Insulin-like Growth factor-I In Treatment Research Articles

Intralesional injection of insulin-like growth factor-I for treatment of superficial digital flexor tendonitis in Thoroughbred racehorses: 40 cases (2000–2004)

OBJECTIVE-To evaluate outcome after intralesional injection of insulin-like growth factor-I (IGF-I) for treatment of superficial digital flexor (SDF) tendonitis in Thoroughbred racehorses. DESIGN-Retrospective case series. ANIMALS-40 Thoroughbred racehorses. PROCEDURES-Medical records of racehorses with SDF tendonitis treated within 13 weeks after injury by intralesional injection of IGF-I (25 or 50 μg every other day for 4 or 5 treatments) were reviewed. Outcome was determined via analysis of race records, owner follow-up, and examination. RESULTS-Mean age of the horses was 3.1 years (range, 2 to 7 years), and time from injury to treatment ranged from 8 to 90 days. Mean ± SD approximate lesion length on admission was 15.6 ± 6.0 cm, and mean percentage cross-sectional area of the tendon affected was 26 ± 18%. Twenty-six of the 40 horses underwent desmotomy of the accessory ligament of the SDF tendon. Echolucency was reduced in 23 of 26 horses by the end of the treatment period. Twenty-one of 34 (62%) horses for which race data were available raced at least once after treatment, including 10 (30%) horses that raced between 1 and 4 times and 11 horses (32%) that raced ≥ 5 times. Thirteen of 28 (46%) horses had a recurrence of tendonitis or developed tendonitis elsewhere. CONCLUSIONS AND CLINICAL RELEVANCE-Results suggested that in Thoroughbred racehorses with SDF tendonitis, intralesional injection of IGF-I led to a decrease in ultrasonographic lesion severity, but treated horses had only a moderate prognosis for return to racing.

Sustained release of recombinant human insulin-like growth factor-I for treatment of diabetes

Recombinant human insulin-like growth factor-I (rhIGF-I) was found to improve glycemic control and enhance insulin sensitivity in patients with a syndrome of severe insulin resistance. Therefore, the protein may be considered as an alternative therapy in the treatment of diabetes when the patients become insensitive to insulin treatment. Because the protein was administered twice per day in the clinical trials, a sustained release polylactic-co-glycolic acid (PLGA) formulation for rhIGF-I with low initial burst (<20%), maximum possible protein loading (15–20%) and a continuous release of 1–2 weeks may provide greater patient convenience and compliance. The protein was encapsulated in PLGA for sustained release using a spray freeze-drying technique. Formulation parameters such as protein loading, polymer end group, and the presence of zinc carbonate were studied for their effects on in vitro release of rhIGF-I from PLGA microspheres. As the protein loading was increased, the initial burst increased. Due to the hydrophilic properties of the polymers, rhIGF-I encapsulated in unblocked PLGA (free acid end groups) gave a lower initial burst and a more steady-state release profile than the blocked PLGA (hydrocarbon end groups) with the same protein loading and PLGA molecular weight. At 15% w/w protein loading, the addition of 6% w/w zinc carbonate as a protein release modifier to the unblocked PLGA (12 kDa) decreased the initial burst of rhIGF-I. Therefore, a formulation consisting of 15% rhIGF-I and 6% zinc carbonate in 12 kDa, unblocked 50:50 PLGA can provide the required release characteristics in vitro. Rat studies revealed that rhIGF-I in this formulation was released in vivo at a rate which was comparable to that observed in vitro. These studies demonstrate the potential for a sustained release, 14-day formulation for rhIGF-I.