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Endocrinology Vol. 140, No. 11 5178-5184
Copyright © 1999 by The Endocrine Society


ARTICLES

Insulin-Like Growth Factor I Is Essential for Postnatal Growth in Response to Growth Hormone

Jun-Li Liu1 and Derek LeRoith

Clinical Endocrinology Branch, The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892-1758

Address all correspondence and requests for reprints to: Dr. Derek LeRoith, CEB/National Institute of Diabetes and Digestive and Kidney Diseases, Building 10, Room 8D12, National Institutes of Health, 10 Center Drive, Bethesda, Maryland 20892-1758. E-mail: Derek{at}helix.nih.gov


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Insulin-like growth factor I (IGF-I) is essential for cell growth and intrauterine development while both IGF-I and GH are required for postnatal growth. To explore the possibility of direct GH action on body growth, independent of IGF-I production, we have studied the effects of GH in an IGF-I-deficient mouse line created by the Cre/loxP system. The IGF-I null mice are born with 35% growth retardation and show delayed onset of peripubertal growth, grow significantly slower, and do not attain puberty. Their adult body weight was approximately one third and body length about two thirds that of their wild-type litter mates. Injection of recombinant human GH (rhGH, 3 mg/kg, twice daily, sc) between postnatal day 14 (P14) to P56 failed to stimulate their growth as measured as both body weight and length. In contrast, wild-type mice receiving the same doses of rhGH exhibited accelerated growth starting at P21 that continued until P56, when their body weight was increased by 30% and length by 12% compared with control mice treated with diluent. Despite the lack of response in growth, IGF-I null mice have normal levels of GH receptor expression in the liver and increased liver Jun B expression and liver size in response to rhGH treatment. Our results support an essential role for IGF-I in GH-induced postnatal body growth in mice.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
GH IS a small protein hormone of 191 amino acids that causes growth of almost all tissues of the body by increasing cell size and cell number and by promoting differentiation of bone and muscle cells (1). Deficiency in either GH or the GH receptor causes severe postnatal growth retardation and proportionate dwarfism in humans and mice (2, 3). Insulin-like growth factor I (IGF-I), expressed by many cells and tissues throughout development, is an essential factor in cell growth, intrauterine development, and postnatal growth (4, 5, 6, 7). IGF-I deficiency in humans and mice causes severe intrauterine and postnatal growth retardation, perinatal lethality, and developmental defects in the bone, muscle, and reproductive systems.

Several modes of GH action on postnatal body growth have been proposed (8, 9). GH may act on a major target organ, namely the liver, to stimulate the synthesis and secretion of IGF-I, which reaches its skeletal targets as a true endocrine reagent (the somatomedin hypothesis) (10). GH may stimulate longitudinal bone growth directly through local production of IGF-I (modified somatomedin hypothesis) (11, 12, 13). In addition, GH may have a direct mitogenic action on target tissues such as the chondrocyte precursor cells, or GH action may be mediated by growth factors other than IGF-I (14, 15, 16). For example, GH was found to stimulate synthesis of the bone morphogenetic proteins in the presence of IGF-I antiserum (14). A recent report from our laboratory has demonstrated that liver-derived "endocrine" IGF-I is not essential for postnatal growth and has challenged the classical somatomedin hypothesis (17). In this study, to test the direct effect of GH, we created viable dwarf mice with IGF-I deficiency by the Cre/loxP system and studied the effect of GH administration on their body growth. Our results demonstrate an essential role for IGF-I in GH-induced postnatal body growth in mice and hence support the modified somatomedin hypothesis.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Animal production
IGF-I null mice were generated while studying EIIa-cre-induced gene recombination in IGF-I floxed (flanked by loxP repeats) mice (18). Briefly, mice (F1) carrying one allele of igf-1/flox and EIIa-cre transgene (L/+, Cre/+) were intercrossed to generate homozygous igf-1/flox mice that were also EIIa-cre positive (F2, L/L, Cre/+) (Fig. 1Go). At that stage, Cre-induced recombination of the igf-1 locus had occurred (18). F2 mice were further intercrossed to generate mice (F3, L/-) with an allele of igf-1/flox and an allele of igf-1 null (germ line transmission from F2) which had segregated the Cre transgene. These L/- mice were assigned to multiple mating pairs to generate IGF-I null (-/-) mice. Among the three genotypes generated [L/L, L/-, and -/-] and used in the current study, L/L and L/- are virtually normal in IGF-I gene expression, development, and growth and are treated as wild-type mice. On the other hand, -/- (IGF-I null) mice have no IGF-I expression and demonstrate a severe defect in intrauterine development and postnatal growth. The animals were kept in a designated breeding room and were observed closely throughout the experiment. Genotyping by PCR and Southern blot analysis has been reported (18). The Animal Care and Use Committee of the NIDDK, National Institutes of Health (Bethesda, MD) approved all of the animal manipulations.



