Proinsulin is the

prohormone A prohormone is a committed Precursor (chemistry), precursor of a hormone consisting of peptide hormones synthesized together that has a minimal hormonal effect by itself because of its expression-suppressing structure, often created by protein fol ...

precursor to

insulin Insulin (, from Latin ''insula'', 'island') is a peptide hormone produced by beta cells of the pancreatic islets encoded in humans by the ''INS'' gene. It is considered to be the main anabolic hormone of the body. It regulates the metabolism o ...

made in the

beta cell Beta cells (β-cells) are a type of cell found in pancreatic islets that synthesize and secrete insulin and amylin. Beta cells make up 50–70% of the cells in human islets. In patients with Type 1 diabetes, beta-cell mass and function are dimini ...

s of the

islets of Langerhans The pancreatic islets or islets of Langerhans are the regions of the pancreas that contain its endocrine (hormone-producing) cells, discovered in 1869 by German pathological anatomist Paul Langerhans. The pancreatic islets constitute 1–2% of ...

, specialized regions of the

pancreas The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e. it has both an end ...

. In humans, proinsulin is encoded by the ''INS''

gene In biology, the word gene (from , ; "...Wilhelm Johannsen coined the word gene to describe the Mendelian units of heredity..." meaning ''generation'' or ''birth'' or ''gender'') can have several different meanings. The Mendelian gene is a ba ...

. The islets of Langerhans only secrete between 1% and 3% of proinsulin intact. However, because proinsulin has a longer half life than insulin, it can account for anywhere from 5–30% of the insulin-like structures circulating in the blood. There are higher concentrations of proinsulin after meals and lower levels when a person is fasting. Additionally, while proinsulin and insulin have structural differences, proinsulin does demonstrate some affinity for the

insulin receptor The insulin receptor (IR) is a transmembrane receptor that is activated by insulin, IGF-I, IGF-II and belongs to the large class of receptor tyrosine kinase. Metabolically, the insulin receptor plays a key role in the regulation of glucose homeo ...

. Due to the relative similarities in structure, proinsulin can produce between 5% and 10% of the metabolic activity similarly induced by insulin. Proinsulin is the final single chain protein structure secreted by cells before cleavage into mature insulin. Proinsulin was discovered by Professor

Donald F. Steiner Donald Frederick Steiner (July 15, 1930 – November 11, 2014) was an American biochemist and a professor at the University of Chicago. Birth and education Donald F. Steiner was born in 1930 in Lima, Ohio. He completed his B.S. in Chemistry ...

of the University of Chicago in 1967.

Structure

Proinsulin is made up of 86 residues in humans (81 in cows), and formed by three distinct chains. The A chain, B chain, and the area connecting the two named the C peptide. The correct structure of proinsulin is crucial for the correct folding of mature insulin, as the placement of the C peptide sets the molecule up to create correctly positioned

disulfide bonds In biochemistry, a disulfide (or disulphide in British English) refers to a functional group with the structure . The linkage is also called an SS-bond or sometimes a disulfide bridge and is usually derived by the coupling of two thiol groups. In ...

in and between the A and B chains. There are three disulfide bonds that are necessary for mature insulin to be the correct structure. Two of these disulfide bonds are between the A and B chains, and one is an intra-A chain bond. The disulfide bonds occur between the seventh residues of the A and B chain, the 20th residue of the A chain and the 19th residue of the B chain, and the 6th and 11th residues of the A chain. The C peptide is between the A and B chains of proinsulin. The connection between the A chain and C peptide is much more stable than the junction between the C peptide and B chain, with alpha helical features being exhibited near the C peptide-A chain connection. The C peptide-A chain junction occurs between residues 64 and 65 of proinsulin. These are

lysine Lysine (symbol Lys or K) is an α-amino acid that is a precursor to many proteins. It contains an α-amino group (which is in the protonated form under biological conditions), an α-carboxylic acid group (which is in the deprotonated −C ...

and

arginine Arginine is the amino acid with the formula (H2N)(HN)CN(H)(CH2)3CH(NH2)CO2H. The molecule features a guanidino group appended to a standard amino acid framework. At physiological pH, the carboxylic acid is deprotonated (−CO2−) and both the am ...

molecules, respectively. The C peptide-B chain connection is between two arginine residues at positions 31 and 32 of proinsulin. There is conservation of much of the structure of proinsulin among mammalian species, with much of the residue changes seen from one species to another present in the C peptide. That said, the residues of the C peptide that are conserved across species interact with similarly conserved residues on the A and B chains. Thus, it is hypothesized that these conserved residues are important for the functionality of mature insulin. File:Proinsulin 3.png File:Proinsulin annotated.png, alt=3D Model of proinsulin - A chain is in blue, b chain in red, c peptide in orange. The dibasic cleavage for c peptide and a chain is in green KR (lysine and arginine), the one for c peptide and b chain is in cyan RR (arginine)., 3D Model of proinsulin - A chain is in blue, b chain in red, c peptide in orange. The dibasic cleavage for c peptide and a chain is in green KR (lysine and arginine), the one for c peptide and b chain is in cyan RR (arginine).

Synthesis and Post-translational Modification

Proinsulin is synthesized on membrane associated ribosomes found on the

rough endoplasmic reticulum The endoplasmic reticulum (ER) is, in essence, the transportation system of the eukaryotic cell, and has many other important functions such as protein folding. It is a type of organelle made up of two subunits – rough endoplasmic reticulum ( ...

