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Journal of Endocrinological Investigation
Published in: Journal of Endocrinological Investigation 12/2016

01-12-2016 | Review

Insulin, insulin receptors, and cancer

Authors: R. Vigneri, I. D. Goldfine, L. Frittitta

Published in: Journal of Endocrinological Investigation | Issue 12/2016

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Abstract

Insulin is a major regulator of cell metabolism but, in addition, is also a growth factor. Insulin effects in target cells are mediated by the insulin receptor (IR), a transmembrane protein with enzymatic (tyrosine kinase) activity. The insulin receptor, however, is represented by a heterogeneous family of proteins, including two different IR isoforms and also hybrid receptors resulting from the IR hemireceptor combination with a hemireceptor of the cognate IGF-1 receptor. These different receptors may bind insulin and its analogs with different affinity and produce different biologic effects. Since many years, it is known that many cancer cells require insulin for optimal in vitro growth. Recent data indicate that: (1) insulin stimulates growth mainly via its own receptor and not the IGF-1 receptor; (2) in many cancer cells, the IR is overexpressed and the A isoform, which has a predominant mitogenic effect, is more represented than the B isoform. These characteristics provide a selective growth advantage to malignant cells when exposed to insulin. For this reason, all conditions of hyperinsulinemia, both endogenous (prediabetes, metabolic syndrome, obesity, type 2 diabetes before pancreas exhaustion and polycystic ovary syndrome) and exogenous (type 1 diabetes) will increase the risk of cancer. Cancer-related mortality is also increased in patients exposed to hyperinsulinemia but other factors, related to the different diseases, may also contribute. The complexity of the diseases associated with hyperinsulinemia and their therapies does not allow a precise evaluation of the cancer-promoting effect of hyperinsulinemia, but its detrimental effect on cancer incidence and mortality is well documented.
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Metadata
Title
Insulin, insulin receptors, and cancer
Authors
R. Vigneri
I. D. Goldfine
L. Frittitta
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Journal of Endocrinological Investigation / Issue 12/2016
Electronic ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-016-0508-7

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