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Stephen Twigg

Stephen Twigg, MBBS, PhD, FRACP
Royal Prince Alfred Hospital, Sydney,
NSW 2006
Tel: 612 9515 6150
Fax: 612 9516 1273


  • Australian Diabetes Society
  • American Diabetes Association
  • Endocrine Society of Australia

Personal Awards

  • 1999-2002 NHMRC of Australia CJ Martin Post-doctoral Fellow – funding for 2 years supervised overseas research, then 2 years research in Australia
  • 1999 Tartar Research Fellowship through Oregon Health Sciences University, USA, to aid post-doctoral research
  • 1998 Endocrine Society of Australia Servier Award for the best work published by a member of The Society who is within 5 years of a PhD
  • 1998 JR Vanderfield Travelling Scholarship, RNSH, Sydney
  • 1995-1997 NHMRC Medical Postgraduate Research Scholarship (3yrs funding)
  • 1989 Undergraduate Summer Student Research Scholarship from Juvenile Diabetes Foundation International - the first awarded in Australia
  • 1989 Second student in medical year honors roll, graduating with first class honors
  • 1989 RNSH Young Investigator Award (Medical)
  • 1987 Cedric Swanton Undergraduate Memorial Prize in Psychiatry; Norton Manning Memorial Prize in Psychiatry
  • 1985 Renwick Scholarship undergraduate prize for proficiency in first and second year undergraduate medicine

Research Themes

Stephen Twigg is a scientist-physician who has been researching growth factors in diabetes since 1995. His Program of Research is dedicated to preventing, detecting, treating and reversing end-organ complications in diabetes. Specifically, he studies the way in which growth factors that are regulated by metabolic changes in diabetes, contribute to extracellular matrix accumulation and fibrosis. Such tissue pathology of fibrosis, or alternatively, a deficiency in granulation tissue formation, is directly linked with the clinical complications of diabetic cardiomyopathy, diabetic nephropathy, fatty liver with fibrosis and diabetic foot disease. His main growth factor expertise is the role played by the CCN family (especially CCN2/CTGF) and the IGF system in diabetes end-organ complications. He also studies the role of these growth factors in mediating fat cell differentiation and insulin resistance, which itself acts as a precursor to diabetes. His team’s research utilises cellular and animal models as well as analysis of human clinical tissues and biological fluids.

Stephen also has 15 years’ clinical experience managing adults with endocrine conditions, mainly those involving diabetes and its complications. He is the Primary Supervisor of 3 current PhD students, 2 Masters and 1 Honours student and Associate Supervisor of 6 PhD students and 1 Masters Student. He has consistently published in high impact refereed international journals, which include Endocrinology, The Journal of Biological Chemistry, Circulation, Circulation Research, Diabetologia and Diabetes Care.

Societies and Boards

  • Executive Council of Australian Diabetes Society, (2003-present), Vice President (2006-present)
  • Board of Directors of Diabetes Australia, honorary member (2003-present)
  • Diabetes Australia Research Trust allocation and coordination panel, member (2001-2003)
  • Chair of the Program Organising Committee, The Endocrine Society of Australia Annual Scientific Meeting (2004-2006)
  • Specialist Advisory Committee in Endocrinology for The Royal Australasian College of Physicians, member (2003-present).

