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Science 15 October 2004:
Vol. 306. no. 5695, pp. 457 - 461
DOI: 10.1126/science.1103160

Research Articles

Endoplasmic Reticulum Stress Links Obesity, Insulin Action, and Type 2 Diabetes

Umut Özcan,1* Qiong Cao,1* Erkan Yilmaz,1 Ann-Hwee Lee,2 Neal N. Iwakoshi,2 Esra Özdelen,1 Gürol Tuncman,1 Cem Görgün,1 Laurie H. Glimcher,2,3 Gökhan S. Hotamisligil1{dagger}

Obesity contributes to the development of type 2 diabetes, but the underlying mechanisms are poorly understood. Using cell culture and mouse models, we show that obesity causes endoplasmic reticulum (ER) stress. This stress in turn leads to suppression of insulin receptor signaling through hyperactivation of c-Jun N-terminal kinase (JNK) and subsequent serine phosphorylation of insulin receptor substrate–1 (IRS-1). Mice deficient in X-box–binding protein–1 (XBP-1), a transcription factor that modulates the ER stress response, develop insulin resistance. These findings demonstrate that ER stress is a central feature of peripheral insulin resistance and type 2 diabetes at the molecular, cellular, and organismal levels. Pharmacologic manipulation of this pathway may offer novel opportunities for treating these common diseases.

1 Department of Genetics and Complex Diseases, Harvard Medical School, Boston, MA 02115, USA.
2 Department of Immunology and Infectious Diseases, Harvard School of Public Health, Harvard Medical School, Boston, MA 02115, USA.
3 Department of Medicine, Harvard Medical School, Boston, MA 02115, USA.



* These authors contributed equally to this work.

{dagger} To whom correspondence should be addressed. E-mail: ghotamis{at}hsph.harvard.edu

