胰岛素样生长因子-1在早产儿视网膜病变（一种中枢神经系统神经血管疾病）中的作用
IGF-1 in retinopathy of prematurity, a CNS neurovascular disease.
作者信息
Liegl Raffael, Löfqvist Chatarina, Hellström Ann, Smith Lois E H
机构信息
Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
出版信息
Early Hum Dev. 2016 Nov;102:13-19. doi: 10.1016/j.earlhumdev.2016.09.008. Epub 2016 Sep 17.
The retina is part of the central nervous system and both the retina as well as the brain can suffer from severe damage after very preterm birth. Retinopathy of prematurity is one of the major causes of blindness in these children and brain neuronal impairments including cognitive defects, cerebral palsy and intraventricular hemorrhage (IVH) are also complications of very preterm birth. Insulin-like growth factor 1 (IGF-1) acts to promote proliferation, maturation, growth and survival of neural cells. Low levels of circulating IGF-1 are associated with ROP and defects in the IGF-1 gene are associated with CNS disorders including learning deficits and brain growth restriction. Treatment of preterm infants with recombinant IGF-1 may potentially prevent ROP and CNS disorders. This review compares the role of IGF-1 in ROP and CNS disorders. A recent phase 2 study showed a positive effect of IGF-1 on the severity of IVH but no effect on ROP. A phase 3 trial is planned.
视网膜是中枢神经系统的一部分，极早早产出生后，视网膜和大脑都可能遭受严重损伤。早产儿视网膜病变是这些儿童失明的主要原因之一，包括认知缺陷、脑瘫和脑室内出血（IVH）在内的脑神经元损伤也是极早早产的并发症。胰岛素样生长因子1（IGF-1）具有促进神经细胞增殖、成熟、生长和存活的作用。循环中IGF-1水平低与早产儿视网膜病变有关，IGF-1基因缺陷与包括学习障碍和脑生长受限在内的中枢神经系统疾病有关。用重组IGF-1治疗早产儿可能预防早产儿视网膜病变和中枢神经系统疾病。本综述比较了IGF-1在早产儿视网膜病变和中枢神经系统疾病中的作用。最近一项2期研究显示IGF-1对脑室内出血的严重程度有积极作用，但对早产儿视网膜病变无作用。计划进行一项3期试验。
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