, 93-113 Lodz, Poland
| | - Natalia Cichoń
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland
| | - Michał Seweryn Karbownik
- Department of Pharmacology and Toxicology, Medical University of Lodz, Żeligowskiego 7/9, 90-752 Lodz, Poland
| | - Luciano Saso
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University, P. le Aldo Moro 5, 00185 Rome, Italy
| | - Joanna Saluk
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland
| | - Elżbieta Miller
- Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa 14, 93-113 Lodz, Poland
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Lee EC, Jeong YJ, Lee HJ, Yoon SY. Prestroke VO 2max by the Jurca prediction index as a predictor of functional outcomes in stroke patients. Top Stroke Rehabil 2021; 29:208-217. [PMID: 33823741 DOI: 10.1080/10749357.2021.1911747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Prestroke cardiopulmonary fitness (CPF) levels can affect post-stroke respiratory function and functional status, including gait and activities of daily living (ADL). OBJECTIVES To investigate the prestroke CPF level measured by the Jurca prediction index as a predictor of functional outcomes after stroke and to evaluate the association between estimated prestroke CPF and respiratory function after stroke. METHODS This was a prospective observational study involving 71 inpatients with first-time subacute stroke between June 2017 and July 2019. The prestroke VO2max was assessed using the Jurca prediction index, which was calculated from age, sex, resting heart rate, body mass index, and physical activity level. Linear regression analysis was performed to determine the relationship between the Jurca prediction index, functional outcomes, pulmonary functions, and cough strength variables. RESULTS The estimated prestroke VO2max was significantly associated with the post-stroke Berg Balance Scale (β=1.199, P<0.001), Trunk Impairment Scale (β=0.308, P=0.006), and Functional Independence Measure score (β=1.102, P=0.004) at admission, and these relationships remained significant at the follow-up evaluation after 1 month of conventional rehabilitation (P<0.001). Among the respiratory function variables, only peak cough flow (PCF) (β=0.696, P=0.037) was significantly associated with the estimated prestroke VO2max. CONCLUSIONS Prestroke CPF likely affects the stability of core muscles that are related to PCF and the functional status, including balance function and ADL after stroke. Regular exercise to increase the CPF level should be encouraged in patients with risk factors for stroke, not only for primary prevention but also for functional improvement after stroke.
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Affiliation(s)
- Eun Chae Lee
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Gyeonggi-do, Republic of Korea
| | - Yoon Jeong Jeong
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Gyeonggi-do, Republic of Korea
| | - Hyo Jeong Lee
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Gyeonggi-do, Republic of Korea
| | - Seo Yeon Yoon
- Department of Physical Medicine and Rehabilitation, Korea University Guro Hospital, Seoul, Republic of Korea
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Åberg ND, Gadd G, Åberg D, Hällgren P, Blomstrand C, Jood K, Nilsson M, Walker FR, Svensson J, Jern C, Isgaard J. Relationship between Levels of Pre-Stroke Physical Activity and Post-Stroke Serum Insulin-Like Growth Factor I. Biomedicines 2020; 8:biomedicines8030052. [PMID: 32143318 PMCID: PMC7148508 DOI: 10.3390/biomedicines8030052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 11/18/2022] Open
Abstract
Physical activity (PA) and insulin-like growth factor I (IGF-I) have beneficial effects for patients who have suffered an ischemic stroke (stroke). However, the relationship between the levels of PA and IGF-I after stroke has not been explored in detail. We investigated the pre-stroke PA level in relation to the post-stroke serum IGF-I (s-IGF-I) level, at baseline and at 3 months after the index stroke, and calculated the change that occurred between these two time-points (ΔIGF-I). Patients (N = 380; 63.4% males; mean age, 54.7 years) with data on 1-year leisure-time pre-stroke PA and post-stroke s-IGF-I levels were included from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Pre-stroke, leisure-time PA was self-reported as PA1–4, with PA1 representing sedentary and PA2–4 indicating progressively higher PA levels. Associations between s-IGF-I and PA were evaluated by multiple linear regressions with PA1 as the reference and adjustments being made for sex, age, history of previous stroke or myocardial infarctions, cardiovascular risk factors, and stroke severity. PA correlated with baseline s-IGF-I and ΔIGF-I, but not with the 3-month s-IGF-I. In the linear regressions, there were corresponding associations that remained as a tendency (baseline s-IGF-I, p = 0.06) or as a significant effect (ΔIGF-I, p = 0.03) after all the adjustments. Specifically, for each unit of PA, ΔIGF-I increased by 9.7 (95% CI 1,1−18.4) ng/mL after full adjustment. This supports the notion that pre-stroke PA is independently related to ΔIGF-I.
