THE INSULIN-LIKE GROWTH-FACTOR SYSTEM IN VASCULAR SMOOTH-MUSCLE - INTERACTION WITH INSULIN AND GROWTH-FACTORS

Vascular smooth muscle cells (SMCs) occur throughout the vascular tree and have important physiological functions. They are also involved in pathological processes such as development and progression of atherosclerotic lesions, restenosis following angioplasty, and in hypertension. This review is focused on the role of the insulin-like growth factor (IGF) system in proliferation, migration, and hypertrophy of vascular SMCs and its interaction with insulin and other growth factors. The IGF-I receptor is highly expressed in SMCs in intact arteries and in cultured SMCs and is activated by binding of IGF-I to the two alpha-subunits. Insulin and IGF-II from the circulation can interact with the IGF-I receptor at higher concentrations, Insulin receptors are few or absent in SMCs and circulating insulin concentrations in vivo are probably too low for a direct action of insulin on the IGF-I receptor in SMCs. Receptor activation initiates a number of signal transduction pathways. Increased phosphatidylinositol turnover and calcium mobilization correlates with actin filament reorganization and stimulation of directed migration of the SMC in a gradient of IGF-I. The effects of IGF-I receptor activation on signal transduction pathways (eg, the MAP kinase cascade) implicated in DNA synthesis and proliferation are weak and this correlates with the meager mitogenic activity of IGF-I in SMC, Several components of the IGF-system in SMC are regulated by growth factors such as platelet derived growth factor (PDGF)-BB and basic fibroblast growth factor (bFGF). IGF-I is downregulated by decreased metabolism (eg, diabetes and fasting) and in these states levels of IGF-I mRNA and IGFBP-2 and -4 mRNA are decreased. On the contrary, SMC hypertrophy is associated with increased levels of IGF-I, IGFBP-2, and IGFBP-4 mRNA. In conclusion, the IGF-system in SMCs is likely to play an important role in SMC migration and the response of the SMCs to metabolic deprivation, and hypertrophy. Copyright (C) 1995 by W.B. Saunders Company.