Table Of ContentTHE IGF SYSTEM
CoNTEMPORARY ENDOCRINOLOGY 
P. Michael Conn,  SERIEs BorroR 
19. Human Growth Hormone: Basics and Clinical Research, edited by RoY G. SMITH 
AND MICHAEL 0. THORNER,  1999 
18. Menopause: Endocrinology and Management, edited by DAVID B. SEIFER AND 
EliZABETH A. KENNARD, 1999 
17. The IGF System: Molecular Biology, Physiology, and Clinical Applications, 
edited by RoN G. RosENFELD AND CHARLES T. RoBERTS JR., 1999 
16. Neurosteroids: A New Regulatory Function in the Nervous System, edited by 
ETIENNE-EMILE BAULIEU, MICHAEL SCHUMACHER, AND PAUL ROBEL, 1999 
15. Autoimmune Endocrinopathies, edited by RoBERT VoLPE,  1999 
14. Hormone Resistance Syndromes, edited by J. LARRY JAMESON,  1999 
13. Hormone Replacement Therapy, edited by A. WAYNE MEIKLE,  1999 
12. Insulin Resistance: The Metabolic Syndrome X, edited by GERALD M. REAVEN 
AND AMI LAWS, 1999 
11. Endocrinology of Breast Cancer, edited by ANDREA MANNI,  1999 
10. Molecular and Cellular Pediatric Endocrinology, edited by 
STUARTHANDWERGER, 1999 
9.  The Endocrinology of Pregnancy, edited by FuLLER W. BAZER, 1998 
8.  Gastrointestinal Endocrinology, edited by GEoRGE H. GREELEY, JR., 1999 
7.  Clinical Management of Diabetic Neuropathy, edited by ARISTIDIS VEVES,  1998 
6.  G Proteins, Receptors, and Disease, edited by ALLEN M. SPIEGEL,  1998 
5.  Natriuretic Peptides in Health and Disease, edited by WILLIS K. SAMSON 
AND ELLIS R. LEVIN, 1997 
4.  Endocrinology of Critical Diseases, edited by K. PATRICK 0BER, 1997 
3. Diseases of the Pituitary: Diagnosis and Treatment, edited by 
MARGARET E. WIERMAN, 1997 
2.  Diseases of the Thyroid, edited by LEWIS E. BRAVERMAN,  1997 
1. Endocrinology of the Vasculature, edited by JAMES R. SowERS, 1996
THE IGF 
SYSTEM 
Molecular Biology, Physiology, and Clinical Applications 
Edited by 
G.c 
RoN  RoSENFELD, MD 
T. 
RoBERTs, JR., 
CHARLES  PhD 
Oregon Health Sciences University 
Portland, OR 
•  SPRINGER SCTENCE+BUSTNESS MEDIA, LLC
© 1999  Springer Science+B  usiness Media New York 
Originally published by Humana Press Inc. in 1999 
All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or 
transmitted in any form or by any means, electronic, mechanical, photocopying, microfilm 
ing, recording, or otherwise without written permission from the Publisher. 
All articles, comments, opinions, conclusions, or recommendations are those of the author( s) , and 
do not necessarily reflect the views of the publisher. 
Cover design by Patricia F. Cleary. 
Cover art: Fig. 19-8; see complete legend on p. 442. 
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Library of Congress Cataloging-in-Publication Data 
The IGF system : molecular biology, physiology, and clinical applications/edited by Ron 
G. Rosenfeld, Charles T. Roberts, Jr. 
p.  em. --(Contemporary endocrinology ; 17) 
Includes index. 
ISBN 978-1-61737-138-7  ISBN 978-1-59259-712-3 (eBook) 
DOI 10.1007/978-1-59259-712-3 
1. Somatomedin--Physiological effects. 2. Somatomedin--Pathophysiology. 3. 
Insulin-like grow factor-binding proteins.  I.  Roberts, Charles T.  II. Rosenfeld, 
Ron G.  III. Series: Contemporary endocrinology (Totowa, N.J.) 