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Affiliation(s)
- N. David Åberg
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden; (G.G.); (D.Å.); (J.S.); (J.I.)
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden;
- Correspondence: ; Tel.: +46-31-342-8422
| | - Gustaf Gadd
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden; (G.G.); (D.Å.); (J.S.); (J.I.)
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden;
| | - Daniel Åberg
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden; (G.G.); (D.Å.); (J.S.); (J.I.)
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden;
| | - Peter Hällgren
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden;
| | - Christian Blomstrand
- Department for Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden; (C.B.); (K.J.)
| | - Katarina Jood
- Department for Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden; (C.B.); (K.J.)
| | - Michael Nilsson
- School of Biomedical Sciences and Pharmacy and the Priority Research Centre for Stroke and Brain Injury, the University of Newcastle, University Dr, Callaghan, NSW 2308, Australia; (M.N.); (F.R.W.)
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305, Australia
| | - Fredrick R. Walker
- School of Biomedical Sciences and Pharmacy and the Priority Research Centre for Stroke and Brain Injury, the University of Newcastle, University Dr, Callaghan, NSW 2308, Australia; (M.N.); (F.R.W.)
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305, Australia
| | - Johan Svensson
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden; (G.G.); (D.Å.); (J.S.); (J.I.)
| | - Christina Jern
- Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden;
- Department of Clinical genetics and genomics, Sahlgrenska University Hospital, SE-41345 Gothenburg, Sweden
| | - Jörgen Isgaard
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden; (G.G.); (D.Å.); (J.S.); (J.I.)
- School of Biomedical Sciences and Pharmacy and the Priority Research Centre for Stroke and Brain Injury, the University of Newcastle, University Dr, Callaghan, NSW 2308, Australia; (M.N.); (F.R.W.)
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Ploughman M, Eskes GA, Kelly LP, Kirkland MC, Devasahayam AJ, Wallack EM, Abraha B, Hasan SMM, Downer MB, Keeler L, Wilson G, Skene E, Sharma I, Chaves AR, Curtis ME, Bedford E, Robertson GS, Moore CS, McCarthy J, Mackay-Lyons M. Synergistic Benefits of Combined Aerobic and Cognitive Training on Fluid Intelligence and the Role of IGF-1 in Chronic Stroke. Neurorehabil Neural Repair 2019; 33:199-212. [PMID: 30816066 DOI: 10.1177/1545968319832605] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Paired exercise and cognitive training have the potential to enhance cognition by "priming" the brain and upregulating neurotrophins. METHODS Two-site randomized controlled trial. Fifty-two patients >6 months poststroke with concerns about cognitive impairment trained 50 to 70 minutes, 3× week for 10 weeks with 12-week follow-up. Participants were randomized to 1 of 2 physical interventions: Aerobic (>60% VO2peak using <10% body weight-supported treadmill) or Activity (range of movement and functional tasks). Exercise was paired with 1 of 2 cognitive interventions (computerized dual working memory training [COG] or control computer games [Games]). The primary outcome for the 4 groups (Aerobic + COG, Aerobic + Games, Activity + COG, and Activity + Games) was fluid intelligence measured using Raven's Progressive Matrices Test administered at baseline, posttraining, and 3-month follow-up. Serum neurotrophins collected at one site (N = 30) included brain-derived neurotrophic factor (BDNF) at rest (BDNFresting) and after a graded exercise test (BDNFresponse) and insulin-like growth factor-1 at the same timepoints (IGF-1rest, IGF-1response). RESULTS At follow-up, fluid intelligence scores significantly improved compared to baseline in the Aerobic + COG and Activity + COG groups; however, only the Aerobic + COG group was significantly different (+47.8%) from control (Activity + Games -8.5%). Greater IGF-1response at baseline predicted 40% of the variance in cognitive improvement. There was no effect of the interventions on BDNFresting or BDNFresponse; nor was BDNF predictive of the outcome. CONCLUSIONS Aerobic exercise combined with cognitive training improved fluid intelligence by almost 50% in patients >6 months poststroke. Participants with more robust improvements in cognition were able to upregulate higher levels of serum IGF-1 suggesting that this neurotrophin may be involved in behaviorally induced plasticity.
