Cited by 471Metabolism, Diabetes, and CancerPancreatic function and diabetesCellular transport and secretion

The DOI matches its Crossref record; 224 of the 224 references it cites were found in a registry or an index.

The cell biology of systemic insulin function

Open access
Tokarz, Victoria L., MacDonald, Patrick E., Klip, Amira·2018·Journal of Cell Biology

Abstract

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.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1083/jcb.201802095

Cites

224 of 224 references verified0 citation errors · 0 not checkable

Statistics

Figures

Figure 1. Journey of insulin in the body. Insulin is transcribed and expressed in the β-cells of the pancreas, from whence it is exported through the portal circulation to the liver. During this first pass, over 50% of insulin is cleared by the hepatocytes in the liver. The remaining insulin exits the liver via the hepatic vein, where it follows the venous circulation to the heart. Insulin is distributed to the rest of the body through the arterial circulation. Along the arterial tree, insulin promotes vasodilation. Arterially delivered insulin exerts its metabolic actions in the liver and is further cleared (second pass). Insulin exits the circulation at the level of the microvasculature, reaching muscle and fat cells, where it stimulates GLUT4 translocation and glucose uptake. Remaining circulating insulin is delivered to and finally degraded by the kidney. This review analyzes the cellular processes at each stage of this journey. This figure was created using Servier Medical Art (available at https://smart.servier.com/).
Figure 1. Journey of insulin in the body. Insulin is transcribed and expressed in the β-cells of the pancreas, from whence it is exported through the portal circulation to the liver. During this first pass, over 50% of insulin is cleared by the hepatocytes in the liver. The remaining insulin exits the liver via the hepatic vein, where it follows the venous circulation to the heart. Insulin is distributed to the rest of the body through the arterial circulation. Along the arterial tree, insulin promotes vasodilation. Arterially delivered insulin exerts its metabolic actions in the liver and is further cleared (second pass). Insulin exits the circulation at the level of the microvasculature, reaching muscle and fat cells, where it stimulates GLUT4 translocation and glucose uptake. Remaining circulating insulin is delivered to and finally degraded by the kidney. This review analyzes the cellular processes at each stage of this journey. This figure was created using Servier Medical Art (available at https://smart.servier.com/).CC BY-NC-SA · PubMed Central
Figure 2. Insulin biosynthesis and secretion. (A) Insulin maturation along the granule secretory pathway. Preproinsulin mRNA is transcribed from the INS gene and translated to preproinsulin peptide. As this transits through the RER and TGN, the prepropeptide is processed to its mature form and ultimately stored as hexameric insulin/Zn2+ crystals within mature secretory granules. (B) Glucose sensing and metabolic signals leading to insulin granule secretion. The release of insulin via exocytosis of secretory granules from pancreatic β-cells is controlled by a series of metabolic and electrical signals arising as a result of glucose entry through GLUTs, phosphorylation by GK, and entry into the TCA cycle. The closure of ATP-dependent K+ (KATP) channels triggers electrical events that culminate in Ca2+ entry through voltage-dependent Ca2+ channels (VDCCs), which triggers exocytosis mediated by SNARE complex proteins. The overall secretory response is modulated by numerous receptors, channels, intracellular Ca2+ stores, metabolic signals, and cytoskeletal elements. (C) Islet communication for coordinated pulsatile insulin secretion. Within an islet, β-cells communicate with each other and with glucagon-producing α-cells and somatostatin (SST)–producing δ-cells to coordinate their activity. Many putative intraislet messengers have been implicated, including ATP, Zn2+, γ-aminobutyric acid (GABA), glucagon-like peptide-1 (GLP-1), acetylcholine (ACh), and others. These, along with electrical coupling via gap junctions, are likely important for the physiological coordination of pulsatile insulin secretion.
Figure 2. Insulin biosynthesis and secretion. (A) Insulin maturation along the granule secretory pathway. Preproinsulin mRNA is transcribed from the INS gene and translated to preproinsulin peptide. As this transits through the RER and TGN, the prepropeptide is processed to its mature form and ultimately stored as hexameric insulin/Zn2+ crystals within mature secretory granules. (B) Glucose sensing and metabolic signals leading to insulin granule secretion. The release of insulin via exocytosis of secretory granules from pancreatic β-cells is controlled by a series of metabolic and electrical signals arising as a result of glucose entry through GLUTs, phosphorylation by GK, and entry into the TCA cycle. The closure of ATP-dependent K+ (KATP) channels triggers electrical events that culminate in Ca2+ entry through voltage-dependent Ca2+ channels (VDCCs), which triggers exocytosis mediated by SNARE complex proteins. The overall secretory response is modulated by numerous receptors, channels, intracellular Ca2+ stores, metabolic signals, and cytoskeletal elements. (C) Islet communication for coordinated pulsatile insulin secretion. Within an islet, β-cells communicate with each other and with glucagon-producing α-cells and somatostatin (SST)–producing δ-cells to coordinate their activity. Many putative intraislet messengers have been implicated, including ATP, Zn2+, γ-aminobutyric acid (GABA), glucagon-like peptide-1 (GLP-1), acetylcholine (ACh), and others. These, along with electrical coupling via gap junctions, are likely important for the physiological coordination of pulsatile insulin secretion.CC BY-NC-SA · PubMed Central