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Figure 1. Breeding strategy for the production of IGF-I null mice. See details in text of Animal Production in Materials and Methods.

 
Growth response to GH
Wild-type (WT) and IGF-I null mice were treated with recombinant human GH (rhGH, Genentech, Inc., South San Francisco, CA), 3 mg/kg twice daily, sc, from postnatal day 14 (P14) to P56. Control mice of both genotypes received an equal volume of normal saline (diluent). Their body weights were measured daily. At the end of the study (8 weeks of age), mice were anesthetized using 0.2% avertin and bled via periorbital puncture; their body length (nose to anus) was measured, and organs (brain, heart, liver, kidney, and spleen) were removed and weighed. Liver RNA was extracted, using RNAzol B reagent (Tel-Test, Friendswood, TX), to determine the level of GH receptor messenger RNA (mRNA) using ribonuclease (RNase) protection assay.

Effect of GH on Jun B gene expression
To study the effect of GH on the expression of immediate early genes, liver expression of Jun B mRNA was analyzed. Mice of wild-type and knockout genotypes, at 6 weeks of age, were fasted overnight and injected with rhGH (3 mg/kg, ip) or diluent. After 30 min, they were anesthetized and bled. Total RNA was extracted from the liver to determine the level of Jun B mRNA by RNase protection assay.

RNase protection assay
The expression of IGF-I from various tissues and expression of Jun B and GH receptor from the liver were studied using the RNase protection assay (19). 32P-labeled riboprobes were made from mouse IGF-I exon 4 (18), pTRI-Jun (B)-mouse (Ambion, Inc., Austin, TX), and mouse GH receptor exon 4 (BamHI/AvaI fragment, provided by Dr. John J Kopchick, Ohio University, Athens, OH) (2).

Hormone assay, serum chemistry, and statistics
The serum concentration of total IGF-I (Diagnostics Systems Laboratories, Inc. Webster, TX), insulin (Linco, St-Charles, MO), and GH (Amersham Pharmacia Biotech, Arlington Heights, IL) were determined by RIA kits available commercially. Glucose was measured with a Glucometer Elite (Bayer Corp., Elkhart, IN). Serum chemistry was performed by the Pathology Department at the Clinical Center of the NIH. Statistical significance was determined by the two-tailed t test using the program SigmaStat 2.03 (Access Softek, Inc., San Rafael, CA).


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Characterization of the IGF-I deletion mutant
To study IGF-I-independent, direct GH action on body growth, we generated IGF-I null mice by inbreeding multiple pairs of L/- mice (with an allele of igf-1/flox and an allele of igf-1 null) (Fig. 1Go). Southern blot analysis was performed on tail DNA to identify the genotype of the offspring (data not shown). RNase protection assay on several tissues was employed to assess the level of IGF-I gene expression and serum IGF-I level was determined by RIA. As shown in Fig. 2Go, wild-type mice have varying amounts of IGF-I mRNA in the liver, heart, and kidney, while IGF-I null mice have undetectable IGF-I mRNA. Their circulating IGF-I concentration was below the detection limit (Table 1Go). As such, the gene deletion was confirmed at the level of tissue DNA, mRNA, and circulating peptide.



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Figure 2. IGF-I gene expression in wild-type (lanes 1–4) and IGF-I null mice (lanes 5–8). Total RNA was prepared from liver (10 µg), heart (50 µg), and kidney (10 µg) of adult mice and analyzed by RNase protection assay using probes for IGF-I exon 4 and 18S ribosome RNA.

