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Himawan A, Vora LK, Permana AD, Sudir S, Nurdin AR, Nislawati R, Hasyim R, Scott CJ, Donnelly RF. Where Microneedle Meets Biomarkers: Futuristic Application for Diagnosing and Monitoring Localized External Organ Diseases. Adv Healthc Mater 2023; 12:e2202066. [PMID: 36414019 DOI: 10.1002/adhm.202202066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/03/2022] [Indexed: 11/24/2022]
Abstract
Extracellular tissue fluids are interesting biomatrices that have recently attracted scientists' interest. Many significant biomarkers for localized external organ diseases have been isolated from this biofluid. In the diagnostic and disease monitoring context, measuring biochemical entities from the fluids surrounding the diseased tissues may give more important clinical value than measuring them at a systemic level. Despite all these facts, pushing tissue fluid-based diagnosis and monitoring forward to clinical settings faces one major problem: its accessibility. Most extracellular tissue fluid, such as interstitial fluid (ISF), is abundant but hard to collect, and the currently available technologies are invasive and expensive. This is where novel microneedle technology can help tackle this significant obstacle. The ability of microneedle technology to minimally invasively access tissue fluid-containing biomarkers will enable ISF and other tissue fluid utilization in the clinical diagnosis and monitoring of localized diseases. This review attempts to present the current pursuit of the application of microneedle systems as a diagnostic and monitoring platform, along with the recent progress of biomarker detection in diagnosing and monitoring localized external organ diseases. Then, the potential use of various microneedles in future clinical diagnostics and monitoring of localized diseases is discussed by presenting the currently studied cases.
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Affiliation(s)
- Achmad Himawan
- School of Pharmacy, Queen's University Belfast, Belfast, BT97BL, UK.,Department of Pharmaceutical Science and Technology, Faculty of Pharmacy, Hasanuddin University, Makassar, 90245, Indonesia
| | | | - Andi Dian Permana
- Department of Pharmaceutical Science and Technology, Faculty of Pharmacy, Hasanuddin University, Makassar, 90245, Indonesia
| | - Sumarheni Sudir
- Department of Pharmacy, Faculty of Pharmacy, Hasanuddin University, Makassar, 90245, Indonesia
| | - Airin R Nurdin
- Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University, Makassar, 90245, Indonesia.,Hasanuddin University Hospital, Hasanuddin University, Makassar, 90245, Indonesia
| | - Ririn Nislawati
- Hasanuddin University Hospital, Hasanuddin University, Makassar, 90245, Indonesia.,Department of Ophthalmology, Faculty of Medicine, Hasanuddin University, Makassar, 90245, Indonesia
| | - Rafikah Hasyim
- Department of Oral Biology, Faculty of Dentistry, Hasanuddin University, Makassar, 90245, Indonesia
| | - Christopher J Scott
- Patrick G Johnson Centre for Cancer Research, Queen's University Belfast, Belfast, BT97BL, UK
| | - Ryan F Donnelly
- School of Pharmacy, Queen's University Belfast, Belfast, BT97BL, UK
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Janssen JAMJL, Varewijck AJ, Brugts MP. The insulin-like growth factor-I receptor stimulating activity (IRSA) in health and disease. Growth Horm IGF Res 2019; 48-49:16-28. [PMID: 31493625 DOI: 10.1016/j.ghir.2019.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 07/26/2019] [Accepted: 08/19/2019] [Indexed: 10/26/2022]
Abstract
Determination of true IGF-I bioactivity in serum and other biological fluids is still a substantial challenge. The IGF-IR Kinase Receptor Activation assay (IGF-IR KIRA assay) is a novel tool to asses IGF-IR stimulating activity (IRSA) and has opened a new era in studying the IGF system. In this paper we discuss many studies showing that measuring IRSA by the IGF-IR KIRA assay often provides fundamentally different information about the IGF system than the commonly used total IGF-I immunoassays. With the IGF-IR KIRA assay phosphorylation of tyrosine residues of the IGF-IR is used as read out to quantify IRSA in unknown (serum) samples. The IGF-IR KIRA assay gives information about net overall effects of circulating IGF-I, IGF-II, IGFBPs and IGFBP-proteases on IGF-IR activation and seems especially superior to immunoreactive total IGF-I in monitoring therapeutic interventions. Although the IRSA as measured by the IGF-IR KIRA assay probably more closely reflects true bioactive IGF-I than measurements of total IGF-I in serum, the IGF-IR KIRA assay in its current form does not give information about all the post-receptor intracellular events mediated by the IGF-IR. Interestingly, in several conditions in health and disease IRSA measured by the IGF-IR KIRA assay is considerably higher in interstitial fluid and ascites than in serum. This suggests that both the paracrine (local) and endocrine (circulating) IRSA should be measured to get a complete picture about the role of the IGF system in health and disease.
