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The cell biology of systemic insulin function
Open accessAbstract
Insulin is the paramount anabolic hormone, promoting carbon energy deposition in the body. Its synthesis, quality control, delivery, and action are exquisitely regulated by highly orchestrated intracellular mechanisms in different organs or “stations” of its bodily journey. In this Beyond the Cell review, we focus on these five stages of the journey of insulin through the body and the captivating cell biology that underlies the interaction of insulin with each organ. We first analyze insulin’s biosynthesis in and export from the β-cells of the pancreas. Next, we focus on its first pass and partial clearance in the liver with its temporality and periodicity linked to secretion. Continuing the journey, we briefly describe insulin’s action on the blood vasculature and its still-debated mechanisms of exit from the capillary beds. Once in the parenchymal interstitium of muscle and adipose tissue, insulin promotes glucose uptake into myofibers and adipocytes, and we elaborate on the intricate signaling and vesicle traffic mechanisms that underlie this fundamental function. Finally, we touch upon the renal degradation of insulin to end its action. Cellular discernment of insulin’s availability and action should prove critical to understanding its pivotal physiological functions and how their failure leads to diabetes.
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“An increase in circulating glucose levels is sensed by pancreatic β‐cells through the glucose transporter GLUT2.”
From Inter‐organ communication: a gatekeeper for metabolic health (2019) · cites this paper as [24]
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“A major forerunner of these events is the deterioration of the action of insulin, which regulates metabolic homeostasis via a complex signal transduction network in multiple tissues (Taniguchi et al. 2006; Tokarz et al. 2018).”
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“…Gd [125,126] Entry 12—[VO( p -dmada)] on GQD [68] Entry 13—Vanadate-PLI complex on GQD, Vanadate-PL2 complex on GQD [6] Entry 14—Vanadyl acetylacetonate complex and 17 β -oestradiol on GQD [7] Since insulin is a peptide hormone, it is subjected to cellular metabolism upon entry into cells [128].”
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“It is the main anabolic hormone of the body that regulates the metabolism of carbohydrate, fat, and proteins by promoting the absorption of glucose from the blood into the liver, fat, and skeletal muscles [143, 144].”
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Wen Dan Tang: A Potential Jing Fang Decoction for Headache Disorders?
Pradhan, S. K., Li, Y., Gantenbein, A. R., Angst, F., Lehmann, S., & Shaban, H. (2022) · Medicines · doi:10.3390/medicines9030022 · Cited by 4
“The signal transmission at the GLUT-4 caused by PI3K binding to the cell membrane resulting in an increase in the transport of glucose into the muscle cells [104, 105].”
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“INTRODUCTION Insulin resistance (IR) is a condition in which the molecular mechanisms of insulin uptake and degradation are impaired, leading to the development of type 2 diabetes (T2D) and cardiovascular diseases in the long term (1-3).”
BackgroundBiochemical Toxicological Study of Insulin Overdose in Rats: A Forensic Perspective
Bian, C., He, X., Wang, Q., Zheng, Z., Zhang, Y., Xiong, H., Li, Y., Zhao, M., & Li, J. (2023) · Toxics · doi:10.3390/toxics12010017 · Cited by 4
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“15,16,19 While the same process applies to all exogenous insulins, it should be noted that BI analogues have been designed to prolong half-life by delaying re-solubilization and absorption, resulting in more stable pharmacokinetic (PK)/pharmacodynamic (PD) profiles that could potentially reduce the…”
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Gestational diabetes mellitus management: diet and lifestyle
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Measurement of GLUT4 Traffic to and from the Cell Surface in Muscle Cells
Antonescu, C. N., Ishikura, S., Bilan, P. J., & Klip, A. (2023) · Current Protocols · doi:10.1002/cpz1.803 · Cited by 4
“…specialized GLUT4 storage vesicle devoid of transferrin receptor but harboring the insulin-responsive aminopeptidase and VAMP2 (reviewed by Fazakerley et al., 2022; Jaldin-Fincati et al., 2017; Klip et al., 2019; Stöckli et al., 2011; Sylow et al., 2021; Tokarz et al., 2018; Zaid et al., 2008).”
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“Insulin clearance includes the insulin uptake and enzymatic degradation (Tokarz et al. 2018).”
Mitochondrial Dysfunction in Propionic Acidemia: A Case‐Report and Review of the Literature
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“Insulin is strongly anabolic [46].”
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“, 2020), with the A and B chains having 21 and 30 amino acid residues, respectively (Adams et al., 2018; de Haro Moreno et al., 2018; Norman & Litwack, 1997; Tokarz et al., 2018).”
