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GH Axis · Reference monograph

Recombinant human IGF-1 for severe primary IGF-1 deficiency

Reference compound — not available from Purity Peptides. Shown for research context.

Overview

Mecasermin is recombinant human insulin-like growth factor-1 (rhIGF-1), a 70-amino-acid polypeptide with three disulfide bonds that is identical in sequence to the endogenous hormone. It is produced in Escherichia coli using recombinant DNA technology. IGF-1 is the principal mediator of many of growth hormone's effects, produced mainly in the liver in response to GH, and it was originally described in the 1950s as a sulfation factor before being sequenced in the 1970s.

Mecasermin was approved by the FDA in 2005 and by the EMA in 2007, marketed as Increlex, for severe primary IGF-1 deficiency. This condition, which includes Laron syndrome caused by GH receptor mutations, involves very low IGF-1 despite normal or elevated GH, so GH itself is ineffective. Research with mecasermin focuses on linear growth in GH insensitivity, IGF-1 receptor signalling and the metabolic consequences of IGF-1 replacement. Because IGF-1 shares signalling features with insulin, hypoglycaemia is the most closely monitored adverse effect in clinical studies. WADA lists IGF-1 and its analogues as prohibited.

Mechanism studied

  1. Mecasermin
  2. IGF-1 receptor
  3. Growth-plate signalling
  4. Linear growth

Mecasermin binds the IGF-1 receptor, a receptor tyrosine kinase structurally related to the insulin receptor. Ligand binding triggers autophosphorylation and recruitment of insulin receptor substrate proteins, activating the PI3K-Akt and Ras-MAPK pathways. These pathways promote cell proliferation, differentiation and survival. At the growth plate, IGF-1 stimulates chondrocyte proliferation and hypertrophy, driving longitudinal bone growth. In GH insensitivity, where hepatic IGF-1 production fails, exogenous rhIGF-1 bypasses the defective GH receptor step. At higher concentrations IGF-1 can also activate insulin receptors and hybrid receptors, which explains its glucose-lowering effects.

Research highlights

  • 01IGF-1 was first described as a GH-dependent sulfation factor in the 1950s, then sequenced in the 1970s.
  • 02Recombinant production in E. coli enabled study of IGF-1 replacement in GH insensitivity.
  • 03Laron syndrome research established the distinction between GH deficiency and GH insensitivity.
  • 04Approved in the US in 2005 and the EU in 2007 for severe primary IGF-1 deficiency.
  • 05Open questions include long-term metabolic and neoplastic considerations of sustained IGF-1 receptor activation.

Latest published research

256 papers on PubMed →

  1. Real world data on rhIGF-1 therapy in children with severe primary IGF-I deficiency - The European experience

    Saavedra J et al. · Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society · 2026 Jun 21 · PMID 42341624

  2. Clinical spectrum of extreme insulin resistance syndromes treated with rhIGF-1: A single-center experience

    Improda N et al. · The Journal of clinical endocrinology and metabolism · 2026 Jun 17 · PMID 41606799

  3. Recombinant human IGF-1 alleviates dyslipidemia induced by lactational maternal dietary restriction

    Liu X et al. · Frontiers in pediatrics · 2026 · PMID 42327899

  4. Placental hormones, IGF-1, and early-life growth: endocrine links between birth size and infant metabolic programming-a systematic review

    Soliman AT et al. · European journal of pediatrics · 2026 Apr 28 · PMID 42050034

  5. Insulin-like growth factor-1 for the prevention or treatment of retinopathy of prematurity

    Trzaski JM et al. · The Cochrane database of systematic reviews · 2026 Apr 15 · PMID 41983451

  6. Recombinant human insulin-like growth factor 1 complex preserves lung development in mechanically ventilated preterm lambs

    Albertine KH et al. · American journal of respiratory and critical care medicine · 2026 Apr 1 · PMID 41738171

  7. Therapeutic approaches for endocrine dysregulation in anorexia nervosa in adolescents

    Hoskens L et al. · Frontiers in pediatrics · 2026 · PMID 41937902

  8. Randomised Phase 2b trial of rhIGF-1/rhIGFBP-3 (OHB-607) for bronchopulmonary dysplasia prevention in preterm neonates: study protocol

    Baraldi E et al. · BMJ paediatrics open · 2026 Mar 5 · PMID 41786363

Live feed from PubMed (NCBI) for “Mecasermin”, updated 2026-10-30. Listing a paper is not an endorsement of its findings.

Registered studies

37 on ClinicalTrials.gov →

From the public ClinicalTrials.gov registry for “Mecasermin”, updated 2026-10-30. Shown for research context only; Purity Peptides products are not for human use.

Key references

  1. [1]Manufacturer's prescribing information — FDA / EMA / ANVISA
  2. [2]Chernausek et al., 2007 — J Clin Endocrinol Metab
  3. [3]WADA — Prohibited List of Substances and Methods

FAQ

  • In severe primary IGF-1 deficiency, such as Laron syndrome, the GH receptor or its signalling is defective. Supplying growth hormone cannot raise IGF-1, so recombinant IGF-1 is used to bypass the blocked step.

  • IGF-1 is structurally similar to insulin and can activate insulin and hybrid receptors at higher concentrations. This promotes glucose uptake, so hypoglycaemia is the most carefully tracked adverse effect in clinical studies.

  • Mecasermin is approved by the FDA and EMA as a prescription medicine for severe primary IGF-1 deficiency. WADA lists IGF-1 as prohibited. Research material is supplied for laboratory investigation only.

FOR RESEARCH USE ONLY.Not for human or veterinary use. Not intended to diagnose, treat, cure, or prevent any disease.

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