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Affiliation(s)
- Joseph A M J L Janssen
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, the Netherlands.
| | - Aimee J Varewijck
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, the Netherlands
| | - Michael P Brugts
- Department of Internal Medicine, Ikazia Hospital, Rotterdam, the Netherlands
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Ramshanker N, Aagaard M, Hjortebjerg R, Voss TS, Møller N, Jørgensen JOL, Jessen N, Bjerring P, Magnusson NE, Bjerre M, Oxvig C, Frystyk J. Effects of Prednisolone on Serum and Tissue Fluid IGF-I Receptor Activation and Post-Receptor Signaling in Humans. J Clin Endocrinol Metab 2017; 102:4031-4040. [PMID: 28945869 DOI: 10.1210/jc.2017-00696] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 09/08/2017] [Indexed: 02/13/2023]
Abstract
CONTEXT Short-term glucocorticoid exposure increases serum insulinlike growth factor I (IGF-I) concentrations but antagonizes IGF-I tissue signaling. The underlying mechanisms remain unknown. OBJECTIVE To identify at which levels glucocorticoid inhibits IGF-I signaling. DESIGN AND METHODS Nineteen healthy males received prednisolone (37.5 mg/d) and placebo for 5 days in a randomized, double-blinded, placebo-controlled crossover study. Serum was collected on days 1, 3, and 5, and abdominal skin suction blister fluid (SBF; ~interstitial fluid) was taken on day 5 (n = 9) together with muscle biopsy specimens (n = 19). The ability of serum and SBF to activate the IGF-I receptor (IGF-IR) (bioactive IGF) and its downstream signaling proteins was assessed using IGF-IR-transfected cells. RESULTS Prednisolone increased IGF-I concentrations and bioactive IGF in serum (P ≤ 0.001) but not in SBF, which, compared with serum, contained less bioactive IGF (~28%) after prednisolone (P < 0.05). This observation was unexplained by SBF concentrations of IGFs and IGF-binding proteins (IGFBPs) 1 to 4. However, following prednisolone treatment, SBF contained less IGFBP-4 fragments (P < 0.05) generated by pregnancy-associated plasma protein A (PAPP-A). Concomitantly, prednisolone increased SBF levels of stanniocalcin 2 (STC2) (P = 0.02) compared with serum. STC2 blocks PAPP-A from cleaving IGFBP-4. Finally, prednisolone suppressed post-IGF-IR signaling pathways at the level of insulin receptor substrate 1 (P < 0.05) but did not change skeletal muscle IGF-IR, IGF-I, or STC2 messenger RNA. CONCLUSION Prednisolone increased IGF-I concentrations and IGF bioactivity in serum but not in tissue fluid. The latter may relate to a STC2-mediated inhibition of PAPP-A in tissue fluids. Furthermore, prednisolone induced post-IGF-IR resistance. Thus, glucocorticoid may exert distinct, compartment-specific effects on IGF action.
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Affiliation(s)
- Nilani Ramshanker
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Maiken Aagaard
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Rikke Hjortebjerg
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
- Danish Diabetes Academy, DK-5000 Odense, Denmark
| | - Thomas Schmidt Voss
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Niels Møller
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, DK-8000 Aarhus C, Denmark
| | - Jens Otto Lunde Jørgensen
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, DK-8000 Aarhus C, Denmark
| | - Niels Jessen
- Research Laboratory for Biochemical Pathology, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Peter Bjerring
- Mølholm Research, Mølholm Private Hospital A/S, DK-7100 Vejle, Denmark
| | - Nils Erik Magnusson
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Mette Bjerre
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Claus Oxvig
- Department of Molecular Biology and Genetics, Faculty of Science & Technology, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Jan Frystyk
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
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Espelund US, Bjerre M, Hjortebjerg R, Rasmussen TR, Lundby A, Hoeflich A, Folkersen BH, Oxvig C, Frystyk J. Insulin-Like Growth Factor Bioactivity, Stanniocalcin-2, Pregnancy-Associated Plasma Protein-A, and IGF-Binding Protein-4 in Pleural Fluid and Serum From Patients With Pulmonary Disease. J Clin Endocrinol Metab 2017; 102:3526-3534. [PMID: 28911149 DOI: 10.1210/jc.2017-00033] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 07/11/2017] [Indexed: 01/02/2023]
Abstract
