Insulin signal transduction pathway

When carbohydrates are consumed, digested, and absorbed the pancreas detects the subsequent rise in blood glucose concentration and releases insulin to promote uptake of glucose from the bloodstream. When insulin binds to the insulin receptor, it leads to a cascade of cellular processes that promote the usage or, in some cases, the storage of glucose in the cell. The effects of insulin vary depending on the tissue involved, e.g., insulin is the most important in the uptake of glucose by Skeletal muscle and adipose tissue.

This insulin signal transduction pathway is composed of trigger mechanisms (e.g., autophosphorylation mechanisms) that serve as signals throughout the cell. There is also a counter mechanism in the body to stop the secretion of insulin beyond a certain limit. Namely, those counter-regulatory mechanisms are glucagon and epinephrine. The process of the regulation of blood glucose (also known as glucose homeostasis) also exhibits oscillatory behavior.

On a pathological basis, this topic is crucial to understanding certain disorders in the body such as diabetes, hyperglycemia and hypoglycemia.

Transduction pathway

The functioning of a signal transduction pathway is based on extra-cellular signaling that in turn creates a response that causes other subsequent responses, hence creating a chain reaction, or cascade. During the course of signaling, the cell uses each response for accomplishing some kind of a purpose along the way. Insulin secretion mechanism is a common example of signal transduction pathway mechanism.

Insulin is produced by the pancreas in a region called islets of Langerhans. In the islets of Langerhans, there are beta-cells, which are responsible for production and storage of insulin. Insulin is secreted as a response mechanism for counteracting the increasing excess amounts of glucose in the blood.

Glucose in the body increases after food consumption. This is primarily due to carbohydrate intake, but to a much lesser degree protein intake ()(). Depending on the tissue type, the glucose enters the cell through facilitated diffusion or active transport. In muscle and adipose tissue, glucose enters through GLUT 4 receptors via facilitated diffusion (). In brain, retina, kidney, RBC, placenta and many other organs, glucose enters using GLUT 1 and GLUT 3. In the beta-cells of the pancreas and in liver cells, glucose enters through the GLUT 2 receptors (process described below).

Insulin biosynthesis and transcription

Insulin biosynthesis is regulated by transcriptional and translational levels. The β-cells promote their protein transcription in response to nutrients. The exposure of rat Langerhans islets to glucose for 1 hour is able to remarkably induce the intracellular proinsulin levels. It was noted that the proinsulin mRNA remained stable. This suggests that the acute response to glucose of the insulin synthesis is independent of mRNA synthesis in the first 45 minutes because the blockage of the transcription decelerated the insulin accumulation during that time. PTBPs, also called polypyrimidine tract binding proteins, are proteins that regulate the translation of mRNA. They increase the viability of mRNA and provoke the initiation of the translation. PTBP1 enable the insulin gene-specific activation and insulin granule protein mRNA by glucose.

Two aspects of the transduction pathway process are explained below: insulin secretion and insulin action on the cell.

Insulin secretion

The glucose that goes into the bloodstream after food consumption also enters the beta cells in the islets of Langerhans in the pancreas. The glucose diffuses in the beta-cell facilitated by a GLUT-2 vesicle. Inside the beta cell, the following process occurs:

Glucose gets converted to glucose-6-phosphate (G6P) through glucokinase, and G6P is subsequently oxidized to form ATP. This process inhibits the ATP-sensitive potassium ion channels of the cell causing the potassium ion channel to close and not function anymore. The closure of the ATP-sensitive potassium channels causes depolarization of the cell membrane causing the cell membrane to stretch which causes the voltage-gated calcium channel on the membrane to open causing an influx of Ca²⁺ ions. This influx then stimulates fusion of the insulin vesicles to the cell membrane and secretion of insulin in the extracellular fluid outside the beta cell; thus making it enter the bloodstream. [Also Illustrated in Figure 1.1.1].