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“Myocytes and adipocytes are important sites of insulin action, glucose uptake, and insulin resistance [2, 3], and ATP is involved in the muscular glucose uptake process [4].”
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Diabetes mellitus impact on fetal liver circulation, and new diagnostic options
Kiserud, T. (2023) · Revista Médica Clínica Las Condes · doi:10.1016/j.rmclc.2023.01.003 · Cited by 3
Omniligase-1-Mediated Phage-Peptide Library Modification and Insulin Engineering
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Insulin receptor-inspired soluble insulin binder
Mendoza, C., Hanegan, C. M., Sperry, A., Vargas, L., Case, T., Bikman, B. T., & Mizrachi, D. (2023) · European Journal of Cell Biology · doi:10.1016/j.ejcb.2023.151293 · Cited by 3
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Fabrication and functionalization of nanochannels for sensing applications
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Insulin-like peptide secretion is mediated by peroxisome-Golgi interplayPreprint
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“Also the action of insulin itself is systemic: it is secreted into the blood stream, regulating e.g. glucagon release from α -cells in the pancreas and glucose uptake into various organs, e.g. muscles (Tokarz et al., 2018).”
Hickey, T. E., Mudunuri, U. S., Hempel, H., Kemp, T. J., Roche, N., Talsania, K., Sellers, B. A., Cherry, J. M., & Pinto, L. A. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1502458 · Cited by 3
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Liver–pancreas communication in disease and drug development
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“…hepatocyte signaling ( i.e. , binding to insulin receptor and activates the PI3K — Akt — mTORC1 signaling) or non-canonical effectors ( e.g. , FoxO1 regulation of fatty acid oxidation and fine-tuning IRS1/IRS2 ratio by peroxisome-proliferator-activated receptor-gamma coactivator-1) 141,142 .”
Palermo, A., Naciu, A. M., Zavatta, G., Sargentini, E., Menale, C., Yavropoulou, M. P., Cipriani, C., Tabacco, G., & Anastasilakis, A. D. (2026) · European Journal of Endocrinology · doi:10.1093/ejendo/lvag076 · Cited by 2
From insulin replacement to bioengineered, encapsulated organoids
Maillard, É., & Sigrist, S. (2020) · Elsevier eBooks · doi:10.1016/b978-0-08-102906-0.00015-5 · Cited by 2
The Insulin Journey in the Human Body
Infante, M. (2022) · IntechOpen eBooks · doi:10.5772/intechopen.107906 · Cited by 2
The Reponic Classification of Insulin
Moen, J. (2023) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2023.05.007 · Cited by 2
Fisiopatología y mecanismos de acción del ejercicio en el manejo de la diabetes mellitus tipo 2
León-Ariza, H. H., Guardela, M. J. R., & Barrera, A. F. C. (2023) · Revista Colombiana de Endocrinología Diabetes & Metabolismo · doi:10.53853/encr.10.2.790 · Cited by 2
Metadata
- Authors
- Tokarz, V. L., MacDonald, P. E., & Klip, A.
- Affiliations
- University of Toronto (CA)
- University of Alberta (CA)
- Corresponding author
- Klip, Amira
- Venue
- Journal of Cell Biology
- Publisher
- Rockefeller University Press
- Published
- 2018-04-05
- Volume
- 217
- Issue
- 7
- Pages
- 2273-2289
- ISSN
- 0021-9525 (ISSN-L)
- 1540-8140
- PMC
- PMC6028526
- OpenAlex
- W2796003794
- Cited by
- 471
- References
- 223
- Citations by year
- 2026: 37 · 2025: 63 · 2024: 46 · 2023: 64 · 2022: 80 · 2021: 88 · 2020: 41 · 2019: 41 · 2018: 10
- FWCI
- 4.41
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Journal of Cell Biology (publishedVersion, cc-by-nc-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research (FRN 148451, FRN: FND-143203)
- University of Toronto
- The Hospital for Sick Children
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Cellular transport and secretion
- Keywords
- insulin, insulin biosynthesis, pancreatic beta cells, insulin secretion, hepatic insulin clearance, muscle glucose uptake, adipocyte glucose uptake, insulin signaling, vesicle trafficking, diabetes mellitus
- MeSH terms
- Adipose Tissue, Diabetes Mellitus, Glucose, Humans, Insulin, Insulin Resistance, Adipocytes, Muscle, Skeletal, Testosterone Congeners, Insulin-Secreting Cells
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