title: Does insulin-like growth factor 1 contribute in red blood cell transfusions to the pathogenesis of retinopathy of prematurity during retinal neovascularization?
abstract: BACKGROUND
  Red blood cell (RBC) transfusions are associated with the development of retinopathy of prematurity (ROP). During the period of retinal neovascularization a rise of insulin-like growth factor 1 (IGF-1) may trigger rapid growth of new blood vessels.
  
  
  OBJECTIVE
  To study endocrine factors in RBC transfusions that might be of importance for ROP.
  
  
  METHODS
  IGF-1, IGF-2 and their binding proteins 1-3 (IGFBP-1-3) were determined by radioimmunoassays in 7 very-low-birthweight (VLBW) infants with ROP >or= stage 2 receiving a RBC transfusion, in 10 controls (VLBW infants with ROP <or= stage 1, no transfusion), in supernatants of 7 RBCs and of 5 washed RBCs (WRBC).
  
  
  RESULTS
  IGF-1 (mean +/- SD) in infants with ROP was 20.0 +/- 4.2 microg/l, in controls 35.9 +/- 15.2 microg/l (Mann-Whitney U test, p = 0.030). IGF-1 in RBC was 12.88 +/- 5.03 microg/l and in WRBC 0.45 +/- 0.74 microg/l (average of the three-course washing procedure). IGF-2 in infants with ROP was 485.67 +/- 158.73 microg/l, in controls 389.9 +/- 102.8 microg/l (not significant), in RBC 109.50 +/- 117.89 microg/l, in WRBC 61.07 +/- 30.0 microg/l. Except for IGFBP-3 other IGFBPs were barely or not detectable in RBC or WRBC.
  
  
  CONCLUSIONS
  Considering lower IGF-1 concentrations in preterm infants than in adults (factor 20), the IGF-1 in RBC transfusions is equivalent to a single dose of 1 microg/kg IGF-1 (5-10% of the adult dose with proved metabolic responses). Endocrinological relationships between the donor's load and the acceptor's individual features are a new aspect of potential side effects of RBC transfusions. Further research is necessary to clarify the share of the described IGF administration on the development of ROP.
authors.affiliation: Department of Pediatric, Friedrich-Schiller-University of Jena, Jena, Germany. Axel.Huebler@med.uni-jena.de
authors.forename: Axel
authors.initials: A
authors.lastname: Hübler
authors.forename: Kerstin
authors.initials: K
authors.lastname: Knote
authors.forename: Eberhard
authors.initials: E
authors.lastname: Kauf
authors.forename: Dagmar
authors.initials: D
authors.lastname: Barz
authors.forename: Dorothea
authors.initials: D
authors.lastname: Schlenvoigt
authors.forename: Dirk
authors.initials: D
authors.lastname: Schramm
mesh_terms: D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood; D018971:Insulin-Like Growth Factor Binding Protein 2 / Q000097:blood; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis / Q000502:physiology*; D007335:Insulin-Like Growth Factor II / Q000032:analysis; D009389:Neovascularization, Pathologic / Q000209:etiology*; D012171:Retinal Vessels / Q000503:physiopathology*; D012178:Retinopathy of Prematurity / Q000209:etiology* / Q000503:physiopathology
chemical_list: D018970:Insulin-Like Growth Factor Binding Protein 1; D018971:Insulin-Like Growth Factor Binding Protein 2; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II