Selected Recent Publications

  • Twigg SM, Hardman KV, Baxter RC.
    A highly purified bovine serum albumin preparation contains an IGFBP-3 fragment that forms ternary complexes selectively with radiolabeled IGF-II and the acid-labile subunit.
    Growth Hormone and IGF Research, 2000 10(4): 215-223, .
  • Dwight T, Twigg S, Delbridge L, Wong FK, Farnebo F, Richardson AL, Nelson A, Zedenius J, Philips J, Larsson C, Teh BT, Robinson B.
    Loss of heterozygosity in sporadic parathyroid tumours: involvement of chromosome 1 and the MEN1 gene locus in 11q13.
    Clin Endocrinol (Oxf). 2000 53(1):85-92 .
  • Twigg SM, Kiefer MC, Zapf J, Baxter RC.
    A central domain binding site in insulin-like growth factor binding protein protein-5 for the acid labile subunit.
    Endocrinology 2000 141(1):454-457.
  • Twigg SM, Chen M, Joly A, Chakrapani SD, Tsubaki J, Kim HS, Oh Y, Rosenfeld RG.
    Connective tissue growth factor (IGFBP-rP2) is up-regulated by advanced glycosylation end-products in human fibroblasts: a potential mechanism for expansion of extracellular matrix in diabetes mellitus.
    Endocrinology, 2001 142:1760- 9.
  • Tsubaki J, Choi WK, Ingermann AR, Twigg SM, Kim HS, Rosenfeld RG, Oh Y.
    Effects of sodium butyrate on expression of members of the IGF-binding protein superfamily in human mammary epithelial cells.
    J Endocrinol, 2001 169:97-110.
  • Candido R, Jandeleit-Dahm KA, Cao Z, Nesteroff SP, Burns Wc, Twigg SM, Dilley RJ, Cooper ME, Allen TJ.
    Prevention of accelerated atherosclerosis with angiotensin converting enzyme inhibitors in diabetic apo-lipoprotein E deficient mice.
    Circulation 2002 106:246-53.
  • Twigg SM, Joly A, Chen M, Tsubaki J, Kim HS, Hwa V, Oh Y, Rosenfeld RG.
    Connective tissue growth factor is a mediator in the induction of fibronectin by advanced glycosylation end-products in human dermal fibroblasts.
    Endocrinology.2002 143:1260-9.
  • Tsubaki J, Hwa V, Twigg SM, and Rosenfeld RG.
    Differential Activation of the IGFBP-3 Promoter by Butyrate in Prostate Cancer Cells.
    Endocrinology 2002 143:1778-88.
  • Twigg SM, Cao Z, Mclennan SV, Burns WC, Brammar G, Forbes JM, Cooper ME.
    Renal connective tissue growth factor induction in experimental diabetes is prevented by aminoguanidine.
    Endocrinology 2002 143:4907-15.
  • Dwight T, Kytola S, Teh BT, Theodosopoulos G, Richardson AL, Philips J, Twigg S, Delbridge L, Marsh DJ, Nelson AE, Larsson C, Robinson BG.
    Genetic analysis of lithium-associated parathyroid tumors.
    Eur J Endocrinol. 2002 146(5): 619-27.
  • Gunton JE, Twigg SM.
    Metformin use as an adjunct to insulin treatment in type 1 diabetes.
    Med J Aust. 2003 178(11):591-2.
  • Candido R, Forbes JM, Thomas MC, Thallas V, Dean RG, Burns WC, Tikellis C, Ritchie RH, Twigg SM, Cooper ME, Burrell LM.
    A breaker of advanced glycation end products attenuates diabetes-induced myocardial structural changes.
    Circ Res. 2003 92(7):785-92.
  • Cooper L, Clifton-Bligh PB, Nery ML, Figtree G, Twigg S, Hibbert E, Robinson BG.
    Vitamin supplementation and bone mineral density in early postmenopausal women.
    Am J Clin Nutr. 2003 77(5):1324-9.
  • Tikellis C, Cooper ME, Twigg SM, Burns WC, Tolcos M.
    Connective tissue growth factor is up-regulated in the diabetic retina: amelioration by angiotensin-converting enzyme inhibition.
    Endocrinology, 2003 145(2):860-6.
  • Kim HS, Ingermann AR, Tsubaki J, Twigg SM, Walker GE, Oh Y.
    Insulin-like growth factor-binding protein 3 induces caspase-dependent apoptosis through a death receptor-mediated pathway in MCF-7 human breast cancer cells.
    Cancer Res., 2003 64(6):2229-37.
  • McLennan SV, Wang XY, Moreno V, Yue DK, Twigg SM.
    Connective tissue growth factor mediates high glucose effects on matrix degradation through tissue inhibitor of matrix metalloproteinase type 1: implications for diabetic nephropathy.
    Endocrinology 2004 145(12):5646-55.
  • Twigg SM, Cooper ME.
    The time has come to target connective tissue growth factor in diabetic complications.
    Diabetologia 2004 47(6):965-8.
  • Galettis A, Campbell S, Morris JM, Jackson CJ, Twigg SM, Gallery ED.
    Monocyte adhesion to decidual endothelial cells is increased in pregnancies complicated by type 1 diabetes but not by gestational diabetes.