There are 3 subfamilies of Ca²⁺ channels; L-type Ca²⁺ channels, non-L-type Ca²⁺ channels (including R-type) and the T-type Ca²⁺ channels. There are two phases of the insulin secretion, the first phase involves the L-type Ca²⁺ channels and the second phase involves the R-type Ca²⁺ channels. The Ca²⁺ influx generated by R-type Ca²⁺ channels is not enough to cause insulin exocytosis, however, it increases the mobilization of the vesicles towards the cell membrane.

Fatty acids and insulin secretion

Fatty acids also affect insulin secretion. In type 2 diabetes, fatty acids are able to potentiate insulin release to compensate the increment need of insulin. It was found that the β-cells express free fatty acid receptors at their surface, through which fatty acids can impact the function of β-cells. Long-chain acyl-CoA and DAG are the metabolites resulting from the intracellular metabolism of fatty acids. Long-chain acyl-CoA has the ability to acylate proteins that are essential in the insulin granule fusion. On the other hand, DAG activates PKC that is involved in the insulin secretion.

Hormonal regulation of insulin secretion

Several hormones can affect insulin secretion. Estrogen is correlated with an increase of insulin secretion by depolarizing the β-cells membrane and enhancing the entry of Ca²⁺. In contrast, growth hormone is known to lower the serum level of insulin by promoting the production of insulin-like growth factor-I (IGF-I). IGF-I, in turn, suppresses the insulin secretion.

Action on the cell

After insulin enters the bloodstream, it binds to a membrane-spanning receptor tyrosine kinase (RTK). This glycoprotein is embedded in the cellular membrane and has an extracellular receptor domain, made up of two α-subunits, and an intracellular catalytic domain made up of two β-subunits. The α-subunits act as insulin receptors and the insulin molecule acts as a ligand. Together, they form a receptor-ligand complex.

Binding of insulin to the α-subunit results in a conformational change of the protein, which activates tyrosine kinase domains on each β-subunit. The tyrosine kinase activity causes an autophosphorylation of several tyrosine residues in the β-subunit. The phosphorylation of 3 residues of tyrosine is necessary for the amplification of the kinase activity.

This autophosphorylation triggers the activation of the docking proteins, in this case IRS (1-4) on which phosphatidylinositol-3-Kinase (PI-3K) can be attached or GRB2 where the ras guanine nucleotide exchange factor (GEF) (also known as SOS) can be attached.

PI-3K causes the phosphorylation of PIP2 to PIP3. This phospholipid acts as a docking site for PDPK1 and AKT2, which is then phosphorylated by the latter and PK2 to be activated. This leads to crucial metabolic functions such as synthesis of lipids, proteins, and glycogen. It also leads to cell survival and cell proliferation. Most importantly, the PI-3K pathway is responsible for the distribution of glucose for important cell functions. For example, the suppression of hepatic glucose synthesis and the activation of glycogen synthesis. Hence, AKT2 plays a crucial role in the linkage of the glucose transporter (GLUT4) to the insulin signaling pathway. The activated GLUT4 will translocate to the cell membrane and promotes the transportation of glucose into the intracellular medium.

The Ras-GEF stimulates the exchange of GDP to GTP in the RAS protein, causing it to activate. Ras then activates the mitogen-activated protein kinase (MAP-Kinase) route, which ultimately results in changes in protein activity and gene expression.

Thus, insulin's role is more of a promoter for the usage of glucose in the cells rather than neutralizing or counteracting it.

Regulation of the insulin receptor signal

PI3K (phosphoinositide 3-kinase) is one of the important components in the regulation of the insulin signaling pathway. It maintains the insulin sensitivity in the liver. PI-3K is composed of a regulatory subunit (P85) and a catalytic subunit (P110). P85 regulates the activation of PI3K enzyme. In the PI-3K heterodimer (P85-P110), P85 is responsible for the PI3K activity, by binding to the binding site on the insulin receptor substrates (IRS). It was noted that an increase of P85 a (isoform of P85) results in a competition between the later and the P85-P110 complex to the IRS binding site, reducing the PI3K activity and leading to insulin resistance. Insulin resistance refers also to type 2 diabetes. It was also noted that increased serine phosphorylation of IRS is involved in the insulin resistance by reducing their ability to attract PI3K. The serine phosphorylation can also lead to degradation of IRS-1.