Figure 3. Insulin clearance in the liver. (A) Insulin is delivered to the hepatic sinusoid, where it freely accesses the liver hepatocytes through the fenestrated sinusoidal endothelium. (B) Proposed mechanism for insulin degradation in hepatocytes. Insulin binds to the IR and forms a complex with CEACAM1. Prior to internalization, extracellular IDE begins to degrade receptor-bound insulin. After internalization, endosomal IDE degrades receptor-bound insulin and, once the endosome acidifies and the complex dissociates, also frees insulin. Any remaining insulin or insulin fragments progress toward lysosomes for their complete proteolytic degradation.
Figure 3. Insulin clearance in the liver. (A) Insulin is delivered to the hepatic sinusoid, where it freely accesses the liver hepatocytes through the fenestrated sinusoidal endothelium. (B) Proposed mechanism for insulin degradation in hepatocytes. Insulin binds to the IR and forms a complex with CEACAM1. Prior to internalization, extracellular IDE begins to degrade receptor-bound insulin. After internalization, endosomal IDE degrades receptor-bound insulin and, once the endosome acidifies and the complex dissociates, also frees insulin. Any remaining insulin or insulin fragments progress toward lysosomes for their complete proteolytic degradation.CC BY-NC-SA · PubMed Central
Figure 4. Insulin interactions with the vasculature. (A) Endothelial insulin signaling leading to vasodilation in the macrovasculature. The endothelial cell IR engages its major substrate in these cells, IRS2, leading downstream to activation of Akt. Akt phosphorylates endothelial NO synthase (eNOS), which catalyzes the production of NO from l-arginine. NO freely diffuses to the underlying vascular smooth muscle layer, where it leads to cyclic guanosine monophosphate production to induce vasorelaxation. (B) Possible routes for insulin exit across microvascular endothelial cells toward the interstitial space in muscle and fat tissue. Insulin may cross the microvascular capillary endothelium either paracellularly (between adjacent endothelial cells) or transcellularly (through individual endothelial cells). For the transcellular route, both receptor-mediated and fluid-phase mechanisms of transport have been proposed.
Figure 4. Insulin interactions with the vasculature. (A) Endothelial insulin signaling leading to vasodilation in the macrovasculature. The endothelial cell IR engages its major substrate in these cells, IRS2, leading downstream to activation of Akt. Akt phosphorylates endothelial NO synthase (eNOS), which catalyzes the production of NO from l-arginine. NO freely diffuses to the underlying vascular smooth muscle layer, where it leads to cyclic guanosine monophosphate production to induce vasorelaxation. (B) Possible routes for insulin exit across microvascular endothelial cells toward the interstitial space in muscle and fat tissue. Insulin may cross the microvascular capillary endothelium either paracellularly (between adjacent endothelial cells) or transcellularly (through individual endothelial cells). For the transcellular route, both receptor-mediated and fluid-phase mechanisms of transport have been proposed.CC BY-NC-SA · PubMed Central
Figure 5. Insulin signaling in muscle and adipose cells leading to recruitment of GLUT4 to the plasma membrane. Insulin binds to its receptor on the surface of muscle or fat cells and activates the canonical insulin-signaling cascade to PI3K and Akt. Downstream of Akt, phosphorylation of AS160 allows for the full activation of Rab8A and Rab13 (in muscle cells) and Rab10 (in adipocytes). In the perinuclear region, Rab8A engages with its effector, MyoVa, and Rab10 with its effector, Sec16A, to promote outward vesicle traffic. Near the plasma membrane, Rab13 engages with MICAL-L2 and Actinin-4, whereas Rab10 engages with RalA, Myo1c, and Exocyst components. Simultaneously, downstream of PI3K, insulin leads to activation of Rac1 that promotes a dynamic cycle of cortical actin remodeling. Together, these actions tether GLUT4 vesicles to the actin cytoskeleton near the plasma membrane. Inset: Docked GLUT4 vesicle ready to fuse with the plasma membrane. Immobilized GLUT4 vesicles fuse with the membrane through formation of a SNARE complex between vesicular VAMP2 and syntaxin4 and SNAP23 on the plasma membrane.
Figure 5. Insulin signaling in muscle and adipose cells leading to recruitment of GLUT4 to the plasma membrane. Insulin binds to its receptor on the surface of muscle or fat cells and activates the canonical insulin-signaling cascade to PI3K and Akt. Downstream of Akt, phosphorylation of AS160 allows for the full activation of Rab8A and Rab13 (in muscle cells) and Rab10 (in adipocytes). In the perinuclear region, Rab8A engages with its effector, MyoVa, and Rab10 with its effector, Sec16A, to promote outward vesicle traffic. Near the plasma membrane, Rab13 engages with MICAL-L2 and Actinin-4, whereas Rab10 engages with RalA, Myo1c, and Exocyst components. Simultaneously, downstream of PI3K, insulin leads to activation of Rac1 that promotes a dynamic cycle of cortical actin remodeling. Together, these actions tether GLUT4 vesicles to the actin cytoskeleton near the plasma membrane. Inset: Docked GLUT4 vesicle ready to fuse with the plasma membrane. Immobilized GLUT4 vesicles fuse with the membrane through formation of a SNARE complex between vesicular VAMP2 and syntaxin4 and SNAP23 on the plasma membrane.CC BY-NC-SA · PubMed Central

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Cited by

Sorted by citations

See all 471

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
Published
2018-04-05
Volume
217
Issue
7
Pages
2273-2289
ISSN
  • 0021-9525 (ISSN-L)
  • 1540-8140
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
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

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review