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Treatment With Recombinant Human Insulin-Like Growth Factor-1 Improves Growth in Patients With PAPP-A2 Deficiency
María T Muñoz-Calvo1, Vicente Barrios1, Jesús Pozo1
1Department of Pediatrics and Pediatric Endocrinology (M.T.M.-C., V.B., J.P., J.A.C., G.A.M.-M., J.A.) Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Universidad Autónoma de Madrid, Department of Pediatrics, Centro de Investigación Biomédica en Red (CIBEROBN), Instituto de Salud Carlos III, 28009 Madrid, Spain; Department of Endocrinology (F.H.), Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, 28040 Madrid, Spain; Cincinnati Center for Growth Disorders (A.D.), Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229; Centro de Investigaciones Endocrinológicas "Dr. César Bergadá" (CEDIE) (H.M.D.), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), FEI, División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, C1425EFD Buenos Aires, Argentina; Department of Basic Science and Craniofacial Biology (S.Y.), New York University College of Dentistry, New York, New York 10010; Oregon Health and Science University (R.G.R.), Portland, Oregon 97239; Stat5 LLC (R.G.R.), Los Altos, California 94022; Genetics Unit (L.A.P.-J.), Universitat Pompeu Fabra, Hospital del Mar Research Institute (IMIM), and CIBER de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 08003 Barcelona, Spain; Department of Molecular Biology and Genetics (C.O.), Aarhus University, 8000 Aarhus, Denmark; and Medical Research Laboratory (J.F.), Department of Clinical Medicine, Faculty of Health, Aarhus University and Department of Endocrinology and Internal Medicine, Aarhus University Hospital, 8000 Aarhus, Denmark.
Recombinant human IGF-1 (rhIGF-1) treatment effectively improved growth velocity and height in siblings with PAPP-A2 deficiency. This study demonstrates rhIGF-1 as a promising therapy for this rare genetic growth disorder.
Area of Science:
- Endocrinology
- Genetics
- Biochemistry
Background:
- Pregnancy-associated plasma protein-A2 (PAPP-A2) is a metalloproteinase crucial for regulating Insulin-like Growth Factor (IGF) bioavailability.
- Mutations in the PAPP-A2 gene lead to postnatal growth failure and skeletal abnormalities due to reduced IGF-1 availability.
- Currently, no established pharmacological treatments exist for PAPP-A2 deficiency.
Observation:
- Two siblings with homozygous loss-of-function PAPP-A2 mutation and short stature were treated with recombinant human IGF-1 (rhIGF-1).
- Treatment involved escalating doses of rhIGF-1 over one year.
- No adverse effects such as hypoglycemia were observed during the treatment period.
Findings:
- Both siblings exhibited a significant increase in growth velocity and overall height.
- Bioactive IGF-1 levels rose, while spontaneous Growth Hormone (GH) secretion decreased post-administration.
- Serum total IGF-1 and IGFBP-3 levels remained elevated throughout the treatment.
Implications:
- Short-term rhIGF-1 administration shows efficacy in improving growth outcomes for patients with PAPP-A2 deficiency.
- This suggests rhIGF-1 is a viable therapeutic option for managing growth failure in PAPP-A2 related disorders.
- Further research can explore long-term effects and optimal dosing strategies for rhIGF-1 therapy in PAPP-A2 deficiency.
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