 

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Table 1. Changes in serum chemistry in IGF-I null mice

 
As a consequence of a diminished negative feedback control by IGF-I, we anticipated finding an increased release of GH from the pituitary in IGF-I null mice. Indeed, in 5-week-old mice, serum GH concentration increased 12.4-fold (Table 1Go). Consistent with GH hypersecretion, adult IGF-I null mice show specific and significant increases in the relative weight of the following organs: brain (+113%), liver (+41%), heart (+37%), and kidney (+21%). No change was found in the weight of the spleen (Table 2Go).


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Table 2. Changes of organ weight (as a % of body weight) and body length (in cm) after 6-week course of rhGH treatment

 
The serum glucose level (24 h fasted) in IGF-I null mice was decreased by 50% (P < 0.001), whereas serum insulin concentrations tended to be higher in these mice (Table 1Go). This finding is similar to a report on severe IGF-I deficient (midi) mice created by an insertional mutation (20). In the standard serum chemistry assay, there was a dramatic 58% reduction in alkaline phosphatase (Table 1Go), associated with the reduction in bone growth.

Postnatal survival and growth rates
While the overall phenotype of the IGF-I null mice generated in this study remains similar to those previously reported (4, 7), demonstrating severe defects in prenatal development and postnatal growth, our IGF-I null mice demonstrate improved postnatal survival rate, which enables a more detailed postnatal study. At birth, viable IGF-I null pups weigh 65% of their wild-type litter mates, which decreased to 50% after 2 weeks, and then the growth curve flattened and body weight decreased to approximately 30% of wild-type litter mates as adults (Fig. 3Go). Thus, while IGF-I is essential for both intrauterine and postnatal development, the growth defect becomes more profound postnatally.



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Figure 3. Postnatal growth curves of IGF-I null vs. wild-type mice. The average body weight vs. age of the wild-type (n >= 7) and IGF-I null (n >= 9) mice were plotted. The differences between these two groups are statistically significant at all time points (P < 0.001). To ensure adequate postweaning survival, IGF-I null mice were weaned at 5 weeks while wild-type mice were weaned at 3 weeks of age.

 
A study of 27 mating pairs and 116 litters revealed that IGF-I null pups were born at a ratio of 18.5%, which is lower than the expected 25%. With 639 pups of L/L and L/- genotypes (expected combined ratio 75%), there should be 213 (25%) of IGF-I null pups born. Instead, we received only 145, representing a possible 31% prenatal lethality. Of those delivered, many die within 24 h, resulting in a postnatal survival rate of 42% (Table 3Go). This rate is relatively high but within the reported range (5% in C57BL/6J, 10% in 129/sv, 16% in C57BL/6J and 129/sv mix, and 68% in MF1 and 129/sv mix) (4, 7).


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Table 3. Birth statistics of IGF-I null pups from 116 litters by 27 mating pairs

 
Effect of GH on postnatal growth
The effect of GH on body growth was studied in wild-type and IGF-I null mice by injecting rhGH from 2 to 8 weeks of age. In wild-type mice, we observed two phases of postnatal growth: an early phase of rapid growth in the first 2–3 weeks of life, which cannot be further stimulated by GH injection (data not shown), and a peripubertal growth spurt from 3 weeks, which can be further increased by GH injection (Fig. 4Go). From 2 weeks on, the IGF-I null mice grow more slowly and have delayed onset of the prepubertal growth and do not undergo pubertal changes. Their final body weight becomes approximately one third and body length about two thirds of their wild-type litter mates as adults. As shown in Fig. 4Go and Table 2Go, continuous injection of rhGH did not affect their growth rate at all, when measured both by weight and length. In contrast, wild-type mice receiving the same doses of rhGH exhibited accelerated growth starting at P21 and continuing to P56, where they showed a 29% increase in body weight and 12% in body length in comparison to those treated with diluent alone.



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Figure 4. Postnatal growth curves of IGF-I null and wild-type mice treated with rhGH. As in Fig. 3Go, the mean body weight was plotted against the age in weeks. Wild-type mice: n = 7, *, P < 0.05; **, P < 0.01. IGF-I null mice: n = 9–10.

