Post-burn hepatic insulin resistance is associated with endoplasmic reticulum (ER) stress

Shock. 2010 Mar;33(3):299-305. doi: 10.1097/SHK.0b013e3181b2f439.

Abstract

Insulin resistance with its associated hyperglycemias represents one significant contributor to mortality in burned patients. A variety of cellular stress-signaling pathways are activated as a consequence of burn. A key player in the cellular stress response is the endoplasmic reticulum (ER). Here, we investigated a possible role for ER-stress pathways in the progression of insulin function dysregulation postburn. Rats received a 60% total body surface area thermal injury, and a laparotomy was performed at 24, 72, and 192 h postburn. Liver was harvested before and 1 min after insulin injection (1 IU/kg) into the portal vein, and expression patterns of various proteins known to be involved in insulin and ER-stress signaling were determined by Western blotting. mRNA expression of glucose-6-phosphatase and glucokinase were determined by reverse-transcriptase-polymerase chain reaction and fasting serum glucose and insulin levels by standard enzymatic and enzyme-linked immunosorbent assay techniques, respectively. Insulin resistance indicated by increased glucose and insulin levels occurred starting 24 h postburn. Burn injury resulted in activation of ER stress pathways, reflected by significantly increased accumulation of phospho-PKR-like ER-kinase and phosphorylated inositol requiring enzyme 1, leading to an elevation of phospho-c-Jun N-terminal kinase and serine phosphorylation of insulin receptor substrate (IRS) 1 postburn. Insulin administration caused a significant increase in tyrosine phosphorylation of IRS-1, leading to activation of the phosphatidylinositol 3 kinase/Akt pathway in normal liver. Postburn tyrosine phosphorylation of IRS-1 was significantly impaired, associated with an inactivation of signaling molecules acting downstream of IRS-1, leading to significantly elevated transcription of glucose-6-phosphatase and significantly decreased mRNA expression of glucokinase. Activation of ER-stress signaling cascades may explain metabolic abnormalities involving insulin action after burn.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Burns / metabolism*
  • Burns / pathology
  • Endoplasmic Reticulum Stress*
  • Gene Expression Regulation, Enzymologic
  • Glucokinase / biosynthesis
  • Glucose-6-Phosphatase / biosynthesis
  • Insulin / metabolism*
  • Insulin Receptor Substrate Proteins / metabolism
  • Insulin Resistance*
  • JNK Mitogen-Activated Protein Kinases / metabolism
  • Liver / metabolism*
  • Liver / pathology
  • Phosphorylation
  • Rats
  • Rats, Sprague-Dawley
  • Signal Transduction*
  • Time Factors

Substances

  • Insulin
  • Insulin Receptor Substrate Proteins
  • Irs1 protein, rat
  • Glucokinase
  • JNK Mitogen-Activated Protein Kinases
  • Glucose-6-Phosphatase