The back and forth of cargo exit from the endoplasmic reticulum

Endoplasmic reticulum (ER) to Golgi trafficking is an essential step in sorting mature, correctly folded, processed and assembled proteins (cargo) from immature proteins and ER-resident proteins. However, the mechanisms governing trafficking selectivity, specificity and regulation are not yet fully understood. To date, three complementary mechanisms have been described that enable regulation of this trafficking step: ER retention of immature proteins in the ER; selective uptake of fully mature proteins into Golgi-bound vesicles; and retrieval from the Golgi of immature cargo that has erroneously exited the ER. Together, these three mechanisms allow incredible specificity and enable the cell to carry out protein quality control and regulate protein processing, oligomerization and expression. This review will focus on the current knowledge of selectivity mechanisms acting during the ER-to-Golgi sorting step and their significance in health and disease. The review will also highlight several key questions that have remained unanswered and discuss the future frontiers.