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Affiliation(s)
- Michelle Ploughman
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Gail A Eskes
- 2 Dalhousie University, Halifax, Nova Scotia, Canada NL, Canada
| | - Liam P Kelly
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Megan C Kirkland
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | | | - Elizabeth M Wallack
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Beraki Abraha
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - S M Mahmudul Hasan
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Matthew B Downer
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Laura Keeler
- 2 Dalhousie University, Halifax, Nova Scotia, Canada NL, Canada
| | - Graham Wilson
- 2 Dalhousie University, Halifax, Nova Scotia, Canada NL, Canada
| | - Elaine Skene
- 2 Dalhousie University, Halifax, Nova Scotia, Canada NL, Canada
| | - Ishika Sharma
- 2 Dalhousie University, Halifax, Nova Scotia, Canada NL, Canada
| | - Arthur R Chaves
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Marie E Curtis
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Emily Bedford
- 2 Dalhousie University, Halifax, Nova Scotia, Canada NL, Canada
| | | | - Craig S Moore
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Jason McCarthy
- 1 Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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Exercise intensity and middle cerebral artery dynamics in humans. Respir Physiol Neurobiol 2019; 262:32-39. [PMID: 30710650 PMCID: PMC6393201 DOI: 10.1016/j.resp.2019.01.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/11/2019] [Accepted: 01/29/2019] [Indexed: 12/24/2022]
Abstract
Despite its necessity for understanding healthy brain aging, the influence of exercise intensity on cerebrovascular kinetics is currently unknown. We, therefore characterized middle cerebral artery blood flow velocity (MCAv) kinetics associated with two exercise intensities: low and moderate. We hypothesized that increasing exercise intensity would increase the MCAv amplitude response (Amp) and that age and estimated fitness (V̇O2max) would be related to Amp. Baseline (BL) values were collected for 90-seconds followed by a 6-minute exercise bout. Heart rate, end-tidal CO2, mean arterial pressure and MCAv were recorded throughout. MCAv kinetics were described by Amp, time delay (TD) and time constant (τ). Sixty-four adults completed the study. Amp was greater during moderate compared to low exercise intensity (p < 0.001) while no difference was observed in either TD (p = 0.65) or τ (p = 0.47). Amp was negatively associated with age (p < 0.01) and positively correlated with estimated V̇O2max (p < 0.01). Although Amp declines with age, maintaining higher V̇O2max may benefit the cerebrovascular response to exercise.
