Low-affinity insulin-like growth factor binding protein 7 and its association with pulmonary arterial hypertension severity and survival.

Low-affinity insulin-like growth factor binding protein 7 and its association with pulmonary arterial hypertension severity and survival.
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DOI:
10.1002/pul2.12284
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发表时间:
2023-07
影响因子:
2.6
通讯作者:
Everett, Allen D.
Everett, Allen D.
中科院分区:
医学4区
文献类型:
--
作者:
Torres, Guillermo;Lancaster, Andrew C.;Yang, Jun;Griffiths, Megan;Brandal, Stephanie;Damico, Rachel;Vaidya, Dhananjay;Simpson, Catherine E.;Martin, Lisa J.;Pauciulo, Michael W.;Nichols, William C.;Ivy, David D.;Austin, Eric D.;Hassoun, Paul M.;Everett, Allen D.

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胰岛素样生长因子(IGF)结合蛋白(IGFBPs)是生长因子调节剂家族,已知其中一些与肺动脉高压(PAH)生存期独立相关。IGF因子结合蛋白7(IGFBP 7)是一种独特的低亲和力IGFBP,独立于IGF,刺激前列环素的产生。本研究建议使用招募和纵向样本建立IGFBP 7与PAH严重程度和生存率之间的关联。PAH患者的血清IGFBP 7水平与对照组相比显著升高。在调整年龄和性别后,IGFBP 7的对数增加与6分钟步行距离缩短20米(6 MWD; p < 0.001),平均右心房压力升高2 - 3 mmHg(p < 0.001和0.02)以及REVEAL 2.0风险类别放置的可能性更高(p < 0.001)相关。Kaplan-Meier分析显示IGFBP 7高于中位数时生存率显著降低,经年龄和性别校正的考克斯多变量分析显示,较高的血清IGFBP 7是生存率的独立预测因子。虽然确切的机制仍然未知,但鉴于IGFBP 7作为前列环素兴奋剂的作用,它有可能用作疾病调节的治疗靶点。
Insulin‐like growth factor (IGF) binding proteins (IGFBPs) are a family of growth factor modifiers, some of which are known to be independently associated with pulmonary arterial hypertension (PAH) survival. IGF factor binding protein 7 (IGFBP7) is a unique low‐affinity IGFBP that, independent of IGF, stimulates prostacyclin production. This study proposed to establish associations between IGFBP7 and PAH severity and survival, using enrollment and longitudinal samples. Serum IGFBP7 levels were significantly elevated in patients with PAH compared to controls. After adjusting for age and sex, logarithmic increases in IGFBP7 were associated with a 20 m shorter six‐minute walk distance (6MWD; p < 0.001), a 2−3 mmHg higher mean right atrial pressure (p < 0.001 and 0.02), and a higher likelihood of a greater REVEAL 2.0 risk category placement (p < 0.001). Kaplan−Meier analysis demonstrated significantly decreased survival with IGFBP7 above the median and Cox multivariable analysis adjusted for age and sex, demonstrated higher serum IGFBP7 was an independent predictor of survival. Though the exact mechanism is still unknown, given IGFBP7's role as a prostacyclin stimulant, it has potential use as a therapeutic target for disease modulation.
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血浆胰岛素样生长因子结合蛋白 7 (IGFBP-7) 导致 ARDS 28 天死亡率:来自多阶段孟德尔随机化的证据。
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