Recombinant Human Insulin-like growth factor-binding protein 3 protein (IGFBP3) (Active)

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Description

IGF-Dependent Roles

  • IGF Stabilization: Extends IGF half-life in circulation by forming ternary complexes with IGFs (IGF-I/II) and the acid-labile subunit (ALS) .

  • Receptor Modulation: Facilitates IGF delivery to IGF-1R, activating downstream pathways (PI3K/Akt and MAPK) that regulate proliferation and survival .

IGF-Independent Roles

  • Apoptosis Induction: Binds TMEM219/IGFBP-3R to activate caspase-8-dependent apoptosis in cancer cells .

  • Nuclear Signaling: Translocates to the nucleus via importin-β, interacting with retinoid X receptor-alpha (RXRα) to suppress pro-survival genes .

  • Metabolic Regulation: Mitigates hyperosmolar stress in corneal epithelium by restoring mitochondrial homeostasis .

Preclinical Findings

Study ModelKey ResultsCitation
Acute Lung Injury (ALI)Reduced mortality, lung inflammation, and NF-κB/VEGF expression in mice
Allergic AsthmaAttenuated airway hyper-responsiveness and VEGF-mediated vascular permeability
Diabetic ComplicationsCounteracted hyperosmolar stress in corneal epithelial cells
CancerInduced apoptosis in breast, lung, and colorectal cancer models

Clinical Potential

  • Anti-Inflammatory Agent: Suppresses TNF-α, IL-6, and IL-1β while elevating IL-10 in inflammatory models .

  • Metabolic Disease Target: Modulates insulin sensitivity and mitochondrial biogenesis .

Critical Considerations

ParameterChallengeSolution
StabilitySusceptible to proteolysis by tPA, ADAMs, and PSA Use protease inhibitors during handling
Bioactivity MaintenanceSensitivity to freeze-thaw cycles Single-use aliquots stored at -80°C
Batch VariabilityGlycosylation differences impact IGF affinity Vendor-specific CoA validation

Product Specs

Buffer
Lyophilized from a 0.2 µm filtered PBS, pH 7.4.
Form
Lyophilized powder
Lead Time
5-10 business days
Notes
Repeated freezing and thawing is not recommended. Store working aliquots at 4°C for up to one week.
Reconstitution
We recommend that this vial be briefly centrifuged prior to opening to bring the contents to the bottom. Please reconstitute protein in deionized sterile water to a concentration of 0.1-1.0 mg/mL. We recommend adding 5-50% of glycerol (final concentration) and aliquoting for long-term storage at -20°C/-80°C. Our default final concentration of glycerol is 50%. Customers could use this as a reference.
Shelf Life
The shelf life is influenced by various factors including storage state, buffer ingredients, storage temperature, and the inherent stability of the protein. Generally, the shelf life of the liquid form is 6 months at -20°C/-80°C. For the lyophilized form, the shelf life is 12 months at -20°C/-80°C.
Storage Condition
Store at -20°C/-80°C upon receipt. Aliquoting is necessary for multiple use. Avoid repeated freeze-thaw cycles.
Tag Info
Tag-Free
Synonyms
Acid stable subunit of the 140 K IGF complex; Binding protein 29; Binding protein 53; BP 53; BP53; Growth hormone dependent binding protein; IBP 3; IBP-3; IBP3; IBP3_HUMAN; IGF binding protein 3; IGF-binding protein 3; IGFBP 3; IGFBP-3; IGFBP3; Insulin Like Growth Factor Binding Protein 3; Insulin-like growth factor binding protein 3 precursor; Insulin-like growth factor-binding protein 3
Datasheet & Coa
Please contact us to get it.
Expression Region
28-291aa
Mol. Weight
28.8 kDa
Protein Length
Full Length of Mature Protein
Purity
>98% as determined by SDS-PAGE.
Research Area
Cancer
Source
E.coli
Species
Homo sapiens (Human)
Target Names
Uniprot No.