[DNLM:  1.  Insulin-Like Growth Factor !--physiology.  2. Molecular Biol 
ogy.  3. Insulin-Like Growth Factor !--therapeutic use.  4. Insulin-Like Growth 
Factor 11--physiology.  5. Insulin-Like Growth Factor 11--therapeutic use.  6. 
Insulin-Like Growth-Factor-Binding Proteins--physiology. QU 107 124 1999) 
QP552.S65133  1999 
612'.015756--dc21 
DNLM/DLC 
for Library of Congress  98-55264 
CIP
PREFACE 
It has been over 40 years since the original report by Salmon and Daughaday demon 
strating that the ability of GH to stimulate sulfation of cartilage was mediated by a 
"sulfation factor." In the ensuing decades, it has become apparent that this "sulfation 
factor activity" encompasses a complex system ofligands (IGFs), receptors, and carrier 
proteins that are, in tum, responsible for a wide array of cellular actions. The IGF system 
has been demonstrated to be critically involved in both intrauterine and postnatal growth, 
and to have important implications in cancer biology as well, owing to the ability of the 
IGFs to function in endocrine, paracrine, and autocrine modes and given the wide distri 
bution of IGFs in virtually every organ system. 
The contributions to The /GF System reflect the wide span of interest in the IGF system 
and its implications for normal and abnormal growth and metabolism. The chapters have 
been divided into four broad sections: I. Molecular biology of the IGF system; II. Bio 
logical actions of the IGFs; III. IGF physiology; and IV. Clinical aspects of the IGFs. We 
have made every effort to highlight the major contemporary themes in IGF biology, but 
as is inevitable in such a fast-moving field, perspectives will continue to change as new 
information is accumulated. Most importantly, we have remained sensitive to the many 
remaining gaps in our knowledge of the role( s) oft he IGF peptides, receptors, and binding 
proteins in cell growth and replication, and are always aware of the admonition that "it 
is better to have unanswered questions than unquestioned answers." 
Ron G. Rosenfeld, MD 
Charles T. Roberts, 
JR., PhD 
v
CONTENTS 
Preface ................................................................................................... v 
Contributors ......................................................................................... ix 
1  Historical Perspective: 
The Origins and Development of the Somatomedin Hypothesis ..... 1 
William H. Daughaday and William D. Salmon, Jr. 
I  MOLECUlAR BIOLOGY OF THE IGF SYSTEM 
2  Molecular Biology of IGF-I and IGF-II ............................................. 19 
Peter Rotwein 
3  Regulation of IGF Gene Expression .................................................. 37 
P. Elly Holthuizen, Paul H. Steenbergh, and John S. Sussenbach 
4  Molecular Biology of the Type 1 IGF Receptor ................................ 63 
Haim Werner 
5  Molecular Biology of the 
IGF-II/Mannose-6-Phosphate Receptor ......................................... 89 
Wieland Kiess 
6  Molecular Biology of the IGF Binding Proteins .............................. 111 
Guck T. Ooi and Yves R. Boisclair 
II  BIOLOGICAL ACTIONS OF THE IGFs 
7  IGF-I Receptor Function: Transducing the IGF-1 Signal 
into Intracellular Events ............................................................... 143 
Vicky A. Blakesley, Andrew A. Butler, Anatolii P. Koval, 
Yumiko Okubo, and Derek LeRoith 
8  Type 2 IGF Receptor-Mediated Events ............................................ 165 
S. Peter Nissley 
9  Alternative IGF-Related Receptors .................................................. 199 
Kenneth Siddle and Maria A. Soos 
10  IGF Binding Proteins as Modulators of IGF Action ........................ 227 
Janet L. Martin and Robert C. Baxter 
