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- Title
Growth hormone/ IGF-1 axis longitudinal evaluation in clinically isolated syndrome patients on interferon β-1b therapy: stimulation tests and correlations with clinical and radiological conversion to multiple sclerosis.
- Authors
Lanzillo, R.; Di Somma, C.; Quarantelli, M.; Carotenuto, A.; Pivonello, C.; Moccia, M.; Cianflone, A.; Marsili, A.; Puorro, G.; Saccà, F.; Russo, C. V.; De Luca Picione, C.; Ausiello, F.; Colao, A.; Brescia Morra, V.
- Abstract
Background and purpose Growth hormone (GH)/insulin-like growth factor 1 ( IGF-1) axis abnormalities in multiple sclerosis ( MS) suggest their role in its pathogenesis. Interferon β ( IFN-β) efficacy could be mediated also by an increase of IGF-1 levels. A 2-year longitudinal study was performed to estimate the prevalence of GH and/or IGF-1 deficiency in clinically isolated syndrome ( CIS) patients and their correlation with conversion to MS in IFN treated patients. Methods Clinical and demographic features of CIS patients were collected before the start of IFN-β-1b. IGF-1 levels and GH response after arginine and GH releasing hormone + arginine stimulation tests were assessed. Clinical and magnetic resonance imaging evaluations were performed at baseline, 1 year and 2 years. Results Thirty CIS patients (24 female) were enrolled. At baseline, four patients (13%) showed a hypothalamic GH deficiency ( GHD), whilst no one had a pituitary GHD. Baseline demographic, clinical and radiological data were not related to GHD, whilst IGF-1 levels were inversely related to age ( P < 0.001) and GH levels ( P = 0.03). GH and IGF-1 serum mean levels were not significantly modified after 1 and 2 years of treatment in the whole group, although 3/4 GHD patients experienced a normalization of GH levels, whilst one dropped out. After 2 years of treatment 13/28 (46%) patients converted to MS. The presence of GHD and GH and IGF-1 levels were not predictive of relapses, new T2 lesions or conversion occurrence. Conclusions Growth hormone/ IGF-1 axis function was found to be frequently altered in CIS patients, but this was not related to MS conversion. Patients experienced an improvement of GHD during IFN therapy. Longer follow-up is necessary to assess its impact on disease progression.
- Subjects
MULTIPLE sclerosis research; PITUITARY dwarfism; SOMATOTROPIN; SOMATOMEDIN C; INTERFERON beta 1b; MEDICAL radiology; DISEASE progression; THERAPEUTICS
- Publication
European Journal of Neurology, 2017, Vol 24, Issue 2, p446
- ISSN
1351-5101
- Publication type
Article
- DOI
10.1111/ene.13207