, where it is folded and its

disulfide bond In biochemistry, a disulfide (or disulphide in British English) refers to a functional group with the structure . The linkage is also called an SS-bond or sometimes a disulfide bridge and is usually derived by the coupling of two thiol groups. In ...

s are oxidized. It is then transported to the

Golgi apparatus The Golgi apparatus (), also known as the Golgi complex, Golgi body, or simply the Golgi, is an organelle found in most eukaryotic cells. Part of the endomembrane system in the cytoplasm, it packages proteins into membrane-bound vesicles ins ...

where it is packaged into secretory vesicles, and where it is processed by a series of proteases to form mature

. Mature insulin has 35 fewer amino acids; 4 are removed altogether, and the remaining 31 form the

C-peptide The connecting peptide, or C-peptide, is a short 31-amino-acid polypeptide that connects insulin, insulin's A-chain to its B-chain in the proinsulin molecule. In the context of diabetes or hypoglycemia, a measurement of C-peptide blood serum lev ...

. The C-peptide is abstracted from the center of the proinsulin sequence; the two other ends (the B chain and A chain) remain connected by disulfide bonds. The

post translational modification Post-translational modification (PTM) is the covalent and generally enzymatic modification of proteins following protein biosynthesis. This process occurs in the endoplasmic reticulum and the golgi apparatus. Proteins are synthesized by ribosome ...

of proinsulin to mature insulin only occurs in the beta cells of the islets of Langerhans. When proinsulin is transported through the Golgi apparatus the C-peptide is cleaved. This cleavage occurs with the aid of two endoproteases. Type I

endoprotease Endopeptidase or endoproteinase are proteolytic peptidases that break peptide bonds of nonterminal amino acids (i.e. within the molecule), in contrast to exopeptidases, which break peptide bonds from end-pieces of terminal amino acids. For this re ...

s, PC1 and PC3, disrupt the C peptide-B chain connection. PC2, a type II endoprotease, cleaves the C peptide-A chain bond. The resulting molecule, now mature insulin, is stored as a hexamer in

secretory vesicles 440px Secretion is the movement of material from one point to another, such as a secreted chemical substance from a cell or gland. In contrast, excretion is the removal of certain substances or waste products from a cell or organism. The classical ...

and is stabilized with

Zn^

ions until it is secreted. File:Proinsulin evolution.png

Immunogenicity

When insulin was originally purified from

bovine Bovines (subfamily Bovinae) comprise a diverse group of 10 genera of medium to large-sized ungulates, including cattle, bison, African buffalo, water buffalos, and the four-horned and spiral-horned antelopes. The evolutionary relationship betwee ...

porcine The pig (''Sus domesticus''), often called swine, hog, or domestic pig when distinguishing from other members of the genus '' Sus'', is an omnivorous, domesticated, even-toed, hoofed mammal. It is variously considered a subspecies of ''Sus s ...

pancreata, all the proinsulin was not fully removed. When some people used these insulins, the proinsulin may have caused the body to react with a rash, to resist the insulin, or even to make dents or lumps in the skin at the place where the insulin was injected. This can be described as an

iatrogenic Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence. "Iatrogenic", ''Merriam-Webster.com'', Merriam-Webster, Inc., accessed 2 ...

injury due to slight differences between the proinsulin of different species. Since the late 1970s, when highly purified

insulin was introduced, and the level of insulin purity reached 99%, this ceased to be a significant clinical issue. With respect to their influence on insulin pharmacokinetics, moderate concentrations of certain insulin antibodies may be of positive advantage to all diabetics without endogenous insulin secretion (e.g. people with

type 1 diabetes Type 1 diabetes (T1D), formerly known as juvenile diabetes, is an autoimmune disease that originates when cells that make insulin (beta cells) are destroyed by the immune system. Insulin is a hormone required for the cells to use blood sugar for ...

) because insulin binding antibodies effectively increase the insulin's clearance rate and distribution space and help to prolong its pharmacological and biological half lives.

Medical Relevance

Historically, the focus of many insulin related metabolic diseases has focused on mature insulin. However, in recent years the importance of studying the structure and function of proinsulin or proinsulin:insulin ratio in relation to these diseases has become increasingly clear.

Diabetes Mellitus Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ap ...

Increased levels of proinsulin in the

circulatory system The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...

relative to mature insulin concentrations can indicate impending

insulin resistance Insulin resistance (IR) is a pathological condition in which cell (biology), cells fail to respond normally to the hormone insulin. Insulin is a hormone that facilitates the transport of glucose from blood into cells, thereby reducing blood gluco ...

and the development of

type 2 diabetes Type 2 diabetes, formerly known as adult-onset diabetes, is a form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, ...

. Additional problems with proinsulin that can lead to diabetes include mutations in the number of cysteines present, which could affect correct folding. If the mutation causes only a mild change it could simply stress the endoplasmic reticulum’s ability to properly fold the protein. This stress, after a while, would lead to a decrease in the number of β-cells producing mature insulin, and would then lead to diabetes mellitus.

Neonatal Diabetes Mellitus Neonatal diabetes mellitus (NDM) is a disease that affects an infant and their body's ability to produce or use insulin. NDM is a monogenic (controlled by a single gene) form of diabetes that occurs in the first 6 months of life. Infants do not pr ...

Postnatal proinsulin is crucial for metabolic regulation. However, proinsulin in

neonates An infant or baby is the very young offspring of human beings. ''Infant'' (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is a formal or specialised synonym for the common term ''baby''. The terms may also be used to ...

is important for normal development of the nerves of the eye, development of the heart, and general survival of embryonic cells. Regulation of the concentration of proinsulin during embryonic development is crucial, as too much or too little of the peptide can cause defects and death of the fetus. Thus far in the study of neonatal diabetes mellitus, only amino acid change mutations found in the B domain lead to the disease.

References

{{reflist Peptides Diabetes