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Cerebrospinal fluid insulin-like growth factor (IGF-1) and insulin-like growth factor binding protein (IGFBP-2) in
Raili Riikonen1, Kim Vettenranta, Pekka Riikonen
1Children's Hospital, University of Kuopio, Finland. Raili.Riikonen@kuh.fi
Insights
Children with acute lymphoblastic leukemia (ALL) show low cerebrospinal fluid (CSF) insulin-like growth factor-1 (IGF-1) during induction chemotherapy. These levels may relate to neurological deficits, though further study is needed.
Area of Science:
- Pediatric Oncology
- Neuroscience
- Endocrinology
Background:
- Insulin-like growth factor-1 (IGF-1) is vital for axonal growth and myelination.
- Low cerebrospinal fluid (CSF) IGF-1 levels are observed in severe neurological conditions.
- Children with acute lymphoblastic leukemia (ALL) may experience neurological deficits.
Purpose of the Study:
- To investigate CSF IGF-1 and IGF binding protein-2 (IGFBP-2) levels in children with ALL.
- To determine if these levels correlate with observed neurological deficits during chemotherapy.
Main Methods:
- Prospective measurement of CSF IGF-1 and IGFBP-2 via radioimmunoassay in 14 children with ALL.
- Comparison with 16 healthy control subjects and patients with severe neurological diseases.
- Monitoring levels throughout ALL chemotherapy treatment.
Main Results:
- Children with ALL exhibited subnormal CSF IGF-1 levels during induction, which normalized after two months.
- Subnormal IGF-1 levels persisted throughout chemotherapy in seven patients, including two with vincristine-induced polyneuropathy.
- A potential link between IGF-1 levels and neurological impairment was observed.
Conclusions:
- Findings suggest a temporary impairment of the IGF-1 trophic system during ALL induction chemotherapy.
- The underlying mechanism for this impairment remains unknown.
- Statistical proof for a correlation between disturbed IGF-1 levels and neuronal function was not established.
Background:
Insulin-like growth factor-1 (IGF-1) has specific effects on axonal growth and myelination, low CSF IGF-1 levels being found in some severe neurologic diseases. We studied the levels of CSF IGF-1 and IGF binding protein-2 (IGFBP-2) in children with ALL to find out whether these levels correlated with any of the neurological deficits observed.
Methods:
IGF-1 and IGFBP-2 levels were prospectively measured by radioimmunoassay in the CSF of 14 children with ALL throughout the ALL chemotherapy. These were compared with the levels of 16 control subjects and of patient groups with severe neurological diseases.
Results:
During induction, the children with ALL had subnormal CSF IGF-1 levels which improved after 2 months. In seven individuals, two with severe vincristine polyneuropathy, the subnormal levels persisted throughout the chemotherapy.
Conclusions:
Our findings suggest impairment of the IGF-1 trophic system during induction by a mechanism so far unknown. Correlation with disturbed neuronal function could not be statistically proven.
