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Insulin-like growth factor-binding proteins (IGFBPs) are a family of six high-affinity proteins (IGFBP-1 to 6) that regulate the bioavailability and activity of insulin-like growth factors (IGF-1 and IGF-2) [1, 3]. They function primarily by transporting IGFs in the circulation and controlling their access to the IGF-1 receptor, thereby modulating cell growth, differentiation, and apoptosis [2, 3]. Beyond their role as carrier proteins, IGFBPs also exhibit IGF-independent actions by interacting with other cell surface receptors or entering the nucleus to regulate gene expression [2, 3]. Dysregulation of IGFBPs is implicated in various pathologies, including cancer, where they can either promote or inhibit tumor progression depending on the context and specific protein subtype [2]. In clinical practice, IGFBPs serve as important biomarkers; for instance, IGFBP-3 is used to assess growth hormone status, and IGFBP-7 is a marker for acute kidney injury [4, 6]. Therapeutic strategies involving IGFBPs include the use of recombinant IGF-1/IGFBP-3 complexes for growth disorders and the development of inhibitors or mimetics to treat cancer and metabolic diseases [5].
Modulation of IGF-1 and IGF-2 bioavailability and signaling through high-affinity binding and sequestration, or through IGF-independent cellular interactions.
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