CONTEXT Members of the insulin-like growth factor (IGF) system are primarily produced in the liver and secreted into the circulation, but they are also produced, recruited, and activated locally in tissues. OBJECTIVE To compare activity and concentrations of IGF system components in pleural fluid and blood. DESIGN Pathological pleural fluid, secondary to lung cancer or nonmalignant disease, and matching blood samples were collected from 24 patients ages 66.7 to 81.9 years. METHODS IGF-related proteins and cytokine levels were measured by immunoassays or immunoblotting. Bioactive IGF was measured by an IGF-1 receptor phosphorylation assay. RESULTS Total IGF-1 concentration did not differ between the compartments, but concentrations of free IGF-1 and bioactive IGF were more than threefold higher in pleural fluid than in corresponding serum samples (P = 0.0004), regardless of etiology. Median pregnancy-associated plasma protein-A (PAPP-A) and interleukin (IL)-6 levels were increased 47-fold and 143-fold, respectively, in pleural fluid compared with plasma (P < 0.0001). PAPP-A and IL-6 concentrations correlated positively (r = 0.46; P = 0.02). In pleural fluid, levels of PAPP-A-generated IGF binding protein-4 fragments correlated inversely with that of stanniocalcin-2 (r ≤ -0.42; P ≤ 0.05), a PAPP-A inhibitor; such correlations were absent in plasma. CONCLUSION Pathological pleural fluid is characterized by increased in vitro IGF bioactivity and elevated concentrations of PAPP-A, an IGF-activating proteinase. Thus, the tissue activity of the IGF system may differ substantially from that of the circulating IGF system. The correlation between IL-6 and PAPP-A indicates that inflammation plays a role in promoting local tissue IGF activity.
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Affiliation(s)
- Ulrick Skipper Espelund
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Mette Bjerre
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Rikke Hjortebjerg
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
- Danish Diabetes Academy, DK-5000 Odense C, Denmark
| | - Torben Riis Rasmussen
- Department of Pulmonary Medicine, Aarhus University Hospital, DK-8000 Aarhus C, Denmark
| | - Anders Lundby
- Safety and GI Biology, Novo Nordisk A/S, Novo Nordisk Park, G9.S.17, DK-2760 Måløv, Denmark
| | - Andreas Hoeflich
- Institute of Genome Biology, Leibniz-Institute for Farm Animal Biology, D-18196 Dummerstorf, Germany
| | | | - Claus Oxvig
- Department of Molecular Biology and Genetics, Faculty of Science and Technology, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Jan Frystyk
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, DK-8000 Aarhus C, Denmark
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Coagulation Factors in the Interstitial Space. Protein Sci 2016. [DOI: 10.1201/9781315374307-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hatje LK, Richter C, Blume-Peytavi U, Kottner J. Blistering time as a parameter for the strength of dermoepidermal adhesion: a systematic review and meta-analysis. Br J Dermatol 2014; 172:323-30. [PMID: 25065915 DOI: 10.1111/bjd.13298] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2014] [Indexed: 01/02/2023]
Abstract
Skin ageing is associated with a flattening of the dermoepidermal junction and a less effective anchoring system, predisposing to bulla formation, trauma and shear-type injuries. An artificial and controlled technique for standardized dermoepidermal separation is the suction blister method, whereby the strength of dermoepidermal adhesion is characterized by blistering time. To identify and quantify influencing factors on blistering time in healthy humans. A search in the Medline and Embase databases (1946 to June 2014) and in reference lists was conducted. In total, results of 146 suction blister experiments in 3418 individuals reported in 59 publications were analysed. The median blister diameter was 6 mm (IQR 5-6) and the median suction pressure was -210 mmHg (IQR -200 to -300), resulting in a median blistering time of 75 min (IQR 48-120). In the multivariate model, skin temperature and age were the strongest predictors for suction blistering time (P < 0·001, R(2) adjusted = 0·707). This strong association between temperature and suction blistering indicates that the dermoepidermal junction loses its strength with increasing skin temperature. This finding supports the practice of skin and tissue cooling to prevent injuries. The increased vulnerability of the skin seems to exist irrespectively of applied mechanical loads. We conclude that blistering time is an important and clinically relevant (outcome) parameter measuring the structural and mechanical integrity of deeper cutaneous layers.
