Insulin signaling pathways in a patient with insulin resistance of difficult management - a case report.

Diabetology & Metabolic Syndrome
Giselle F TaboadaMarília de B Gomes

Abstract

Insulin signalling pathways were investigated in a 33 year-old woman with immunologic insulin resistance. Her past medical history was remarkable for intermittent use of insulin and allergic reactions to several drugs, and measure of plasma anti-insulin antibodies level corroborated the clinical suspicion of immune mediated insulin resistance (8074 nU/ml - RIA - Ref value: <60). Treatment with several immunosuppressive regimens was tried, however the results were disappointing. Possible subcellular mechanisms of insulin resistance were investigated by performing analysis of insulin receptor and post receptor signaling in skeletal muscle biopsy. The expression of insulin receptor (IR), insulin receptor substrate 1 (IRS-1) and glucose transporter 4 (GLUT-4) was evaluated in total extract from muscle tissue by Western blotting. Basal IR, IRS-1 and GLUT-4 expression was detected, however receptor autophosphorylation was not observed. A study of translocation of GLUT-4 to plasma membrane showed that tissue presented low levels of membrane-associated GLUT-4. When in vitro stimulation was undertaken, tissue was capable to be responsive to insulin. Our results suggest that even though IR expression was normally occurring, IR beta-subu...Continue Reading

References

Jul 1, 1990·The Journal of Allergy and Clinical Immunology·M A GanzL C Grammer
Jan 1, 1993·Diabetes Research and Clinical Practice·D MicićJ Micić
Aug 29, 2003·Biochimica Et Biophysica Acta·Marta Sampaio de FreitasChristina Barja-Fidalgo
Dec 1, 1996·Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases·B F Mandell

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