11  IGF-Independent Actions of the IGF Binding Proteins ................... 257 
Youngman Oh and Ron G. Rosenfeld 
12  IGF Binding Proteins and Extracellular Matrix ............................... 273 
David R. Clemmons 
13  Biological Actions of Proteolytic Fragments 
of the IGF Binding Proteins ......................................................... 281 
Michel Binoux, Claude Lalou, and Sarah Mohseni-Zadeh 
14  The IGF Binding Protein Superfamily ............................................. 315 
Vivian Hwa, Youngman Oh, Christine P. Burren, 
Won Kyu Choi, Donna L. Graham, Angela Ingermann, 
Ho-Seong Kim, Abel Lopez-Bermejo, Giuseppe Minniti, 
Srinivasa R. Nagalla, Kisoo Pai, Anna Spagnoli, 
Peter Vorwerk, Don L. V. Wanek, Elizabeth M. Wilson, 
Yoshitaka Yamanaka, Doo Hyun Yang, and Ron G. Rosenfeld 
Vll
viii  Contents 
15  IGFs and Cell Growth ....................................................................... 329 
Renato Baserga, Marco Prisco, and Atsushi Hongo 
16  Posttranslational Modification of the IGF Binding Proteins ........... 355 
Cheryl A. Conover 
III  IGF PHYSIOLOGY 
17  IGFs in the Female Reproductive System ........................................ 379 
Linda C. Giudice 
18  The IGF Axis in the Male Reproductive System ............................. 407 
Stuart A. Weinzimer and Pinchas Cohen 
19  IGFs and the Nervous System .......................................................... 425 
PhillipS. Leventhal, James W. Russell, and Eva L. Feldman 
20  IGF System Components and Their Role in Bone Metabolism ...... 457 
Subburaman Mohan and David J. Baylink 
21  IGFs and Skeletal Muscle ................................................................. 497 
Stephen M. Rosenthal 
22  IGFs and the Digestive Tract.. .......................................................... 517 
P. Kay Lund 
23  Actions of IGF System Proteins from Studies of Transgenic 
and Gene Knockout Models ......................................................... 545 
A. Joseph D'Ercole 
IV  CLINICAL ASPECTS OF THE IGFs 
24  Metabolic Effects of IGFs ................................................................ 577 
Jiirgen Zap/, E. Rudolph Froesch, and Christoph Schmid 
25  Clinical Uses of IGF-1 and IGF Binding ProteinA  ssays ................. 617 
Louis E. Underwood 
26  IGF Binding Protein Proteolysis in Various Clinical States ............ 633 
Laura A. Maile, Anna L. Crown, and Jeff M.P. Holly 
27  IGF Deficiency .................................................................................. 651 
Katie A. Woods and Martin 0. Savage 
28  Tumor Hypoglycemia Linked to IGF-11 ........................................... 675 
Christian A. Koch, Kristina I. Rother, and Jesse Roth 
29  IGFs in the Evaluation of Acromegaly ............................................. 699 
Marlys R. Drange and Shlomo Melmed 
30  IGF in the Treatment of Diabetes ..................................................... 721 
Robert A. Gabbay and Alan C. Moses 
31  IGF-I Treatment of Growth Hormone Insensitivity ......................... 739 
Arlan L. Rosenbloom 
Index .................................................................................................. 771
CONTRIBUTORS 
RENATO BASERGA, MD, Department of Microbiology and Immunology, Kimmel 
Cancer Center, Thomas Jefferson University, Philadelphia, PA 
RoBERT C. BAXTER, PHD, DSC, Kolling Institute of Medical Research, Royal North 
Shore Hospital, St. Leonards, Australia 
DAVID J. BAYLINK, MD, Mineral Metabolism, Jerry L. Pettis VA Medical Center; 
Departments of Medicine and Biochemistry, Loma Linda University, 
Loma Linda, CA 
MICHEL BINoux, MD, Institut National de la Sante et de la Recherche Medicale, 
Hopital Saint Antoine, Paris, France 
