pathogenesis of increased ICP in these children. The IGF-1 axis also has a significant role in the pathogenesis of obesity. Obese patients often have numerous hormonal abnormalities including glucose intolerance, insulin resistance, hyperinsulinemia, low plasma levels of GH, and high levels of free IGF-1 due to overproduction of IGF-1 by adipocytes (51–53). It is well known that IIH is a disease that mostly affects obese women of childbearing age. Octreotide treatment in such patients might decrease levels of circulating IGF-1, but could also counteract its biological activity at the level of CP epithelium. In human retinal pigment epithelial cells (SSTR1 and 2 positive), SST and octreotide inhibit the biological effects of IGF-1 by inhibition of autophosphorylation of IGF1R, thereby inhibiting the IGF-1 signaling cascade (54). Analogous to their demonstration and to their function in kidney and ocular tissues, SSTRs may be involved in the processes of CSF production and absorption in humans, and may play a role in the increased ICP in IIH.

ACKNOWLEDGMENT

This study was supported in part by the Ohio Lions Eye Research Foundation, The Bremer Fund, The George and Miriam Mikesell Research Fund, The Jacob and Florence Moses Fund (The Columbus Foundation), and ROI CA 64177.

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