Functional and Complementary Phosphorylation State Attributes of Human Insulin-like Growth Factor-Binding Protein-1 (IGFBP-1) Isoforms Resolved by Free Flow Electrophoresis

Fetal growth restriction (FGR) is a common disorder in which a fetus is unable to achieve its genetically determined potential size. High concentrations of insulin-like growth factor-binding protein-1 (IGFBP-1) have been associated with FGR. Phosphorylation of IGFBP-1 is a mechanism by which insulin-like growth factor-I (IGF-I) bioavailability can be modulated in FGR. In this study a novel strategy was designed to determine a link between IGF-I affinity and the concomitant phosphorylation state characteristics of IGFBP-1 phosphoisoforms. Using free flow electrophoresis (FFE), multiple IGFBP-1 phosphoisoforms in amniotic fluid were resolved within pH 4.43–5.09. The binding of IGFBP-1 for IGF-I in each FFE fraction was determined with BIAcore biosensor analysis. The IGF-I affinity (K) for different IGFBP-1 isoforms ranged between 1.12e−08 and 4.59e−07. LC-MS/MS characterization revealed four phosphorylation sites, Ser(P)⁹⁸, Ser(P)¹⁰¹, Ser(P)¹¹⁹, and Ser(P)¹⁶⁹, of which Ser(P)⁹⁸ was new. Although the IGF-I binding affinity for IGFBP-1 phosphoisoforms across the FFE fractions did not correlate with phosphopeptide intensities for Ser(P)¹⁰¹, Ser(P)⁹⁸, and Ser(P)¹⁶⁹ sites, a clear association was recorded with Ser(P)¹¹⁹. Our data demonstrate that phosphorylation at Ser¹¹⁹ plays a significant role in modulating affinity of IGFBP-1 for IGF-I. In addition, an altered profile of IGFBP-1 phosphoisoforms was revealed between FGR and healthy pregnancies that may result from potential site-specific phosphorylation. This study provides a strong basis for use of this novel approach in establishing the linkage between phosphorylation of IGFBP-1 and FGR. This overall strategy will also be broadly applicable to other phosphoproteins with clinical and functional significance.The insulin-like growth factor (IGF)¹ axis plays an important role in human fetal growth and development. Insulin-like growth factor-binding protein-1 (IGFBP-1) is a major IGF-binding protein in amniotic fluid (AF) (1, 2). The physiological role of IGFBP-1 is considered to be highly dependent on its differential phosphorylation (3–5). Phosphorylation of IGFBP-1 increases its affinity for IGF-I (6), suggesting that IGFBP-1 may modulate the action of IGF-I specifically with respect to fetal and placental growth (4, 7).AF is a dynamic and complex biofluid and reflects the physiological status of the developing fetus (8). Fetal growth restriction (FGR) is a condition in which a fetus is unable to achieve its genetically determined potential size. The concentration of total IGFBP-1 is increased in FGR (9–12). Multiple phosphorylated species of IGFBP-1 have been detected during healthy pregnancy in both maternal circulation and in AF throughout gestation (1, 13, 14). Several studies have considered the clinical implications of IGFBP-1 phosphorylation, focusing on correlating variable ratios of high to low concentrations of IGFBP-1 phosphoisoforms with fetal outcome in FGR pregnancies (15–19). Although phosphorylation of IGFBP-1 has since been suggested to be critical, the predictive or functional value of IGFBP-1 phosphorylation in FGR is still not clear. The inconsistency in measurements of variable degrees of IGFBP-1 phosphorylation by ELISAs has resulted in inconclusive findings (20).IGFBP-1 phosphoisoforms have been characterized previously using conventional methods (1, 13, 14). IGFBP-1, although relatively abundant in AF, still represents less than 0.01% of the total protein content (21). With restricted volumes available from clinical samples, isolation of functional IGFBP-1 phosphoisoforms using traditional approaches (13, 22, 23) is challenging. Our goal is to obtain a comprehensive understanding of the clinical and functional implications of IGFBP-1 phosphorylation in human FGR pregnancies. We developed an efficient, reproducible, and entirely liquid-based native IEF separation technology based on free flow electrophoresis (FFE) (24) to facilitate characterization of both the state of phosphorylation and IGF-I binding kinetics of variably phosphorylated IGFBP-1 isoforms in a clinical sample. As a prerequisite to application of this approach clinically, we also evaluated representative AF samples to determine whether or not differential patterns of IGFBP-1 phosphorylation exist in FGR and whether these changes could be attributed to augmentation of IGF-I affinity in the disease.