• growth factors;
  • insulin-like growth factor-I;
  • morphoea;
  • scleroderma;
  • sclerosis


Background  Morphoea (scleroderma) is a chronic disorder characterized by circumscribed sclerotic plaques with the hallmark of increased fibroblast activation and fibrosis. Through its effect on connective tissue cells and immune cells, insulin-like growth factor (IGF)-I has been found to play a role in some autoimmune connective tissue diseases and has been implicated in the pathogenesis of several fibrotic disorders.

Objectives  To evaluate the role of IGF-I in the pathogenesis of morphoea.

Methods  The study was carried out on 15 patients with morphoea and nine healthy controls. Two 5-mm punch skin biopsies were taken from every patient (one from lesional and one from non-lesional skin) and a single biopsy was taken from the normal skin of each control. A 10-mL blood sample was also taken from each patient and control. Quantitative detection of tissue and serum levels of IGF-I was done using an enzyme-linked immunosorbent assay technique.

Results  IGF-I in lesional skin was significantly higher than in non-lesional and control skin (= 0·001 and = 0·021, respectively). Moreover, a significantly higher level of IGF-I was detected in patient serum when compared with control serum (< 0·001). A direct significant correlation existed between lesional and non-lesional skin level (= 0·618, = 0·014), and between lesional skin level and Rodnan score (= 0·538, = 0·039).

Conclusions  Despite the small sample size, this study suggests that IGF-I plays an important role in the pathogenesis of fibrosis, characteristic of morphoea. Studies on a larger number of patients with morphoea as well as on patients with systemic sclerosis are recommended. Furthermore, therapeutic trials using IGF-I antagonist (octreotide) are highly recommended in patients with morphoea.