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Affiliation(s)
- L K Hatje
- Charité-Universitätsmedizin, Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117, Berlin, Germany
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Vestergaard PF, Hansen M, Frystyk J, Espelund U, Christiansen JS, Jørgensen JOL, Fisker S. Serum levels of bioactive IGF1 and physiological markers of ageing in healthy adults. Eur J Endocrinol 2014; 170:229-36. [PMID: 24179101 DOI: 10.1530/eje-13-0661] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Senescent changes in body composition and muscle strength are accompanied by reduced production of GH and IGF1, but the causal relationship remains elusive. We speculate that serum bioactive IGF1, measured by the IGF1 kinase receptor activation assay, is closer related to human physiological ageing than total IGF1 measured by immunoassay. DESIGN We conducted a cross-sectional study in 150 adult males and females, between 20 and 70 years. After an overnight fasting, serum levels of bioactive IGF1, total IGF1 and IGF-binding protein 1 (IGFBP1) and IGFBP3 were assessed. Furthermore, body composition and muscle strength was measured. RESULTS Total IGF1 levels were higher in females (P=0.048). Bioactive IGF1 were identical in males and females (P=0.31), decreasing with age. Total IGF1 tended to decrease more with age compared with bioactive IGF1 (-1.48 vs -0.89 percent/year, P=0.052). Total body fat (TBF) was lower and BMI was higher in males (P<0.001 and P=0.005), and both increased with age. Knee extension and elbow flexion force were higher in males (P=0.001 and P=0.001), but decreased with age in both genders. Total but not bioactive IGF1 was positively correlated to TBF, knee extension and muscle function in males. In multiple linear regression, only age predicted total IGF1, whereas age and IGFBP1 predicted bioactive IGF1. CONCLUSIONS Bioactive IGF1 tends to decrease to a lesser extent than total IGF1 with age and was not correlated with measures of body composition or muscle strength. Therefore, levels of circulating bioactive IGF1 does not appear to be a better biomarker of physiological ageing than total IGF1.
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Affiliation(s)
- Poul Frølund Vestergaard
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark
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Abstract
The worldwide clinical and scientific interest in peptides belonging to the insulin-like growth factor (IGF) system has brought along a call for standardization of assays used to quantify the different IGF related proteins. This relates in particular to the measurement of IGF-I, which has stood the test of time as an important biochemical tool in the diagnosis and treatment of growth hormone (GH) related disorders. The first international consensus statement on the measurement of IGF-I in 2011 represents an important milestone and will undoubtedly improve commutability of reference ranges for IGF-I and clinically applicable cut-off values. By contrast, there is no consensus addressing the measurements of the other IGF-related peptides. Nevertheless, measurement of these peptides may be of interest, either as additional tools in GH disorders or as prognostic biomarkers of various diseases. Therefore, standardization of assays for the other IGF-related peptides is highly relevant. This chapter discusses the recent consensus on IGF-I measurements and how this approach may be applied to measurement of the other IGF-related peptides. In addition, assay pitfalls, pre- and post-analytical challenges, alternative methods for IGF-I measurements and potential assays of tomorrow will be discussed.
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Affiliation(s)
- Rikke Hjortebjerg
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, DK-8000 Aarhus C, Denmark
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Hjortebjerg R, Flyvbjerg A, Frystyk J. Insulin growth factor binding proteins as therapeutic targets in type 2 diabetes. Expert Opin Ther Targets 2013; 18:209-24. [PMID: 24261835 DOI: 10.1517/14728222.2014.858698] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The signaling pathways of the insulin-like growth factors (IGFs) have been implicated in the aetiology of type 2 diabetes (T2D) and a number of therapeutic modalities aiming at the IGF-axis have been considered. Administration of IGF-I has been reported to improve insulin sensitivity in healthy subjects and patients with T2D. In recent years, the IGF binding proteins (IGFBPs) have also been associated with metabolic disorders, prompting the idea that IGFBPs play important roles in the pathogenesis of T2D. Thus, by virtue of their role in the regulation of IGF effects, the IGFBPs have emerged as potential biomarkers and therapeutic targets in metabolic syndromes and T2D. AREAS COVERED The article provides an overview on recent findings in clinical and experimental IGFBP-research and addresses the studies that have investigated the potentials of the IGFBPs as therapeutic targets in T2D. EXPERT OPINION There is plenty of therapeutic promise within the IGF system, but further understanding of the IGFs in T2D is necessary to avoid off-target effects. Strong evidence supports the use of IGFBPs as therapeutic targets in the treatment of T2D, and it is not difficult to foresee the use of IGFBPs as part of a combination therapy alongside other anti-diabetic drugs.
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Affiliation(s)
- Rikke Hjortebjerg
- Aarhus University, Department of Clinical Medicine, Medical Research Laboratory, Faculty of Health , DK-8000 Aarhus C , Denmark
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