IGF-1 as a Target in Emerging Heart Failure Therapeutics

Abstract

Insulin-like growth factor 1 (IGF-1) signaling plays a role in the regulation of heart disease. While most therapeutics target the consequences of cell loss and tissue necrosis, the underlying pathophysiology is not addressed. Emerging therapeutics are exploring the potential effects of IGF-1 in cardiac repair and regeneration. IGF-1 has established a role as a cardioprotective cytokine with pleiotropic effects regulating cell growth, proliferation, metabolism, and survival in the heart. Local expression of IGF-1 in cardiac cells constitutes protection from irreversible loss of cell function post cardiac injury. Its deficiency is implicated in dysregulation of IGF-1 signaling and associated with reductions in heart function. Methods to directly increase endogenous levels of IGF-1 in the injured heart are emerging and while the optimal delivery methods, doses, time spans, and frequencies may not be established, it is known that IGF-1 is a necessary component in sustaining cardiomyocyte function in the diseased and failing heart. In this review, I provide background on heart failure and the pathophysiological injurious processes that up and coming therapeutics, targeting IGF-1, can potentially modulate, with IGF-1 as a regulator of cardiac repair and regeneration.