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7 1) Zapf J, Walter H and Froesch ER: Radioimmunological determination of insulin-like growth factors I and II in normal subjects and in patients with growth disorders and extrapancreatic tumor hypoglycemia. J Clin Invest (1981) 68, ) Humbel RE: Insulin-like growth factors I and II. Eur J Biochem (1990) 190, ) Zapf J, Schonle E and Froesch ER: Insulin-like growth factors I and II: Some biological actions and receptor binding characteristics of two purified constituents of non-suppressible insulin-like activity of human serum. Eur J Biochem (1978) 87, ) Lindahl A, Isgaard J and Carlsson L: Differential effects of growth hormone and IGF-I on colony formation of epiphyseal chondrocytes in suspension culture in rats of different ages. Endocrinology (1987) 121, ) Ernst M and Rodan GA: Increased activity of insulin-like growth factor (IGF) in osteoblastic cells in the presence of growth hormone (GH): positive correlation with the presence of GH-induced IGF-binding protein-3. Endocrinology (1990) 127, ) Mohan S, Bautista CM, Wergedal JE and Baylink DJ: Isolation of an inhibitory insulin-like growth factor (IGF) binding protein from bone cell-conditioned medium: a potential local regulator of IGF action. Proc Natl Acad Sci USA (1989) 86, ) La Tour D, Mohan S, Linkhart TA, Baylink DJ and Strong DD: Inhibitory insulin-like growth factor-binding protein: Cloning, complete sequence, and physiological regulation. Mol Endocrinol (1990) 4, ) Kiefer MC, Masiarz FR, Bauer DM and Zapf J: Identification and molecular cloning of two new

8 30 kda insulin-like growth factor binding proteins isolated from adult human serum. J Biol Chem (1991) 266, ) Rosen C, Donahue LR, Hunter S, Holick M, Kavookjian H, Kirschenbaum A, Mohan S and Baylink DJ: The 24/25-kDa serum insulin-like growth factor-binding protein is increased in elderly women with hip and spine fractures. J Clin Endocrinol & Metab (1992) 74, ) Scharla SH, Strong DD, Rosen C, Mohan S, Holick M, Baylink and Linkhart TA: 1,25 - Dihydroxyvitamin D3 increases secretion of insulin-like growth factor binding protein-4 (IGFBP-4) by human osteoblast-like cells in vitro and elevates IGFBP-4 serum levels in vivo. J Clin Endocrinol & Metab (1993) 77, ) Shimasaki S, Gao L, Shimonaka M and Ling N: Isolation and molecular cloning of insulin-like growth factor-binding protein-6. Mol Endocrinol (1991) 5, ) Malpe S, Strong DD, Baylink DJ and Mohan S: Stimulation of human bone cell proliferation by an antisense oligodexyribonucleotide to IGFBP-4 mrna. J Bone Miner Res (1992) 7 (Suppl. 1), S ) Cheung PT, Smith EP, Shimasaki S, Ling N and Chernausek SD: Characterization of an insulin like growth factor binding protein (IGFBP-4) produced by B104 rat neuronal cell line: chemical and biological properties and differential synthesis by sublines. Endocrinology (1991) 129, ) Culouscou JM and Shoyab M: Purification of a colon cancer cell growth inhibitor and its identifica tion as an insulin-like growth factor binding protein. Cancer Res (1991) 51, ) Chen TL, Liu F, Bates RL and Hintz RL: Further characterization of insulin-like growth factor binding proteins in rat osteoblast-like cell culture: modulation by 17ƒÀ-estradiol and human growth hormone. Endocrinology (1991) 128, ) Greenberg C, Kukreja SC, Bowser EN, Hargis GK, Henderson WJ and Williams GA: Parathyroid hormone secretion: effect of estradiol and progesterone. Metabolism (1987) 36, ) Torring O, Firek AF, Heath HIII and Conover CA: Parathyroid hormone and parathyroid hormone related peptide stimulate insulin-like growth factor-binding protein secretion by rat osteoblast-like cells through a adenosine 3 L,5 L-monophosphate-dependent mechanism. Endocrinology (1991) 128, ) Mohan S and Baylink DJ: Evidence that the inhibition of TE85 human bone cell proliferation by agents which stimulate camp production may in part be mediated by changes in the IGF-II regulatory system. Growth Regulation (1991) 1, ) Lee K, Mohan S, Baylink DJ and Strong DD: Evidence for transcriptional regulation of insulin-like growth factor binding protein-4 (IGFBP-4) gene in human bone cells. J Bone Miner Res (1992) 7 (Supple. 1), ) Scharla SH, Strong DD, Mohan S, Baylink DJ and Linkhart TA: 1, 25-Dihydroxyvitamin D3 differentially regulates the production of insulin-like growth factor (IGF-I) and IGF-binding protein -4 in mouse osteoblast. Endocrinology (1991) 129, ) Mohan S, Strong DD, Lempert UG, Wergedal JE and Baylink DJ: Studies on regulation of insulin-like growth factor binding protein (IGFBP)-3 and IGFBP-4 production in human bone cells. Acta Endocrinol (1992) 127, ) Isaksson OGP, Lindahl A, Nilsson A and Isgaard J: Mechanism of the stimulatory effect of growth hormone on longitudinal bone growth. Endocr Rev (1987) 8,

9 Insulin-like growth factor binding protein-4 (IGFBP-4) and bone growth Yoshitaka in childhood YAMANAKA Department of Pediatrics, Okayama University Medical School, Okayama 700, Japan (Director: Prof. Y. Seino) IGFBP-4 is a 24kD protein, originally isolated from the conditioned medium of human bone cells, and has been implicated as a potent inhibitor of IGF action in vitro. To clarify its biological functions in human bone, I measured the serum concentration of IGFBP-4 from patients with endocrinologic disorders, using Western immunoblot. In normal children, IGFBP-4 increased with age. The serum IGFBP-4 levels of patients with GH deficiency and panhypopituitarism were lower than those of normal children. In addition, the serum levels of IGFBP-4 were also significantly lower in children with Turner's syndrome than in the age-matched normal children who were post pubertal. These findings suggest that GH and the sex steroid increase the production of serum IGFBP-4. Then, I examined the influence of GH on the serum level of of IGFBP-4. In the good responders to GH therapy, IGFBP-4 decreased rapidly during the first month, continued to decrease until the third month, and then increased slowly. On the contrary, in the poor responders to GH therapy, the IGFBP-4 level increased until the third month and then remained at a high level. The increased serum IGFBP-4 level may, at least in part, contribute to the low response to GH therapy in the poor responders.

1) Roth, J., Glick, S. M., Yalow, R. S. and Berson, S. A.: Hypoglycemia: A potent stimulus to secretion of growth hormone. Science, 140, 987-988, 1963. 2) Ogawa, N.: Routine Ultramicro-Measurement of Human

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