 
Changes in organ weight caused by IGF-I deficiency and GH injection
At the end of the 6-week injection, we measured the weight of several organs. In wild-type mice, GH induced a significant, 27% increase in relative liver weight, decreased the relative weight of the brain (-20%) and kidney (-22%) (due to the increase in body weight, because the absolute weights of organs other than liver were unchanged), but had no effect on the relative weight of the heart and the spleen (Table 2Go). As stated earlier, IGF-I null mice have enlarged brain, liver, heart, and kidney and GH injection caused a further increase of 16% in liver weight (P < 0.05) (Table 2Go). Therefore, GH induced liver enlargement despite the IGF-I deficiency.

GH receptor expression in the liver
To exclude the possibility that the lack of growth responsiveness to GH is due to a decrease in GH receptor expression in the face of IGF-I deficiency, we performed RNase protection assays from mouse liver at the end of the period of GH injections. As shown in Fig. 5Go, hepatic GH receptor mRNA level was affected neither by IGF-I deficiency nor by GH treatment.



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Figure 5. Levels of hepatic GH receptor-mRNA in wild-type and IGF-I null mice after a 6-week treatment with or without rhGH. Total liver RNA (50 µg) was hybridized to probes containing exon 4 of the GH receptor gene and 18S ribosomal RNA (rRNA). A representative blot is illustrated from a study of seven wild-type and five IGF-I null mice treated and untreated with GH. No significant variation was revealed by densitometry analysis.

 
Effect of GH on Jun B expression in the liver
In addition to chronic effects on body growth, GH induces immediate early gene expression (including Fos, Jun, and Jun B) (21, 22). After injection of a single dose (3 mg/kg) of rhGH to overnight fasted, 6-week-old mice, we measured hepatic Jun B-mRNA levels at 30 min. GH stimulated Jun B expression by about 2.9-fold in the wild-type as well as in the IGF-I null mice (Fig. 6Go). Thus, GH actions (on Jun B expression and liver enlargement) are not affected by IGF-I deficiency. It further demonstrates that GH was functional in IGF-I null mice although it failed to increase body growth.



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Figure 6. Effect of acute rhGH injection on hepatic Jun B expression. Mice (6 weeks of age) were injected with a single dose of GH (3 mg/kg) for 30 min, and liver total RNA was isolated and subject to RNase protection assay with probes for Jun B and 18S ribosomal RNA (rRNA). A representative blot was illustrated from two experiments. Despite lack of IGF-I, Jun B expression was stimulated approximately 2.9-fold by GH in mice of both genotypes.

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
The current study used mice with IGF-I gene deficiency similar to those described in two previous reports (4, 7), although the target region used is unique due to the removal of the selection marker and different genetic strains of mice studied. We have replaced the entire exon 4 with a loxP site, representing a larger portion of the gene, rather than targeting only a part of the exon or exon 3 (4, 7, 18). The neomycin gene cassette was removed by Cre expression, because of concerns that it may interfere with the cognate intron/exon structures and create a microenvironment of gene activity. The adverse effect caused by the selection marker gene used in gene targeting has been reported (23, 24). In addition, our mice were bred on a mixed genetic background of 129/sv, C57BL/6J, and FVB/N, which may also add to some different aspects of the phenotype described below.

In addition to the previously reported phenotype of pre- and postnatal growth retardation, perinatal lethality, and infertility, in our IGF-I-deficient mice, we propose a 30% prenatal lethality, which suggests that some IGF-I null fetuses did not survive due to developmental retardation. We further demonstrate, in these IGF-I null mice, GH-resistant dwarfism and marked serum GH elevation. In addition, there is enlargement of multiple organs (brain, liver, kidney, and heart). Finally, IGF-I null mice have normal liver GH receptor expression and liver Jun B response to GH.