Target Background

Function
IGF-binding proteins extend the half-life of the IGFs and have been demonstrated to either inhibit or stimulate the growth-promoting effects of the IGFs on cell culture. They modify the interaction of IGFs with their cell surface receptors. Additionally, IGFBP3 exhibits IGF-independent antiproliferative and apoptotic effects mediated by its receptor TMEM219/IGFBP-3R. It inhibits the positive effect of humanin on insulin sensitivity and promotes testicular germ cell apoptosis.
Gene References Into Functions
  1. In cancerous tissues of colorectal cancer (CRC) patients, the miR197 level was inversely correlated with the expression of IGFBP3, suggesting that miR197 may modulate cell migration and invasion by targeting IGFBP3 in CRC patients. PMID: 30106114
  2. Findings indicate that MTA1 acts as a modifier of DNMT3a and IGFBP3 expression, highlighting the role of the MTA1-DNMT3a-IGFBP3 axis in breast cancer progression. PMID: 28393842
  3. B-Myb functions as a tumor-promoting gene by targeting IGFBP3 in NSCLC cells, suggesting its potential as a diagnostic and therapeutic target in NSCLC. PMID: 29772705
  4. IGFBP-3 up-regulates the PI3K/Akt/mTOR signaling pathway and down-regulates autophagy during cell aging. The decrease of IGFBP-3 expression in senescence and cell aging by H2O2 leads to up-regulation of mTOR and p53 signaling pathway, suggesting that IGFBP-3 could play a key role as an aging marker. PMID: 29579543
  5. Low IGFBP-3 serum levels were associated with Pancreatic Cancer. PMID: 28681154
  6. IGFBP-3 Interacts with the Vitamin D Receptor in Insulin Signaling Associated with Obesity in Visceral Adipose Tissue. PMID: 29112142
  7. IGFBP3, a gene associated with preeclampsia pathophysiology, was validated as a target gene of miR-210. PMID: 28653360
  8. Analysis of IGFBP3-IGF1 correlation with the risk of esophageal carcinoma suggests that the free form of IGFBP3 might be inversely associated with esophageal cancer incidence. PMID: 28596684
  9. Targeting IGFBP-3-dependent signaling pathways through gefitinib-FTY720 co-therapy may be effective in many basal-like breast cancers, suggesting tissue IGFBP-3 and CD44 measurement as potential biomarkers of treatment efficacy. PMID: 28778177
  10. Laboratory models corroborate intertumor heterogeneity of endocrine response in HGSOC but identify features associated with functional ERalpha and endocrine responsiveness. Assessing ERalpha function (e.g., IGFBP3 expression) in conjunction with H-score may help select patients who would benefit from endocrine therapy. Preclinical data suggest that SERDs might be more effective than tamoxifen. PMID: 28073843
  11. In longitudinal analysis, changes of FGF-21 were not significantly related to changes of height, IGF-1 or IGFBP-3 in obese children. PMID: 26887040
  12. This study investigated the concentrations of insulin, IGF-1, IGFBP-3 and their association with prostate size in patients with BPH. PMID: 28300542
  13. The study confirmed a previously reported association between circulating IGFBP-3 and diabetes risk in the older adult population. PMID: 29040592
  14. While not clearly supporting associations between these obesity-related biomarkers and renal cell carcinoma risk, the results suggest an association with elevated IGFBP-3 among obese individuals. PMID: 28484923
  15. This study reveals a new function of IGFBP2, providing insight into the mechanism of adipogenic differentiation and identifying a potential target mediator for improving adipose tissue engineering based on Wharton's jelly of the umbilical cord (WJCMSCs). PMID: 28859160
  16. Increased IGFBP3 level was associated with decreased risk of frailty in men. PMID: 28609827
  17. Functional IGFBP-3 was significantly lower in postmenopausal women than in premenopausal women, for both patients with rheumatoid arthritis and controls. There was a significant decrease in plasma functional IGFBP-3 levels in postmenopausal RA in comparison to healthy premenopausal subjects. PMID: 27775453
  18. The study suggests high-order interactions of the IGFBP-3 rs2854744 AA genotype, BMI>/=24kg/m2, and DISI<9.85 mg/day on increased BC risk, particularly among postmenopausal women. PMID: 27631779
  19. The stratification of individuals by gender revealed that Slovak males carrying IGFBP-3 G alleles (G32G or GG) had marginally increased risk for developing MDD as compared to CC homozygous males (p=0.09). In women, an inverse association was observed between SNP rs1042522 and MDD risk (p=0.04 for recessive model). PMID: 27755861
  20. Results indicate that hypoxia suppresses the osteogenic differentiation of mesenchymal stem cells via IGFBP3 up-regulation. PMID: 27563882