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King M, Kelly LP, Wallack EM, Hasan SMM, Kirkland MC, Curtis ME, Chatterjee T, McCarthy J, Ploughman M. Serum levels of insulin-like growth factor-1 and brain-derived neurotrophic factor as potential recovery biomarkers in stroke. Neurol Res 2019; 41:354-363. [PMID: 30620251 DOI: 10.1080/01616412.2018.1564451] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Our objectives were: 1) to determine whether maximal aerobic exercise increased serum neurotrophins in chronic stroke and 2) to determine the factors that predict resting and exercise-dependent levels. METHODS We investigated the potential predictors of resting and exercise-dependent serum insulin-like growth factor-1 and brain-derived neurotrophic factor among 35 chronic stroke patients. Predictors from three domains (demographic, disease burden, and cardiometabolic) were entered into 4 separate stepwise linear regression models with outcome variables: resting insulin-like growth factor, resting brain-derived neurotrophic factor, exercise-dependent change in insulin-like growth factor, and exercise-dependent change brain-derived neurotrophic factor. RESULTS Insulin-like growth factor decreased after exercise (p = 0.001) while brain-derived neurotrophic factor did not change (p = 0.38). Greater lower extremity impairment predicted higher resting brain-derived neurotrophic factor (p = 0.004, r2 = 0.23). Higher fluid intelligence predicted greater brain-derived neurotrophic factor response to exercise (p = 0.01, r2 = 0.18). There were no significant predictors of resting or percent change insulin-like growth factor-1. DISCUSSION Biomarkers have the potential to characterize an individual's potential for recovery from stroke. Neurotrophins such as insulin-like growth factor-1 and brain-derived neurotrophic factor are thought to be important in neurorehabilitation; however, the factors that modulate these biomarkers are not well understood. Resting brain-derived neurotrophic factor and percent change in brain-derived neurotrophic factor were related to physical and cognitive recovery in chronic stroke, albeit weakly. Insulin-like growth factor-1 was not an informative biomarker among chronic stroke patients. The novel finding that fluid intelligence positively correlated with exercise-induced change in brain-derived neurotrophic factor warrants further research.
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Affiliation(s)
- Michael King
- a Recovery and Performance Laboratory, Faculty of Medicine , Memorial University , St. John's , Canada
| | - Liam P Kelly
- a Recovery and Performance Laboratory, Faculty of Medicine , Memorial University , St. John's , Canada
| | - Elizabeth M Wallack
- a Recovery and Performance Laboratory, Faculty of Medicine , Memorial University , St. John's , Canada
| | - S M Mahmudul Hasan
- a Recovery and Performance Laboratory, Faculty of Medicine , Memorial University , St. John's , Canada
| | - Megan C Kirkland
- a Recovery and Performance Laboratory, Faculty of Medicine , Memorial University , St. John's , Canada
| | - Marie E Curtis
- a Recovery and Performance Laboratory, Faculty of Medicine , Memorial University , St. John's , Canada
| | - Tanaya Chatterjee
- a Recovery and Performance Laboratory, Faculty of Medicine , Memorial University , St. John's , Canada
| | - Jason McCarthy
- a Recovery and Performance Laboratory, Faculty of Medicine , Memorial University , St. John's , Canada
| | - Michelle Ploughman
- a Recovery and Performance Laboratory, Faculty of Medicine , Memorial University , St. John's , Canada
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Billinger SA, Sisante JFV, Whitaker AA, Abraham MG. Time Course of Flow-Mediated Dilation and Vascular Endothelial Growth Factor following Acute Stroke. J Stroke Cerebrovasc Dis 2017; 27:957-962. [PMID: 29198900 DOI: 10.1016/j.jstrokecerebrovasdis.2017.10.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 10/31/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES People after stroke demonstrate alterations in vascular endothelial function measured by flow-mediated dilation. Limited information is available in the literature on possible protective factors following stroke. The aims of the secondary analysis were (1) to characterize the time course of vascular endothelial function using flow-mediated dilation at 72 hours after stroke and 1 week later during inpatient stroke rehabilitation and (2) to determine whether flow-mediated dilation was related to vascular endothelial growth factor, brain-derived neurotrophic factor, or estimated prestroke peak oxygen uptake. METHODS Flow-mediated dilation using Doppler ultrasound was assessed in bilateral brachial arteries at the defined time points. Flow-mediated dilation and blood draws occurred on the same day between 7:30 am and 9:00 am following an overnight fast. Enzyme-linked immunosorbent assay was used to quantify plasma vascular endothelial growth factor and brain-derived neurotrophic factor values. A nonexercise estimate was used to calculate prestroke peak oxygen uptake. RESULTS We have shown that between-limb differences are evident within 72 hours after stroke and remain 1 week later during inpatient rehabilitation. Higher values for vascular endothelial growth factor were associated with increased flow-mediated dilation at both time points. Higher estimated prestroke peak oxygen uptake was related to flow-mediated dilation. Brain-derived neurotrophic factor was not related to any outcome measures. CONCLUSIONS Unique vascular adaptations start early after stroke in the stroke-affected limb and remain through inpatient stroke rehabilitation. Vascular endothelial growth factor and prestroke physical activity may have a protective role in vascular function following stroke. Future work should focus on mechanistic pathways for preservation of vascular health.