The rate of growth retardation of the IGF-I null mice started at 35% at birth and worsened to approximately 65% as adults, in terms of body weight. This may indicate that the fetal development of the IGF-I null mice is partially compensated by IGF-I produced from the placenta or possibly the presence of IGF-II and insulin. The placenta produces a large number of hormones, including GH, IGF-I, and IGF-II, that may reach the fetus (25, 26). Deficiency in either IGF-II or insulin contributes to intrauterine growth retardation. Birth weights of IGF-II knockout mice are 60% and IGF-I/II double knockout are only 30% of their wild-type litter mates (27, 28), while insulin-1 and -2 double knockouts also induce 15–20% growth retardation in mouse embryos (29). After birth, a further growth retardation was observed, since the pups were no longer influenced by placental IGF-I, mouse IGF-II level diminishes quickly, and the role of insulin on postnatal growth is apparently very limited (29).

According to the somatomedin hypothesis, production of IGF-I from the liver and other tissues is regulated by GH release from the pituitary. Like many other physiological systems, overproduction of IGF-I sends a signal to inhibit GH production via a long loop (involving GHRH and somatostatin) and a short loop (directly on somatotrophs) negative feedback mechanism (30, 31, 32). It is well established that exogenous IGF-I, when administered in vivo, suppresses GH secretion, while IGF-I deficiency is accompanied by GH hypersecretion (20, 23, 33). In a separate study, when IGF-I production was abolished exclusively from the liver (using albumin-Cre/loxP system), we effectively decreased serum IGF-I level by 75% without affecting the growth and development of extrahepatic tissues. Serum GH increased 6.4-fold in these mice, suggesting that circulating IGF-I affects GH secretion (17). The current study abolished both endocrine and paracrine IGF-I production and thereby increased serum GH level even further to 12.4-fold. The fold increase in serum GH concentration correlates well with serum IGF-I levels under these circumstances. Therefore, our studies demonstrate the presence of a potent negative feedback on GH secretion by IGF-I.

A central issue in the somatomedin hypothesis is that GH acts through IGF-I production from the liver or local tissues in stimulating body growth. There have been suggestions that GH exerts some direct effects on target tissues that are not mediated by IGF-I (15, 16, 25, 34). The current study demonstrates that IGF-I null mice are selectively resistant to GH in terms of body growth, directly confirming that GH works exclusively via IGF-I production in this aspect. This is consistent with an earlier report on the ineffectiveness of GH on weight gain of IGF-I null mice (35). As for the role of IGF-I in the circulation or as a paracrine growth factor, our study on liver-specific IGF-I gene deletion demonstrated that liver-derived endocrine IGF-I is not essential for postnatal growth (17, 36). These studies, as well as those by other investigators (37), demonstrate that IGF-I, most probably produced by nonhepatic tissues, is essential for GH-stimulated postnatal growth.

One exception to the above conclusion is that the profound defect in development and metabolism caused by IGF-I deficiency may have impaired the ability of GH and its other growth mediators to promote body growth. To address this question, we have demonstrated that IGF-I null mice have normal levels of GH receptor mRNA in the liver and that rhGH caused a significant increase in liver size. Furthermore, in an acute experiment, we tested the effect of rhGH on liver Jun B expression. Early response genes encode for transcription factors including Fos, Jun, Jun B, and Myc, which can be induced by GH and are involved in activating DNA synthesis, downstream gene expression, and cell proliferation (21, 22). As expected, Jun B expression was activated within 30 min of an in vivo rhGH injection in wild-type mice. The response in IGF-I null mice was virtually identical, further demonstrating the presence of a functional GH signaling system. The current study therefore does not support direct GH action on growth and indicates that those IGF-I-independent mechanisms of GH at least in mice, are not involved in body growth regulation.

Defects in GH receptor or downstream targets (such as STAT5b, HNF-1{alpha}, and IGF-I) cause GH insensitivity (GHIS) or Laron Syndrome. Patients with GH receptor gene mutations show normal prenatal development, severe postnatal growth retardation, high serum GH, and low levels of serum IGF-I that cannot be corrected by GH injection (38). A second class of Laron type dwarfism, induced by HNF-1{alpha} deficiency in mice, demonstrates normal GH receptor level, elevated serum GH, and diminished IGF-I and insulin concentrations (23). These HNF-1{alpha} null mice are viable and sterile and develop non-insulin-dependent diabetes mellitus. Deficiency in STAT5b (signal transducer and activator of transcription 5b), another transcription factor downstream of GH, also causes Laron type of dwarfism with virtually identical features to HNF-1{alpha} (hepatocyte nuclear factor 1{alpha}) null mice (39). Defects in IGF-I production are rare, probably due to intrauterine lethality. The only case of IGF-I deficiency reported features growth failure before and after birth, high GH level, and resistance to GH treatment (6). In agreement with the report on patients, our data demonstrate a dramatic increase in serum GH level and the inability of GH to promote body growth in the face of IGF-I deficiency. It clearly defines a new class of GH-resistant dwarfism (similar to GHIS) and proves that IGF-I is essential for GH-stimulated postnatal growth. This mouse model provides a valuable tool with which to explore the relationship of the GH-IGF-I axis and to provide therapeutic modalities to treat such dwarfism.

