IGF-1 and retinopathy of prematurity in the preterm infant.
BACKGROUND
Retinopathy of prematurity (ROP) continues to be a major cause of blindness in children. Although ablation of the retina reduces the incidence of blindness by suppressing the neovascular phase of ROP, the visual outcomes after treatment are often poor. Preventive therapy is required and will likely come from a better understanding of the pathophysiology of the disease.


OBJECTIVE
To study the role of insulin-like growth factor 1 (IGF-1) and vascular endothelial growth factor (VEGF) in both the proliferative phase of ROP (phase II) and in the early phase when blood vessels are lost.


METHODS
Using both a mouse model of ROP and clinical studies the relationship between IGF-1, VEGF and both vessel loss and vessels proliferation in the retina was studied.


RESULTS
IGF-1 is required for maximum VEGF activation of vascular endothelial cell proliferation and survival pathways. IGF-1 levels are deficient after premature birth, setting the stage for retinal vascular loss and ROP.


CONCLUSIONS
Restoration of IGF-1 to levels found in utero may help prevent ROP.
Smith
Lois E H
LE
Department of Ophthalmology, Children's Hospital, Harvard Medical School, Boston, MA 02115, USA. lois.smith@childrens.harvard.edu
D001724:Birth Weight; D001921:Brain / Q000254:growth & development; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007334:Insulin-Like Growth Factor I / Q000172:deficiency; D010100:Oxygen / Q000502:physiology; D012160:Retina / Q000254:growth & development / Q000473:pathology; D012178:Retinopathy of Prematurity / Q000209:etiology / Q000473:pathology; D012307:Risk Factors
D007334:Insulin-Like Growth Factor I; D010100:Oxygen