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J. Lipid Res. 49, 880-892
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Inhibition of Foxo1 Protects Pancreatic Islet {beta}-Cells Against Fatty Acid and Endoplasmic Reticulum Stress-Induced Apoptosis.
S. C. Martinez, K. Tanabe, C. Cras-Meneur, N. A. Abumrad, E. Bernal-Mizrachi, and M. A. Permutt (2008)
Diabetes 57, 846-859
   Abstract »    Full Text »    PDF »
Quantitative Linkage Analysis for Pancreatic B-cell Function and Insulin Resistance in a Large Twin Cohort.
M. Falchi, S. G. Wilson, D. Paximadas, R. Swaminathan, and T. D. Spector (2008)
Diabetes 57, 1120-1124
   Abstract »    Full Text »    PDF »
Commonality of functional annotation: a method for prioritization of candidate genes from genome-wide linkage studies.
D. Shriner, T. M. Baye, M. A. Padilla, S. Zhang, L. K. Vaughan, and A. E. Loraine (2008)
Nucleic Acids Res. 36, e26
   Abstract »    Full Text »    PDF »
Therapeutic Potential of Peroxisome Proliferators-Activated Receptor-{alpha}/{gamma} Dual Agonist With Alleviation of Endoplasmic Reticulum Stress for the Treatment of Diabetes.
K. L. Han, J. S. Choi, J. Y. Lee, J. Song, M. K. Joe, M. H. Jung, and J.-K. Hwang (2008)
Diabetes 57, 737-745
   Abstract »    Full Text »    PDF »
Differential activation of ER stress and apoptosis in response to chronically elevated free fatty acids in pancreatic {beta}-cells.
E. Lai, G. Bikopoulos, M. B. Wheeler, M. Rozakis-Adcock, and A. Volchuk (2008)
Am J Physiol Endocrinol Metab 294, E540-E550
   Abstract »    Full Text »    PDF »
HSP72 protects against obesity-induced insulin resistance.
J. Chung, A.-K. Nguyen, D. C. Henstridge, A. G. Holmes, M. H. S. Chan, J. L. Mesa, G. I. Lancaster, R. J. Southgate, C. R. Bruce, S. J. Duffy, et al. (2008)
PNAS 105, 1739-1744
   Abstract »    Full Text »    PDF »
The Role for Endoplasmic Reticulum Stress in Diabetes Mellitus.
D. L. Eizirik, A. K. Cardozo, and M. Cnop (2008)
Endocr. Rev. 29, 42-61
   Abstract »    Full Text »    PDF »
An intact unfolded protein response in Trpt1 knockout mice reveals phylogenic divergence in pathways for RNA ligation.
H. P. Harding, J. G. Lackey, H.-C. Hsu, Y. Zhang, J. Deng, R.-M. Xu, M. J. Damha, and D. Ron (2008)
RNA 14, 225-232
   Abstract »    Full Text »    PDF »
In Vivo Effects of Insulin and Free Fatty Acids on Matrix Metalloproteinases in Rat Aorta.
G. Boden, W. Song, L. Pashko, and K. Kresge (2008)
Diabetes 57, 476-483
   Abstract »    Full Text »    PDF »
Sequential phosphorylation of insulin receptor substrate-2 by glycogen synthase kinase-3 and c-Jun NH2-terminal kinase plays a role in hepatic insulin signaling.
H. Sharfi and H. Eldar-Finkelman (2008)
Am J Physiol Endocrinol Metab 294, E307-E315
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Local activation of the I{kappa}K-NF-{kappa}B pathway in muscle does not cause insulin resistance.
E. Polkinghorne, Q. Lau, G. J. Cooney, E. W. Kraegen, and M. E. Cleasby (2008)
Am J Physiol Endocrinol Metab 294, E316-E325
   Abstract »    Full Text »    PDF »
Diabetes and Obesity: Part 1.
Z. T. Bloomgarden (2007)
Diabetes Care 30, 3145-3151
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Obesity-Induced Inflammation in White Adipose Tissue Is Attenuated by Loss of Melanocortin-3 Receptor Signaling.
K. L. J. Ellacott, J. G. Murphy, D. L. Marks, and R. D. Cone (2007)
Endocrinology 148, 6186-6194
   Abstract »    Full Text »    PDF »
Essential Role of Mitochondrial Function in Adiponectin Synthesis in Adipocytes.
E. H. Koh, J.-Y. Park, H.-S. Park, M. J. Jeon, J. W. Ryu, M. Kim, S. Y. Kim, M.-S. Kim, S.-W. Kim, I. S. Park, et al. (2007)
Diabetes 56, 2973-2981
   Abstract »    Full Text »    PDF »
The Role of Brain-derived Neurotrophic Factor (BDNF)-induced XBP1 Splicing during Brain Development.
A. Hayashi, T. Kasahara, K. Iwamoto, M. Ishiwata, M. Kametani, C. Kakiuchi, T. Furuichi, and T. Kato (2007)
J. Biol. Chem. 282, 34525-34534
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HIV-1 Protease Inhibitors Nelfinavir and Atazanavir Induce Malignant Glioma Death by Triggering Endoplasmic Reticulum Stress.
P. Pyrko, A. Kardosh, W. Wang, W. Xiong, A. H. Schonthal, and T. C. Chen (2007)
Cancer Res. 67, 10920-10928
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Activation of Endoplasmic Reticulum Stress in Degenerating Photoreceptors of the rd1 Mouse.
L.-p. Yang, L.-m. Wu, X.-j. Guo, and M. O. M. Tso (2007)
Invest. Ophthalmol. Vis. Sci. 48, 5191-5198
   Abstract »    Full Text »    PDF »
Disruption of CXC Motif Chemokine Ligand-14 in Mice Ameliorates Obesity-induced Insulin Resistance.
N. Nara, Y. Nakayama, S. Okamoto, H. Tamura, M. Kiyono, M. Muraoka, K. Tanaka, C. Taya, H. Shitara, R. Ishii, et al. (2007)
J. Biol. Chem. 282, 30794-30803
   Abstract »    Full Text »    PDF »



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