Pregnancy-associated plasma protein-A (
PAPP-A) has been identified as the
insulin-like growth factor (IGF)-dependent IGF-binding protein-4 (IGFBP-4)
protease produced by human fibroblasts. Recently, we found that serum
proteases induced during human pregnancy cleaved
IGFBP-4 in both an
IGF-II-dependent and an
IGF-II-independent fashion. This study sought to determine whether
PAPP-A is the predominant
IGFBP-4 protease in human pregnancy serum (PS) and to assess the in vitro role of serum
PAPP-A. Immunoprecipitation with
PAPP-A antibody effectively depleted
PAPP-A from the PS and completely abolished both
IGF-II-dependent and
IGF-II-independent
IGFBP-4 proteolytic activity in PS. Direct addition of
PAPP-A antibody to PS completely blocked
IGFBP-4 proteolysis and partially blocked
IGFBP-5 proteolysis, but had no effect on
IGFBP-3 proteolysis. To evaluate the role of serum
PAPP-A, we tested whether
PAPP-A in PS modulated the inhibitory activity of
IGFBP-4 on
IGF-II-induced cell proliferation in human
osteosarcoma MG63 cells. The wild-type
IGFBP-4 (WTBP-4; 200 ng/mL) failed to inhibit proliferation of the cells treated with PS (0.1% or 0.3%) alone or in combination with
IGF-II (40 ng/mL), whereas the inhibitory effect of WTBP-4 was observed in the cells treated with nonpregnancy serum alone or in combination with
IGF-II (P < 0.05). In contrast to WTBP-4, a
protease-resistant
IGFBP-4 was able to inhibit proliferation of the cells treated with PS alone or in combination with
IGF-II (P < 0.05). In the presence of
PAPP-A neutralizing antibody, the inhibitory effect of WTBP-4 on proliferation of the cells treated with
IGF-II and PS was restored. In summary, these data demonstrate 1) that
PAPP-A represents the predominant
IGFBP-4 protease in PS; 2) that
PAPP-A may in part contribute to
IGFBP-5, but not
IGFBP-3, proteolytic activity in PS; and 3) that
PAPP-A enhances the bioactivity of IGFs in vitro by degrading
IGFBP-4.