[The insulin transduction system]

Insulin is a key hormone regulating glucose homeostasis and has many cellular effects on metabolism, growth, and differentiation. Insulin action is mediated through a specific cell-surface receptor. The first step following insulin binding consists in receptor autophosphorylation and stimulation of its tyrosine kinase activity. Among the multiple substrates, the insulin receptor substrate-1 (IRS-1) is the major cytoplasmic substrate for insulin. IRS-1 binds several Src homology 2 (SH2) proteins through its multiple tyrosine phosphorylation sites: phosphatidylinositol 3-kinase (PI 3-kinase), the Ras guanine-nucleotide-releasing complex Grb2-SOS, the tyrosine phosphatase Syp, and the adapter protein Nck. IRS-1 is essential for many, but not all of the insulin's biological responses. Recently, a primary alternative substrate, i.e. IRS-2, was purified and cloned. Numerous biochemical abnormalities of the insulin signaling system lead to insulin resistance. No doubt, the recent data about the molecular mechanisms of insulin action will provide new insights into the pathophysiology and therapy of diabetes and other insulin resistant states.