    Diabetes Care 2004 27(10):2514-5.
  • Omari A, Yue DK and Twigg SM.
    Metformin induced Exercise Hypoglycaemia: A neglected Entity.
    British Journal of Diabetes and Vascular Disease, 2005 5:106-08, (2005).
  • Qi W, Twigg S, Chen X, Polhill TS, Poronnik P, Gilbert RE, Pollock CA.
    The integrated actions of transforming growth factor-beta1 and connective tissue growth factor in renal fibrosis.
    Am J Physiol Renal Physiol. 2005 288(4): F800-9, (2005).
  • Dean RG, Balding LC, Candido R, Burns WC, Cao Z, Twigg SM, Burrell LM.
    Connective Tissue Growth Factor and Cardiac Fibrosis after Myocardial Infarction.
    J Histochem Cytochem. 2005 53(10):1245-56, (2005).
  • Qi W, Chen X, Polhill TS, Sumual S, Twigg S, Gilbert RE, Pollock CA.
    Transforming growth factor-{beta}1 induces interlukin-8 and macrophage chemoattractant protein-1 through a connective tissue growth factor independent pathway.
    Am J Physiol Renal Physiol. 2005 290(3):F703-9.
  • Chan SS, Twigg SM, Firth SM, Baxter RC.
    Insulin-like growth factor binding protein-3 leads to insulin resistance in adipocytes.
    J Clin Endocrinol Metab. 2005 90(12):6588-95.
  • Johnson PR, Burgess JK, Ge Q, Poniris M, Boustany S, Twigg SM, Black JL.
    Connective tissue growth factor induces extracellular matrix in asthmatic airway smooth muscle.
    Am J Respir Crit Care Med. 2006 173(1):32-41.
  • Burgess JK, Ge Q, Poniris MH, Boustany S, Twigg SM, Black JL, Johnson PR.
    Connective tissue growth factor and vascular endothelial growth factor from airway smooth muscle interact with the extracellular matrix.
    Am J Physiol Lung Cell Mol Physiol.2006 290(1):L153-61.
  • Wong J, Molyneaux L, Constantino MC, Twigg SM, and Yue DK.
    The Metabolic Syndrome in Type-2 Diabetes: When does it matter?
    Diabetes Obesity and Metabolism. 2006 8(6):690-7 .
  • Thompson SJ, McLennan SV, Twigg SM.
    The role of Growth Factors in diabetic complications.
    Exp. Rev. Clin. Immunol. 2006 2,(3), pp. 403-418(16).
  • Qi W, Chen X, Twigg S, Polhill TS, Gilbert RE, Pollock CA.
    Tranilast attenuates connective tissue growth factor-induced extracellular matrix accumulation in renal cells.
    Kidney Int. 2006 69(6):989-95 .
  • Qi W , Chen X, Holian J, Mreich E, Twigg S, Gilbert RE, Pollock CA.
    Transforming growth factor-beta1 differentially mediates fibronectin and inflammatory cytokine expression in kidney tubular cells.
    Am J Physiol Renal Physiol. 2006 291(5):F1070-7.
  • Ong CR, Molyneaux LM, Constantino MI, Twigg SM, Yue DK.
    Long-term efficacy of metformin therapy in non-obese individuals with type 2 diabetes.
    Diabetes Care. 2006 29(11):2361-4.
  • Burns WC, Twigg SM, Forbes JM, Pete J, Tikellis C, Thallas-Bonke V, Thomas MC, Cooper ME, Kantharidis P.
    Connective tissue growth factor plays an important role in advanced glycation end product-induced tubular epithelial-to-mesenchymal transition: implications for diabetic renal disease.
    J Am Soc Nephrol. 2006 17(9):2484-94.
  • Samaras K, McElduff A, Twigg SM, Proietto J, Prins JB, Welborn TA, Zimmet P, Chisholm DJ, Campbell LV.
    Insulin levels in insulin resistance: phantom of the metabolic opera?
    Med J Aust.2006 185(3):159-61.
  • Xu L, McLennan SV, Lo L, Natfaji A, Bolton T, Liu Y, Twigg SM, Yue DK.
    Bacterial load predicts healing rate in neuropathic diabetic foot ulcers.
    Diabetes Care 2007 30(2):378-80.
  • Twigg SM, Kamp MC, Davis TM, Neylon EK, JR Flack.
    Prediabetes: a position statement of the Australian Diabetes Society and Australian Diabetes Educators Association.
    Medical Journal of Australia 2007 186(9): 461-465.
  • Thomson SE, McLennan SV, Kirwan PD, Heffernan SJ, Hennessy A, Yue DK and Twigg SM.
    Renal connective tissue growth factor (CTGF) correlates with glomerular basement membrane thickness and prospective albuminuria in a non-human primate model of diabetes: Possible predictive marker for incipient diabetic nephropathy.
    J. of Diabetes and its Complications (2007) In press, .
  • Brooks BA, Franjic B, Ban CR, Swaraj K, Yue DK, Celermajer DS and Twigg SM.
    Diastolic Dysfunction and abnormalities of the microcirculation in type 2 diabetes.
    J Diab. Obesity and Metabolism (2007) In press