  21. Meta-analysis suggests that for esophageal cancer, the low IGFBP-3 level is associated with high cancer risk, poor prognosis, and unfavorable tumor stage and metastasis. [meta-analysis] PMID: 27978831
  22. Expression of IL-24 and IGFBP-3 significantly suppressed prostate cancer tumor growth in vivo. PMID: 26323436
  23. Blood IGFBP3 was lower in Black participants compared to Whites. PMID: 27455178
  24. The microRNA-125b level promotes invasive ability in p53-mutated cells via PI3K/AKT activation by targeting of insulin-like growth factor-binding protein-3. PMID: 28378642
  25. High expression of IGFBP3 is associated with metastasis in nasopharyngeal carcinoma. PMID: 27658775
  26. Results indicated that miR-197 targeted IGFBP3 to induce the overgrowth and anti-apoptotic effects of Wilms tumor cells. PMID: 27223680
  27. There is no interaction between IGFBP3 and MTA1 in ESCC, and they are not independent risk factors for esophageal squamous cell carcinoma prognosis. PMID: 27035126
  28. Insulin-like growth factor binding protein-3 is a new predictor of radiosensitivity on esophageal squamous cell carcinoma. PMID: 26670461
  29. Study showed that IGFBP3 is dramatically induced in pancreatic tumors, and is abundantly produced in pancreatic cancer cells, causing muscle wasting through both impaired myogenesis via, at least, inhibition of IGF/PI3K/AKT signaling. PMID: 26975989
  30. Insulin-like growth factor-independent insulin-like growth factor binding protein 3 promotes cell migration and lymph node metastasis of oral squamous cell carcinoma cells via integrin beta1 signaling. PMID: 26540630
  31. Endogenous IGFBP-3 is a p53 target that plays a role in breast cancer cell responsiveness to DNA damaging therapy. PMID: 26378048
  32. Data indicate that IGF-binding protein 3 (IGFBP3) and F3 gene expression levels in formalin fixed paraffin embedded (FFPE) prostate cancer tissue would provide an improved survival prediction for prostate cancer patients. PMID: 26731648
  33. Calcineurin in astrocytes was activated by Amyloid beta, leading to IGFBP-3 release. PMID: 26637371
  34. Circulating levels of IGF-1, IGFBP-3 and their molar ratio were not associated with the risk of occurrence of colorectal adenoma. PMID: 26388613
  35. Independent of obesity, high insulin levels but reduced levels of IGFBP-3 were associated with increased lung cancer risk in current smokers. PMID: 27071409
  36. IGFBP-3 levels after ischemic stroke may independently predict functional outcome after one year. PMID: 26069074
  37. -202 A/C IGFBP3 polymorphisms did not show any consistent association with clinical and laboratory features of acromegalic patients even after treatment. PMID: 25552351
  38. Polymorphism in IGFBP-3 rs2854744 A>C might be a potential predictor of esophageal squamous cell carcinoma risk and patient survival. PMID: 26349977
  39. Humanin Peptide Binds to Insulin-Like Growth Factor-Binding Protein 3 (IGFBP3) and Regulates Its Interaction with Importin-beta. PMID: 26216267
  40. Authors demonstrate that IGFBP3 is a direct TAp73alpha (the p73 isoform that contains the trans-activation domain) target gene and activates the expression of IGFBP3 in actively proliferating cells. PMID: 26063735
  41. Methylation of IGFBP-3 in colorectal cancer was identified to be significantly associated with risk of recurrence. PMID: 25822686
  42. Data indicate that IGF binding protein-3 (IGFBP-3) reduced transcription of a variety of integrins, especially integrin beta4. PMID: 25945837
  43. Serum IGFBP3 was increased in hepatocellular carcinoma patients compared to patients with liver cirrhosis, but lower than in healthy controls. PMID: 26068014
  44. The current meta-analysis suggests that the IGFBP-3 C2133G polymorphism may confer susceptibility to colorectal cancer. [Meta-analysis] PMID: 25966104
  45. In women with normal somatotroph function, IGFBP3 levels do not change in the first trimester of pregnancy. PMID: 25179796
  46. Loss of IGFBP3 expression is associated with Colorectal Cancer. PMID: 25987030
  47. IGFBP-3 polymorphism is not a cause of delayed infancy-childhood transition in idiopathic short stature children. PMID: 25742716
  48. The functional IGFBP3 A-202C polymorphism may influence the susceptibility and progression of breast cancer in the Chinese population. PMID: 25960224
  49. Results suggest that immediately postexercise testosterone and IGFPB-3 responses are significantly increased after endurance training followed by strength training but not after strength training followed by endurance training. PMID: 25028991
  50. These findings indicate that IGFBP-3 enhances etoposide-induced cell growth inhibition by blocking the NF-kappaB signaling pathway in gastric cancer cells. PMID: 25662950