VICKY A. BLAKESLEY, MD, PHD, Diabetes Branch, National Institute of Diabetes 
and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 
YvEs R. BOISCLAIR, PHD, Department ofA  nimal Science, Cornell University, 
Ithaca, NY 
CHRISTINE P. BuRREN, MD, Department of Pediatrics, School of Medicine, Oregon 
Health Sciences University, Portland, OR 
ANDREW A. BuTLER, PHD, Diabetes Branch, National Institute of Diabetes 
and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 
WoN KYu CHOI, MD, Department of Pediatrics, School of Medicine, Oregon Health 
Sciences University, Portland, OR 
DAVID R. CLEMMONS, MD, Department of Medicine, University of North Carolina 
at Chapel Hill, Chapel Hill, NC 
PINCHAS CoHEN, MD, Department of Pediatrics, University of California 
at Los Angeles, Los Angeles, CA 
CHERYL A. CoNOVER, PHD, Endocrine Research Unit, Mayo Clinic and Mayo 
Foundation, Rochester, MN 
ANNAL. CROWN, MD, University of Bristol Division of Surgery, Department 
of Hospital Medicine, Bristol Royal Infirmary, Bristol, United Kingdom 
WILLIAM H. DAUGHADAY, MD, Balboa Island, CA 
MARLYS R. DRANGE, MD, PHD, Division of Endocrinology and Metabolism, 
Cedars-Sinai Medical Center, Los Angeles, CA 
A. JosEPH D'ERCOLE, MD, Department of Pediatrics, University of North Carolina 
at Chapel Hill, Chapel Hill, NC 
EvA L. FELDMAN, MD, PHD, Department of Neurology, University of Michigan, 
Ann Arbor, MI 
E. RuDOLPH FROESCH, MD, Department of Internal Medicine, Division 
of Endocrinology and Diabetes, University Hospital, Zurich, Switzerland 
RoBERT A. GABBAY, MD, PHD, Section of Endocrinology, Diabetes, and Metabolism, 
Hershey Medical Center, Penn State Geisinger Health System, Hershey, PA 
LINDA C. GIUDICE, MD, PHD, Division of Reproductive Endocrinology and Fertility, 
Department of Obstetrics and Gynecology, Stanford University Medical Center, 
Stanford, CA 
DoNNA L. GRAHAM, Department of Pediatrics, School of Medicine, Oregon Health 
Sciences University, Portland, OR 
ix
X  Contributors 
VIVIAN HwA, PHD, Department of Pediatrics, School of Medicine, Oregon Health 
Sciences University, Portland, OR 
JEFF M.P. HoLLY, PHD,  University of Bristol Division of Surgery, Department 
of Hospital Medicine, Bristol Royal Infirmary, Bristol, United Kingdom 
P. ELLY HoLTHUIZEN, PHD, Laboratory for Physiological Chemistry, Utrecht 
University, Utrecht, The Netherlands 
ATSUSHI HoNGO, PHD, Department of Microbiology and Immunology, Kimmel Cancer 
Center, Thomas Jefferson University, Philadelphia, PA 
ANGELA lNGERMANN, Department of Pediatrics, School of Medicine, Oregon Health 
Sciences University, Portland, OR 
WIELAND KIEss, MD, Children's Hospital, University of Leipzig, Leipzig, Germany 
Ho-SEONG KIM, MD, Department of Pediatrics, School of Medicine, Oregon Health 
Sciences University, Portland, OR 
CHRISTIAN A. KocH, MD, National Institute of Child Health and Human Development, 
National Institutes of Health, Bethesda, MD 
ANATOLII P. KovAL, PHD, Diabetes Branch, National Institute of Diabetes 
and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 
CLAUDE LALOU, PHD, Institut National de la Sante et de la Recherche Medicate, 
Hopital Saint Antoine, Paris, France 
DEREK LEROITH, MD, PHD, Diabetes Branch, National Institute of Diabetes and 
Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 
PHILLIP S. LEVENTHAL, PHD, Department of Neurology, University of Michigan, 
Ann Arbor, MI 
ABEL LOPEZ-BERMEJO, MD, Department of Pediatrics, School of Medicine, Oregon 
Health Sciences University, Portland, OR 
P. KAY LUND, PHD, Departments of Physiology and Pediatrics and Center 
for Gastrointestinal Biology and Disease, University of North Carolina 
at Chapel Hill, Chapel Hill, NC 
