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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
2
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pubmed:dateCreated |
1998-2-27
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pubmed:abstractText |
Leprechaunism is the most severe form of insulin resistance, manifesting with abnormal glucose metabolism and retarded growth. In the present study, we investigated the biological actions of recombinant human insulin-like growth factor I (rhIGF-I) in fibroblasts derived from a patient with leprechaunism. In the same patient, we also investigated the pharmacokinetics of IGF-I and the long-term effect of rhIGF-I treatment on metabolic control and physical growth. The patient's fibroblasts showed normal binding of IGF-I, normal phosphorylation of the beta-subunit of the IGF-I receptor, and normal [3H]thymidine incorporation in response to IGF-I. The fibroblast studies suggested that the patient would respond to IGF-I therapy, but certainly did not exclude the possibility of IGF-I resistance in vivo. Administration of recombinant human GH at the dose of 2.0 IU/kg for 3 consecutive days induced a minimal response of serum total IGF-I and IGF-binding protein-3 (IGFBP-3), suggesting partial GH resistance. To increase the serum total IGF-I level, we administered rhIGF-I with combination therapy of intermittent and continuous s.c. injection. This sustained the serum total IGF-I level, but not the serum IGFBP-3 level, within the normal range. The patient was treated with combination therapy of rhIGF-I by both s.c. injection and continuous s.c. infusion for 6 yr and 10 months. Administration of rhIGF-I at total daily dose of 1.6 mg/kg maintained her growth rate and hemoglobin A1c level nearly within the normal range. These findings suggest 1) that this leprechaun patient has an IGF-I-deficient state and partial GH resistance, as reflected by impaired production of IGF-I and IGFBP-3; 2) that rhIGF-I treatment works effectively for preventing postnatal growth retardation and normalizing glucose metabolism in patients with extreme insulin resistance; 3) that this treatment requires relatively higher dose of rhIGF-I; and 4) that treatment appears to be safe and devoid of adverse effects.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
AIM
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pubmed:chemical |
http://linkedlifedata.com/resource/pubmed/chemical/Blood Glucose,
http://linkedlifedata.com/resource/pubmed/chemical/DNA,
http://linkedlifedata.com/resource/pubmed/chemical/Human Growth Hormone,
http://linkedlifedata.com/resource/pubmed/chemical/Insulin-Like Growth Factor Binding...,
http://linkedlifedata.com/resource/pubmed/chemical/Insulin-Like Growth Factor I,
http://linkedlifedata.com/resource/pubmed/chemical/Receptor, IGF Type 1,
http://linkedlifedata.com/resource/pubmed/chemical/Recombinant Proteins
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pubmed:status |
MEDLINE
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pubmed:month |
Feb
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pubmed:issn |
0021-972X
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
83
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
542-9
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pubmed:dateRevised |
2009-11-19
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pubmed:meshHeading |
pubmed-meshheading:9467572-Blood Glucose,
pubmed-meshheading:9467572-Cells, Cultured,
pubmed-meshheading:9467572-Child,
pubmed-meshheading:9467572-DNA,
pubmed-meshheading:9467572-Drug Resistance,
pubmed-meshheading:9467572-Female,
pubmed-meshheading:9467572-Fibroblasts,
pubmed-meshheading:9467572-Growth,
pubmed-meshheading:9467572-Growth Disorders,
pubmed-meshheading:9467572-Human Growth Hormone,
pubmed-meshheading:9467572-Humans,
pubmed-meshheading:9467572-Insulin-Like Growth Factor Binding Protein 3,
pubmed-meshheading:9467572-Insulin-Like Growth Factor I,
pubmed-meshheading:9467572-Japan,
pubmed-meshheading:9467572-Phosphorylation,
pubmed-meshheading:9467572-Receptor, IGF Type 1,
pubmed-meshheading:9467572-Recombinant Proteins
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pubmed:year |
1998
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pubmed:articleTitle |
Long-term effect of recombinant human insulin-like growth factor I on metabolic and growth control in a patient with leprechaunism.
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pubmed:affiliation |
Department of Pediatrics, Hokkaido University School of Medicine, Sapporo, Japan.
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pubmed:publicationType |
Journal Article,
Case Reports
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