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Database Links

HGNC: 5472

OMIM: 146732

KEGG: hsa:3486

STRING: 9606.ENSP00000370473

UniGene: Hs.450230

Subcellular Location
Secreted.
Tissue Specificity
Expressed by most tissues. Present in plasma.

Customer Reviews

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Applications : Partial correlation analysis

Review: Correlation between IGF-1 and IGFBP-3 in the BC patients serum. The results of partial correlation analysis showed that the levels in serum for IGFBP-3, IGF-1 were positively correlated in BC patients (1=0.970, P<0.001).

Q&A

What is the molecular structure of IGFBP3?

IGFBP3 is a 264-amino acid peptide with a molecular weight of 29 kDa, primarily produced by the liver. It is the most abundant of six IGF binding proteins that have highly conserved structures and bind insulin-like growth factors (IGF-1 and IGF-2) with high affinity. In circulation, IGFBP3 forms a 150-kDa ternary complex with IGF-I and an acid labile subunit (ALS), which significantly extends the half-life of these growth factors from minutes to hours. Specifically, non-complexed IGFBP-3 and IGF-1 have short half-lives of 30-90 minutes and 10 minutes respectively, while the IGFBP-3/IGF-1 complex is cleared with a much slower half-life of approximately 12 hours .

How does IGFBP3 regulate IGF bioavailability in research models?

IGFBP3 serves as the primary transport protein for IGFs in circulation, carrying these growth factors in stable complexes with ALS. For IGFs to reach tissues from the bloodstream, these complexes must partially dissociate, a process that may be enhanced by limited proteolysis of IGFBP3. Within tissues, IGFBP3 can bind IGF-1 and IGF-2 released by many cell types and block their access to the IGF-1 receptor (IGF1R). The IGF-1/IGFBP-3 ratio has sometimes been used as an index of IGF bioavailability, though this approach has limitations as it doesn't account for binding to other IGFBPs or the fact that IGF-2 (three times more abundant than IGF-1 in adult circulation) occupies most binding sites on circulating IGFBP-3 .

What are the IGF-independent functions of IGFBP3 relevant to researchers?

Beyond its role in IGF transport and regulation, IGFBP3 exhibits distinct biological effects independent of IGF binding. These include inhibition of cell proliferation and induction of apoptosis in various cell types. IGFBP3 interacts with cell-surface proteins, affecting cell signaling from outside the cell or after internalization. It can also enter the cell nucleus where it binds to nuclear hormone receptors and other ligands. Additionally, IGFBP3 has been shown to inhibit tumor necrosis factor (TNF)-α-induced nuclear factor (NF)-κB activity, thereby restoring deregulated insulin signaling and countering TNF-α-induced inhibition of glucose uptake in certain experimental models .

What are the optimal conditions for IGFBP3 sample collection and processing?

For reliable IGFBP3 measurement, researchers should observe specific sample collection protocols:

  • Patient preparation: Subjects should avoid biotin supplements (common in hair, skin, and nail supplements and multivitamins) for 12 hours before specimen collection.

