Abstract

Introduction: Acromegaly is characterized by growth hormone (GH) and Insulin-like Growth Factor 1 (IGF1) excess and is accompanied by an increased cardiovascular diseases (CVD) risk. As innate immune responses are crucial in CVD development, and IGF1 is linked to subclinical inflammation, we hypothesized that GH/IGF1 excess contributes to CVD development via potentiating systemic inflammation. We aimed to assess the effects of GH/IGF1 on inflammatory cytokine production.

Methods: Whole blood from acromegaly patients and healthy volunteers, and peripheral blood mononuclear cells (PBMC) from healthy volunteers were stimulated with Toll-like receptor (TLR) ligands, with or without adding GH or IGF1 (in PBMC). Cytokine concentrations were measured by ELISA. The underlying signalling pathways were investigated by inhibition of downstream targets of the IGF1 receptor.

Results: GH or IGF1 alone did not influence cytokine production in PBMCs. GH did not affect TLR-induced cytokine production, but co-stimulation with IGF1 dose-dependently increased the TLR ligand-induced production of IL6 (P<0.01), TNF alpha (P=0.02), and IFNg (P<0.01), as well as the production of the anti-inflammatory cytokine IL10 (P=0.01). IGF1 had no effect on IL1B, IL17 and IL22 production. Inhibition of the MAPK pathway, but not mTOR, completely abrogated the synergistic effect of IGF1 on the LPS-induced IL6 and TNF alpha production. In whole blood of acromegaly patients, ex vivo IL6 production was increased (P<0,01).

Conclusion: IGF1, but not GH, has pro-inflammatory effects, probably via the MAPK signalling pathway and might be involved in the pathogenesis of atherosclerosis in acromegaly. The increased IL10 production possibly counteracts the pro-inflammatory effects.