LAURA A. MAILE, PHD, University of Bristol Division of Surgery, Department 
of Hospital Medicine, Bristol Royal Infirmary, Bristol, United Kingdom 
JANET L. MARTIN, PHD, Kolling Institute of Medical Research, Royal North Shore 
Hospital, St. Leonards, Australia 
SHLOMO MELMED, MD, Research Institute, UCLA School of Medicine, Cedars-Sinai 
Medical Center, Los Angeles, CA 
GIUSEPPE MINNITI, MD, Department of Pediatrics, School of Medicine, Oregon Health 
Sciences University, Portland, OR 
SuBBURAMAN MOHAN, PHD, Mineral Metabolism, Jerry L. Pettis VA Medical Center; 
Departments of Medicine, Biochemistry, and Physiology, Lorna Linda University, 
Lorna Linda, CA 
SARAH MoHSENI-ZADEH, PHD, Institut National de la Sante et de Ia Recherche 
Medicate, Hopital Saint Antoine, Paris, France 
ALAN C. MosEs, MD, General Clinical Research Center and Division 
of Endocrinology, Beth Israel Deaconess Medical Center, Harvard 
Medical Center, Boston, MA 
SRINIVASA R. NAGALLA, MD, Department of Pediatrics, School of Medicine, Oregon 
Health Sciences University, Portland, OR
Contributors  xi 
S. PETER NISSLEY, MD, National Cancer Institute, National Institutes of Health, 
Bethesda, MD 
YouNGMAN OH, PHD, Department of Pediatrics, School of Medicine, Oregon Health 
Sciences University, Portland, OR 
YuMIKO OKUBO, MD, Diabetes Branch, National Institute of Diabetes and Digestive 
and Kidney Diseases, National Institutes of Health, Bethesda, MD 
GucK T. Om, PHD, Prince Henry's Institute of Medical Research, Clayton, Victoria, 
Australia 
K1soo PAI, MD, Department of Pediatrics, School of Medicine, Oregon Health 
Sciences University, Portland, OR 
MARCO PRISCO, PHD, Department of Microbiology and Immunology, Kimmel Cancer 
Center, Thomas Jefferson University, Philadelphia, PA 
ARLAN L. RosENBLOOM, MD, Department of Pediatrics, University of Florida College 
of Medicine, Children's Medical Services Center, Gainesville, FL 
RoN G. RosENFELD, MD, Department of Pediatrics, School of Medicine, Oregon Health 
Sciences University, Portland, OR 
STEPHEN M. RosENTHAL, MD, Department of Pediatrics, University of California 
San Francisco, San Francisco, CA 
JESSE RoTH, MD, FACP, Department of Medicine, Johns Hopkins University School 
of Medicine, Baltimore, MD 
KRISTINA I. RoTHER, MD, National Institute of Child Health and Human Development, 
National Institutes of Health, Bethesda, MD 
PETERS. RoTWEIN, MD, Department of Medicine, Division of Molecular Medicine, 
Oregon Health Sciences University, Portland, OR 
JAMES W. RussELL, MD, Department of Neurology, University of Michigan, 
Ann Arbor, MI 
WILLIAM D. SALMON, Jr., MD 
MARTIN 0. SAVAGE, MA, MD, FRCP, Paediatric Endocrinology, St. Batholomew's 
Hospital, London, United Kingdom 
CHRISTOPH ScHMID, MD, Department of Internal Medicine, Division of Endocrinology 
and Diabetes, University Hospital, Zurich, Switzerland 
KENNETH SIDDLE, PHD, Department of Clinical Biochemistry, University 
of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom 
MARIA A. Soos, PHD, Department of Clinical Biochemistry, University of Cambridge, 
Addenbrooke's Hospital, Cambridge, United Kingdom 
ANNA SPAGNOLI, MD, Department of Pediatrics, School of Medicine, Oregon Health 
Sciences University, Portland, OR 
PAUL H. STEENBERGH, PHD, Laboratory for Physiological Chemistry, Utrecht 
University, Utrecht, The Netherlands 
JoHN S. SussENBACH, PHD, Laboratory for Physiological Chemistry, Utrecht 
University, Utrecht, The Netherlands 
Loms E. UNDERWOOD, MD, Division of Pediatric Endocrinology, School of Medicine, 
University of North Carolina at Chapel Hill, Chapel Hill, NC 
PETER VoRWERK, MD, Department of Pediatrics, School of Medicine, Oregon Health 
Sciences University, Portland, OR