  • Collection container: Red top tubes are preferred; serum gel tubes are acceptable alternatives.

  • Processing: Samples should be centrifuged promptly and serum aliquoted into plastic vials.

  • Volume requirements: A specimen volume of 0.8 mL is recommended, with a minimum required volume of 0.3 mL.

  • Sample stability and storage conditions:

Specimen TypeTemperatureStability TimeNotes
SerumAmbient72 hours
SerumRefrigerated72 hours
SerumFrozen14 daysPreferred method
  • Sample quality: Gross hemolysis and gross icterus are rejection criteria, while gross lipemia is acceptable .

What analytical methods are most reliable for IGFBP3 quantification in research settings?

The gold standard for IGFBP3 quantification in research and clinical settings is the Enzyme-Labeled Chemiluminescent Immunometric Assay (ICMA). This methodology offers high sensitivity and specificity with a typical result turnaround time of 1-3 days. When implementing this assay, researchers should be aware that biotin supplementation can interfere with results, necessitating a 12-hour abstention period before sample collection. The assay can detect physiologically relevant changes in IGFBP3 levels across various experimental conditions and disease states, making it valuable for both basic science investigations and translational research .

How should reference ranges be established for experimental studies involving IGFBP3?

When establishing reference ranges for IGFBP3 in experimental studies, researchers must consider several critical factors:

  • Age-specific normative data: IGFBP3 levels vary significantly with age, requiring age-matched controls.

  • Sex differences: Reference ranges should be sex-specific when possible.

  • Diurnal variation: Unlike GH, which shows significant diurnal variation, IGFBP3 levels show only minor fluctuations, making them more stable markers.

  • Population characteristics: Ethnicity, nutritional status, and other demographic factors may influence reference ranges.

  • Analytical method consistency: Reference ranges are method-specific and should be established using the same analytical platform used for experimental measurements.

For clinical interpretations, values below the 2.5th percentile for age are consistent with GH deficiency or severe resistance, though patients with incomplete GH deficiency or mild-to-moderate GH resistance may have levels within the reference range .

What mechanisms facilitate IGFBP3 cellular uptake and nuclear translocation?

IGFBP3 transport across the plasma membrane involves multiple endocytosis mechanisms that researchers should consider when designing uptake experiments:

  • Classical clathrin-dependent endocytosis: IGFBP3 can interact with transferrin, which binds to transferrin receptors, enabling internalization through receptor-mediated endocytosis. Inhibition of transferrin receptor with antibodies reduces nuclear accumulation of IGFBP3.

  • Caveolae/lipid raft-mediated uptake: IGFBP3 also utilizes this alternative endocytic pathway.

  • Fluid-phase uptake: A less specific mechanism that may contribute to cellular internalization.

  • Receptor-mediated pathways: IGFBP3 binds to TGF-β receptors (TGF-βRI, TGF-βRII, and TGF-βRV) and a specific IGFBP3 receptor (IGFBP-3R), which may facilitate its uptake.

Nuclear translocation depends critically on phosphorylation of IGFBP3 at Ser156, catalyzed by DNA-PK. This phosphorylation reduces IGFBP3's affinity for IGF-1, ensuring its release from IGF-IGFBP3 complexes prior to nuclear localization. The protein importin-β appears to bind equally well to both phosphorylated and dephosphorylated forms of IGFBP3, suggesting phosphorylation primarily affects intranuclear functions rather than the import mechanism itself .

How does IGFBP3 induce apoptosis through IGF-independent pathways?

IGFBP3 induces apoptosis through several IGF-independent mechanisms that researchers can experimentally manipulate:

  • IGFBP-3R-mediated pathway: IGFBP3 binding to its receptor (IGFBP-3R) induces caspase-8-dependent apoptosis in multiple cancer cell lines. IGFBP-3R has been characterized as a novel death receptor that mediates tumor suppression.

  • Nuclear receptor interactions: In prostate cancer cells, exogenous IGFBP3 induces apoptosis through the export of orphan nuclear receptors Nur77 and its binding partner RXR-α from the nucleus.

