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Neurological improvement, when present, often began within 12 weeks and could resolve within 1 month, particularly with early parenteral therapy, though recovery was incomplete in a subset with severe funicular myelosis or chronic spinal involvement

Adverse Events/Precautions Rare, but devastating long-term adverse effects of LIS including physical disfigurement and the off-label manner of administration have prevented widespread use of medical-grade LIS

In line with previously published studies 30,31,32 , we found that proIGF-1Eb and proIGF-1Ec partially accumulated in the nucleus of HEK293-transfected cells, while proIGF-1Ea was mainly localised into the ER (Fig