Elevated Serum Insulin-Like Growth Factor 1 Levels in Patients with Neurological Remission after Traumatic Spinal Cord Injury

PLoS ONE, 2016 · DOI: 10.1371/journal.pone.0159764 · Published: July 22, 2016

Simple Explanation

After a spinal cord injury, the body goes through phases, including an inflammatory phase and a repair phase. Growth factors, like Insulin-like Growth Factor 1 (IGF-1), are thought to help with repair. This study looks at IGF-1 levels in people after spinal cord injuries. The study followed 45 patients for three months, measuring IGF-1 levels and tracking their clinical outcomes using the ASIA Impairment Scale (AIS). The aim was to see if IGF-1 levels changed over time and whether they correlated with patient improvement. The researchers found that IGF-1 levels increased in all patients after injury. Patients who showed neurological improvement had higher IGF-1 levels than those who did not. This suggests IGF-1 may play a role in nerve repair after spinal cord injury.

Study Duration

3 Months

Participants

45 patients (35 male, 10 female) after traumatic spinal cord injury

Evidence Level

Not specified

Key Findings

1
IGF-1 serum levels were significantly different from initial measurements at four, nine hours, seven, 14 days after injury as well as one, two and three months after injury.
2
Patients with clinically documented neurological remission showed consistently higher IGF-1 levels than patients without neurological remission.
3
Initially AIS A classified patients showed constantly higher IGF-1 levels than initially AIS B-D classified patients, on average 22.86pg/mL (18.66%) higher.

Research Summary

This study investigated the serum levels of IGF-1 in patients after traumatic spinal cord injury over a three-month period, finding distinct patterns in the expression of IGF-1 regardless of the degree of plegia. The study revealed that all patients showed a marked increase of IGF-1 levels seven days after injury, with levels being significantly different from initial measurements at various time points post-injury. Patients with clinically documented neurological remission exhibited consistently higher IGF-1 levels than those without remission, suggesting a possible influence of IGF-1 on neuroprotective processes.

Practical Implications

Animal Model Development

The data could be the base for the establishment of animal models for further and much needed research in the field of spinal cord injury.

Therapeutic Target

The IGF-1/ IGF-1R pathway is a highly interesting and much promising target for therapy after nerve and spinal cord injury.

Early Intervention

Early astrocytic production of IGF-I might be involved in myelin regeneration, having a positive effect on neuroprotection as myelin has important protective and nutritional functions for the nerve.

Study Limitations

1
Small sample size (n=45) which may limit the generalizability of the findings.
2
Statistical analysis and p-values are unadjusted for multiple testing and should be interpreted descriptively.
3
Missing samples in early and late time-points of the protocol due to urgent procedures and loss to follow-up, respectively.

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