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IGF-1 may lower apoptosis rates in intra-articular fractures

Results of an animal study suggest IGF-1 may have a potential in preventing post-traumatic arthritis, but more research remains.

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Insulin-like growth factor-1 may block chondrocyte apoptosis, a process that some researchers believe may influence post-traumatic arthritis, results of an animal study suggest.

Researchers at the University of Utah found that rabbits injected with insulin-like growth factor-1 (IGF-1) after fracture repair had significantly lower apoptosis rates up to 4 weeks post-injection compared to control rabbits, according to Thomas F. Higgins, MD, one of the study authors and an assistant professor at the university.

"In the future, this kind of technology may hold some promise for the clinical treatment of intra-articular fractures," he said during a presentation at the Orthopaedic Trauma Association annual meeting.

Higgins and colleagues created medial femoral intra-articular fractures in 24 skeletally mature New Zealand White rabbits. The researchers subsequently treated all animals with open reduction and internal fixation along with placement of a fibrin clot either alone or containing 25 µg/mL of IGF-1.

Half of the animals were sacrificed after 2 weeks, with the remaining animals sacrificed at 4 weeks. Investigators then used TUNEL staining to detect chondrocyte apoptosis, according to the study.

The researchers found that all fractures had healed. However, animals treated with IGF-1 had significantly lower rate of apoptosis at 2 weeks, averaging 12% compared to 21% for control animals (P=.04). Apoptosis was also significantly lower among IGF-1-treated animals at 4 weeks and averaged 10% compared with 23% for control animals (P=.01), according to the study.

The research suggests that IGF-1 may have a potential role in preventing post-traumatic arthritis, Higgins said.

"We hope to learn about the potential role for IGF-1 in improving outcomes of articular fractures. And if it is in fact helpful, then [to determine] what is the optimal timing and application of this intervention," he said.

For more information:

• Higgins TF, Johnson BD. Effect of IGF-1 on chondrocyte apoptosis in a rabbit intra-articular fracture model. #44. Presented at the Orthopaedic Trauma Association 22nd Annual Meeting. Oct. 4-7, 2006. Phoenix.