IGFBP-4

IGFBP-4 is a widely expressed IGF-binding protein that consistently inhibits IGF action, blunting IGF-1 and IGF-II signaling in the tissues where it acts. Its regulatory signature is proteolysis: the metalloproteinase PAPP-A (pregnancy-associated plasma protein A) specifically cleaves IGFBP-4, releasing free IGFs locally and making the IGFBP-4/PAPP-A axis a spatially precise mechanism for tuning growth factor availability. PAPP-A is abundant in placenta and serves as a Down syndrome screening marker, and heightened PAPP-A activity has been linked to atherosclerotic plaque growth. Physiological studies assign IGFBP-4 roles in bone remodeling, vascular biology and reproduction, and knockout mice show impaired embryonic growth and cardiac development.