This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schwab, S. Articles by Bettendorf, M. Search for Related Content PubMed PubMed Citation Articles by Schwab, S. Articles by Bettendorf, M.

(Stroke. 1997;28:1744-1748.)
© 1997 American Heart Association, Inc.

Articles

Plasma Insulin-like Growth Factor I and IGF Binding Protein 3 Levels in Patients With Acute Cerebral Ischemic Injury

Stefan Schwab, MD; Matthias Spranger, MD; Sebastian Krempien, MD; Werner Hacke, MD; Markus Bettendorf, MD

From the Departments of Neurology (S.S., M.S., S.K., W.H.) and Pediatric Endocrinology, Department of Pediatrics (M.B.), University of Heidelberg (Germany).

Correspondence to Stefan Schwab, MD, Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.

Background and Purpose The insulin-like growth factors (IGF) are synthesized in the brain and are involved in fetal brain development. An increased expression of IGF-I and IGF-II occurs in cerebral regions with neuronal damage after experimental hypoxic injury. Furthermore, the expression of mRNAs coding for IGF-I and the binding proteins IGFBP-2 and IGFBP-3 is augmented in response to unilateral ischemia in animal models. The secretory dynamics of IGF-I in human cerebral ischemia have not yet been investigated.

Methods Plasma IGF-I and IGFBP-3 were measured sequentially in 20 patients with acute ischemic stroke (within 24 hours and 3, 5, and 10 days thereafter). For analysis the patients were assigned to three groups according to the diameter of the infarct area as measured on CT scan: small (<1.5 cm), moderate (1.5 cm and 5 cm), and large (>5 cm). Eight age-matched patients with nonvascular, neurological illnesses served as controls.

Results Plasma IGF-I and IGFBP-3 plasma concentrations after acute cerebral ischemia were strikingly lower than those in control subjects and healthy individuals reported in the literature. Plasma IGF-I levels in patients with large infarcts were significantly statistically lower than those in control subjects (P<.05), and plasma IGFBP-3 levels were significantly lower than those in control subjects on days 5 and 10.

Conclusions IGF-I and IGFBP-3 plasma levels are decreased in patients after cerebral ischemia. After acute ischemic stroke, increased demand for growth factors, altered tissue distribution, and accelerated metabolic clearance rate or central inhibition of the somatotrophic axis may contribute to these low plasma concentrations. Growth factors such as IGF-I and IGFBP-3 may play an important role in the pathophysiology of acute cerebral ischemia, and growth factors may have a considerable effect on future therapeutic regimens.

Key Words: cerebral ischemia • growth factors • neuroprotection • stroke outcome

This article has been cited by other articles:

				M. Bondanelli, M. R. Ambrosio, A. Onofri, A. Bergonzoni, S. Lavezzi, M. C. Zatelli, D. Valle, N. Basaglia, and E. C. degli Uberti Predictive Value of Circulating Insulin-Like Growth Factor I Levels in Ischemic Stroke Outcome J. Clin. Endocrinol. Metab., October 1, 2006; 91(10): 3928 - 3934. [Abstract] [Full Text] [PDF]

				M J E van Rijn, A J C Slooter, M J Bos, C F B S Catarino, P J Koudstaal, A Hofman, M M B Breteler, and C M van Duijn Insulin-like growth factor I promoter polymorphism, risk of stroke, and survival after stroke: the Rotterdam study J. Neurol. Neurosurg. Psychiatry, January 1, 2006; 77(1): 24 - 27. [Abstract] [Full Text] [PDF]

				S. P. Johnsen, H. H. Hundborg, H. T. Sorensen, H. Orskov, A. Tjonneland, K. Overvad, and J. O. L. Jorgensen Insulin-Like Growth Factor (IGF) I, -II, and IGF Binding Protein-3 and Risk of Ischemic Stroke J. Clin. Endocrinol. Metab., November 1, 2005; 90(11): 5937 - 5941. [Abstract] [Full Text] [PDF]

				C. Lopez-Lopez, D. LeRoith, and I. Torres-Aleman Insulin-like growth factor I is required for vessel remodeling in the adult brain PNAS, June 29, 2004; 101(26): 9833 - 9838. [Abstract] [Full Text] [PDF]

				J. C. Chavez and J. C. LaManna Activation of Hypoxia-Inducible Factor-1 in the Rat Cerebral Cortex after Transient Global Ischemia: Potential Role of Insulin-Like Growth Factor-1 J. Neurosci., October 15, 2002; 22(20): 8922 - 8931. [Abstract] [Full Text] [PDF]

				W.-R. Schabitz, T. T. Hoffmann, S. Heiland, R. Kollmar, J. Bardutzky, C. Sommer, and S. Schwab Delayed Neuroprotective Effect of Insulin-Like Growth Factor-I After Experimental Transient Focal Cerebral Ischemia Monitored With MRI Stroke, May 1, 2001; 32(5): 1226 - 1233. [Abstract] [Full Text] [PDF]