  • Mitochondrial pathway: IGFBP3 augments the association between RXR-α and Nur77 and their translocation from the nucleus into mitochondria, triggering the intrinsic apoptotic pathway and release of cytochrome c.

  • Caspase activation: IGFBP3 and Nur77 demonstrate an additive increase in the activation of caspases 3 and 7, leading to increased apoptosis. siRNA knockdown of Nur77 decreases anisomycin-induced intrinsic apoptosis by reducing caspase 3 and 7 activation.

  • Phosphorylation-dependent mechanisms: Phosphorylated IGFBP3 interacts with phosphorylated forms of Nur77 and RXR-α, facilitating nuclear export and apoptosis induction .

What role does IGFBP3 play in metabolic regulation and insulin signaling?

IGFBP3 exhibits complex effects on glucose metabolism and insulin signaling that appear context-dependent:

These findings indicate that researchers should carefully consider the physiological or pathological context when investigating IGFBP3's metabolic effects .

What experimental models are most appropriate for studying different aspects of IGFBP3 biology?

Researchers investigating IGFBP3 should select experimental models based on their specific research questions:

  • In vivo models:

    • Transgenic mice overexpressing IGFBP3: Valuable for studying systemic effects on growth, metabolism, and cancer progression.

    • IGFBP3 knockout mice: Useful for understanding physiological roles through loss-of-function approaches.

    • Recombinant IGFBP3 administration models: Allow for dose-response studies and temporal analysis of acute effects.

  • In vitro models:

    • T47D breast cancer cells: Lack functional TGF-β signaling due to absence of TGF-βRII, enabling studies of IGFBP3's interaction with this pathway.

    • Prostate cancer cells: Particularly valuable for investigating IGFBP3's role in apoptosis through nuclear export of Nur77 and RXR-α.

    • Human aortic endothelial cells (HAECs): Suitable for studying IGFBP3's effects on vascular inflammation and endothelial function.

    • Primary hepatocytes: Appropriate for investigating IGFBP3 production and regulation, as the liver is the primary source of circulating IGFBP3.

Each model system provides unique advantages for investigating different aspects of IGFBP3 biology, from cellular mechanisms to systemic physiology .

How can researchers effectively distinguish between IGF-dependent and IGF-independent effects of IGFBP3?

Differentiating between IGF-dependent and IGF-independent actions of IGFBP3 requires strategic experimental approaches:

  • Protein engineering approaches:

    • Use of IGFBP3 mutants with reduced IGF binding capacity but retained structural integrity

    • Creation of domain-specific deletion mutants to identify regions responsible for IGF-independent effects

    • Generation of phosphorylation-site mutants (particularly at Ser156)

  • Receptor manipulation strategies:

    • IGF1R inhibition using specific tyrosine kinase inhibitors or neutralizing antibodies

    • IGF1R knockdown or knockout models

    • Parallel experiments in IGF1R-negative cell lines

  • Signaling pathway analysis:

    • Monitoring IGF-specific downstream signals (PI3K/Akt, MAPK pathways)

    • Assessing IGF-independent pathways (caspase activation, NF-κB signaling)

    • Phosphoproteomic profiling to identify divergent signaling nodes

  • Biochemical approaches:

    • Co-immunoprecipitation to identify IGFBP3 binding partners

    • Subcellular fractionation to track protein localization

    • Chromatin immunoprecipitation to identify genomic targets of nuclear IGFBP3

By implementing these complementary approaches, researchers can build a comprehensive understanding of IGFBP3's diverse biological functions .

What methodological considerations are important when investigating IGFBP3-induced apoptosis?