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Affiliation(s)
- Sandra A Billinger
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas.
| | - Jason-Flor V Sisante
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Alicen A Whitaker
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Michael G Abraham
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas; Department of Radiology, University of Kansas Medical Center, Kansas City, Kansas
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Bianchi VE, Locatelli V, Rizzi L. Neurotrophic and Neuroregenerative Effects of GH/IGF1. Int J Mol Sci 2017; 18:ijms18112441. [PMID: 29149058 PMCID: PMC5713408 DOI: 10.3390/ijms18112441] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/06/2017] [Accepted: 11/09/2017] [Indexed: 12/12/2022] Open
Abstract
Introduction. Human neurodegenerative diseases increase progressively with age and present a high social and economic burden. Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) are both growth factors exerting trophic effects on neuronal regeneration in the central nervous system (CNS) and peripheral nervous system (PNS). GH and IGF-1 stimulate protein synthesis in neurons, glia, oligodendrocytes, and Schwann cells, and favor neuronal survival, inhibiting apoptosis. This study aims to evaluate the effect of GH and IGF-1 on neurons, and their possible therapeutic clinical applications on neuron regeneration in human subjects. Methods. In the literature, we searched the clinical trials and followed up studies in humans, which have evaluated the effect of GH/IGF-1 on CNS and PNS. The following keywords have been used: “GH/IGF-1” associated with “neuroregeneration”, “amyotrophic lateral sclerosis”, “Alzheimer disease”, “Parkinson’s disease”, “brain”, and “neuron”. Results. Of the retrieved articles, we found nine articles about the effect of GH in healthy patients who suffered from traumatic brain injury (TBI), and six studies (four using IGF-1 and two GH therapy) in patients with amyotrophic lateral sclerosis (ALS). The administration of GH in patients after TBI showed a significantly positive recovery of brain and mental function. Treatment with GH and IGF-1 therapy in ALS produced contradictory results. Conclusions. Although strong findings have shown the positive effects of GH/IGF-1 administration on neuroregeneration in animal models, a very limited number of clinical studies have been conducted in humans. GH/IGF-1 therapy had different effects in patients with TBI, evidencing a high recovery of neurons and clinical outcome, while in ALS patients, the results are contradictory. More complex clinical protocols are necessary to evaluate the effect of GH/IGF-1 efficacy in neurodegenerative diseases. It seems evident that GH and IGF-1 therapy favors the optimal recovery of neurons when a consistent residual activity is still present. Furthermore, the effect of GH/IGF-1 could be mediated by, or be overlapped with that of other hormones, such as estradiol and testosterone.
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Affiliation(s)
- Vittorio Emanuele Bianchi
- Endocrinology and Metabolism, Clinical Center Stella Maris, Strada Rovereta, 42-47891 Falciano, San Marino.
| | - Vittorio Locatelli
- School of Medicine and Surgery, University of Milano-Bicocca via Cadore, 48-20900 Monza Brianza, Italy.
| | - Laura Rizzi
- Molecular Biology, School of Medicine and Surgery, University of Milano-Bicocca, via Cadore, 48-20900 Monza Brianza, Italy.
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