title: The induction of a specific protease for insulin-like growth factor binding protein-3 in the circulation during severe illness.
abstract: The insulin-like growth factors (IGF-I and IGF-II) are almost completely bound in the circulation to specific binding proteins (IGFBPs). These IGFBPs appear to play a pivotal role in maintaining circulating levels and modulating the delivery of the IGFs to the tissues. A large proportion of the circulating IGFs are bound with high affinity to one of the binding proteins. IGFBP-3. The mechanism by which these IGFs are transferred from the circulatory pool to the tissue receptors is at present unclear. Recent studies in late pregnancy have demonstrated the presence of specific proteases which may modify the IGFBPs such that their affinities for the IGFs are reduced. In this paper, we have demonstrated the presence of a heat-sensitive cation-dependent proteolytic enzyme specific for IGFBP-3 in the serum of five severely ill patients. The activity of this protease was found to vary in these patients, becoming more apparent during fasting than when studied after commencement of parenteral nutrition, indicating that one of the influencing factors in the activity of this protease is the nutritional intake of the patient. Age- and sex-matched healthy adults were also studied in a similar protocol, but no proteolytic modification of any of the IGFBPs was found in any of the samples examined. As the levels of both IGF-I and IGF-II were found to be low in the patients, the presence of a circulatory protease suggests that this may be an adaptive response to increase the bioavailability of the IGFs and possibly to improve the nitrogen retention and counter the catabolic state in severe illness.
authors.affiliation: Department of Endocrinology, St Bartholomew's Hospital, West Smithfield, London.
authors.forename: S C
authors.initials: SC
authors.lastname: Davies
authors.forename: J A
authors.initials: JA
authors.lastname: Wass
authors.forename: R J
authors.initials: RJ
authors.lastname: Ross
authors.forename: A M
authors.initials: AM
authors.lastname: Cotterill
authors.forename: C R
authors.initials: CR
authors.lastname: Buchanan
authors.forename: V J
authors.initials: VJ
authors.lastname: Coulson
authors.forename: J M
authors.initials: JM
authors.lastname: Holly
mesh_terms: D000368:Aged; D015153:Blotting, Western; D002352:Carrier Proteins / Q000378:metabolism*; D003422:Critical Care; D010450:Endopeptidases / Q000097:blood*; D005215:Fasting / Q000097:blood*; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007335:Insulin-Like Growth Factor II / Q000032:analysis; D008875:Middle Aged; D010288:Parenteral Nutrition; D011480:Protease Inhibitors / Q000494:pharmacology
chemical_list: D002352:Carrier Proteins; D018969:Insulin-Like Growth Factor Binding Proteins; D011480:Protease Inhibitors; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II; D010450:Endopeptidases