When studying IGFBP3's pro-apoptotic effects, researchers should consider these methodological approaches:

  • Apoptosis detection methods:

    • Annexin V/PI staining for early/late apoptosis discrimination

    • TUNEL assay for DNA fragmentation

    • Caspase activity assays (particularly caspases 3, 7, and 8)

    • PARP cleavage detection by western blotting

    • Mitochondrial membrane potential assessment

  • Mechanistic investigations:

    • siRNA/shRNA knockdown of potential mediators (e.g., Nur77, RXR-α)

    • Phosphorylation status analysis using phospho-specific antibodies

    • Nuclear/cytoplasmic fractionation to track protein translocation

    • Fluorescence microscopy to visualize protein co-localization

    • Protein complex analysis by native gel electrophoresis

  • Experimental controls:

    • Dose-response and time-course analyses

    • Comparison of wild-type vs. mutant IGFBP3

    • Positive controls using established apoptosis inducers

    • Use of specific pathway inhibitors to confirm mechanism

These approaches have successfully elucidated IGFBP3's pro-apoptotic mechanisms, particularly its interactions with nuclear receptors and activation of the intrinsic apoptotic pathway .

How should IGFBP3 measurements be integrated with other biomarkers in growth disorder research?

In growth disorder investigations, IGFBP3 should be interpreted within a multiparameter framework:

  • Integrated biomarker approach:

    • IGFBP3 and IGF-1 measurements in combination provide superior diagnostic utility compared to either alone

    • GH levels and stimulation test results provide complementary information

    • Auxological data (height, growth velocity) remain essential clinical parameters

  • Interpretation guidelines:

    • IGFBP3 and IGF-1 levels below the 2.5th percentile for age suggest GH deficiency or severe resistance

    • Incomplete GH deficiency or mild-to-moderate GH resistance may present with normal levels

    • In GH deficiency, GH levels are low with suboptimal stimulation test responses

    • In GH resistance, GH levels are elevated despite low IGF-1/IGFBP3

  • Diagnostic algorithm refinement:

    • For initial screening, both IGF-1 and IGFBP3 should be measured

    • In cases of discordance, additional testing may be warranted

    • Dynamic GH testing should be performed and interpreted in specialized endocrine centers

This integrated approach enhances diagnostic accuracy and facilitates appropriate therapeutic decision-making in growth disorders .

What protocol is recommended for monitoring recombinant human GH treatment using IGFBP3?

Optimal monitoring of recombinant human GH therapy incorporates IGFBP3 measurements as follows:

  • Treatment objectives:

    • Target IGFBP3 and IGF-1 levels within age- and sex-appropriate reference ranges

    • Ideal target is the middle to upper third of the reference range

    • Avoid excessive levels that might confer no additional benefit while potentially increasing adverse effect risk

  • Monitoring schedule:

    • Baseline measurement before treatment initiation

    • Follow-up at 3-6 month intervals during dose adjustment phase

    • Annual monitoring once stable dosing is established

    • More frequent monitoring if clinical status changes

  • Dose adjustment strategy:

    • Incremental dose modifications based on IGFBP3/IGF-1 levels

    • Consideration of clinical response alongside biochemical parameters

    • Individualization based on age, body composition, and comorbidities

  • Special considerations:

    • Concomitant hypothyroidism, diabetes, or malnutrition may affect response

    • Pubertal status significantly influences IGFBP3 levels

    • Treatment adherence assessment with unexpected low levels

This systematic approach optimizes therapeutic outcomes while minimizing adverse effects .

What is the value of IGFBP3 measurement in acromegaly and gigantism research studies?

In acromegaly and gigantism research, IGFBP3 offers specific utility:

  • Diagnostic considerations:

    • Elevated IGF-1 and IGFBP3 levels support the diagnosis in symptomatic individuals

    • IGF-1 generally shows superior correlation with disease activity than IGFBP3

    • IGFBP3 measurement adds limited additional diagnostic information beyond IGF-1

  • Treatment monitoring parameters:

    • In successfully treated patients, levels should normalize (ideally within the lower third of reference range)

    • Persistent elevation suggests incomplete disease control

    • IGF-1 remains the preferred biomarker for monitoring treatment efficacy

  • Research applications:

    • IGFBP3:IGF-1 ratios may provide insights into disease pathophysiology

    • Alterations in IGFBP3 proteolysis may be mechanistically important

    • IGFBP3 gene polymorphisms might influence disease susceptibility or severity

While IGFBP3 can serve as an adjunct biomarker in acromegaly research, its clinical utility is generally secondary to IGF-1 measurement, which shows stronger correlation with disease activity and treatment response .

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