The finding of multiple organ enlargement (relative weight) in IGF-I null mice is an extension of previously observed weight increases of the brain and the liver and may be the result of a sustained GH hypersecretion (7, 40). To exclude the influence of an overall change in body weight, we expressed the organ weight as per body weight and found that IGF-I null mice have a 21–113% increase in the weight of the kidney, heart, liver, and brain. GH further induced changes in both wild-type and IGF-I null mice. In wild-type mice, chronic rhGH administration increased the weight of the liver by 27% but decreased the relative weights of the brain and the kidney. In IGF-I null mice, a 15% increase in liver weight, caused by GH treatment, and no change in other organs were observed.

The relationship of GH with organ growth has been well studied. For example, prolonged excessive secretion of GH by GH3 tumor cells in rats induced widespread visceromegaly affecting the liver, kidney, spleen, heart, and adrenals that was associated with an increase in DNA synthesis (41); transgenic mice overexpressing GH have selective splanchnomegaly coupled with glomerular sclerosis and hepatomegaly (42); pulsatile administration of GH in broiler pullets induced hepatomegaly due largely to cellular hypertrophy (43); and GH-transgenic mice have accelerated liver, kidney, and skeletal growth (44). Because the IGF-I null mice have no IGF-I production and a marked increase in GH secretion, we propose an IGF-I-independent, direct GH action on hepatocyte growth and proliferation under conditions of both IGF-I-deficient status and when GH was exogenously administered.

Analysis of a standard serum chemistry profile revealed a marked decrease in alkaline phosphatase and glucose concentrations among IGF-I null mice. Alkaline phosphatase from the bone and other tissues is essential for normal skeletal mineralization and growth (45, 46, 47). IGF-I has been found to influence alkaline phosphatase activity as part of the mechanism of stimulating bone formation. For example, locally infused IGF-I into mouse femurs can stimulate expression of alkaline phosphatase and bone formation; the age-dependent decline in bone formation can be attributed in part to a decline in local IGF-I expression and response (48); and IGF-I stimulates alkaline phosphatase activity and type I procollagen mRNA expression in osteoblastic cells in vitro (49). The current study demonstrates severe hypophosphatasia due to IGF-I deficiency and suggests that alkaline phosphatase activity may be an important downstream target of IGF-I action on postnatal skeletal growth.

In conclusion, using the Cre/loxP system, we have generated IGF-I null mice that have a 42% postnatal survival rate and enable an in-depth postnatal study. These mice exhibited multiple organ enlargement accompanied by decreased serum alkaline phosphatase and glucose concentrations. The increase in serum GH concentration and failure of GH in stimulating body growth in these IGF-I null mice clearly demonstrate GH resistance (with respect to body growth) and the role of IGF-I in feedback control of GH secretion.


    Acknowledgments
 
The authors wish to thank Dr. John Kopchick (Ohio University, Athens, OH) for providing the GH receptor probe; Dr. Peter Rotwein (Oregon Health Sciences University, Portland, OR) for the IGF-I exon 4 probe; Bernice Samuels (NIDDK, NIH, Bethesda, MD) for performing insulin RIA; Genentech, Inc. (South San Francisco, CA) for providing the rhGH; and Drs. Matthew Rechler, Mark Sperling, Michael Karas, Liliana Uribe, and David Kleiner for helpful communications.


    Footnotes
 
1 Supported by a fellowship from the Medical Research Council of Canada. Back

Received June 10, 1999.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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