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A novel adult case of juvenile-onset Alexander disease: complete remission of neurological symptoms for over 12 years, despite insidiously progressive cervicomedullary atrophy

Conversely, overfeeding increases intra-portal insulin levels that enhances hepatic GH sensitivity to a degree where relatively low GH secretion is sufficient to maintain ambient hepatic IGF-I synthesis and secretion, and normal circulating IGF-I levels ( Figure 1 This review summarizes how changes in hepatic exposure to intra-portal insulin in health and disease states modulates the GH/IGF-I axis

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For this reason, it is relevant to understand the environmental constraints that allowed such protective defense enzymes to evolve