INSR/CD220

The insulin receptor (CD220) is a disulfide-linked heterotetramer of two extracellular alpha subunits and two transmembrane beta subunits with intrinsic tyrosine kinase activity. Ligand binding to the alpha subunits triggers autophosphorylation of the beta subunits and recruitment of IRS and Shc adaptors, launching the PI3K-AKT metabolic arm and the MAPK mitogenic arm. Alternative splicing at exon 11 generates an A isoform predominant in fetal and cancer cells and a B isoform of mature metabolic tissues. Loss-of-function mutations cause severe insulin resistance syndromes, the receptor is downregulated in type 2 diabetes, and anti-insulin receptor antibodies can produce both hypoglycemia and extreme resistance.