Endocrinology Vol. 143, No. 1 37-46
Copyright © 2002 by The Endocrine Society
INSULIN-GLUCAGON-GI PEPTIDES-DIABETES MELLITUS |
Ceramide and Glucosamine Antagonism of Alternate Signaling Pathways Regulating Insulin- and Osmotic Shock-Induced Glucose Transporter 4 Translocation
Steve F. Kralik1,
Ping Liu1,
Brian J. Leffler and
Jeffrey S. Elmendorf
Department of Cellular and Integrative Physiology, Indiana
University School of Medicine, Center for Diabetes Research,
Indianapolis, Indiana 46202
Address all correspondence and requests for reprints to: Dr. Jeffrey S. Elmendorf, Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Center for Diabetes Research, Indianapolis, Indiana 46202-5120. E-mail: jelmendo{at}iupui.edu
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Abstract
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In addition to insulin, hyperosmolarity induces glucose transporter
4 (GLUT4) translocation in 3T3-L1 adipocytes. However, in contrast to
insulin this stimulation is independent of PI3K/Akt. In this study we
assessed whether ceramide and/or glucosamine, two known
insulin-signaling antagonists, also affected the PI3K/Akt-independent
signal. Insulin, but not hyperosmolarity, clearly increased the
activities of PI3K and Akt. C2-ceramide did not alter
insulin-stimulated PI3K activity, but did decrease the ability of
insulin to activate Akt and GLUT4 translocation. Consistent with
osmotic shock- mediated GLUT4 translocation being independent of
PI3K/Akt, GLUT4 translocation induced by hyperosmolarity was not
altered by C2-ceramide. In contrast to the specific C2-ceramide-induced
attenuation of insulin-stimulated GLUT4 translocation, overexpression
of glutamine:fructose-6-phosphate amidotransferase, the rate-limiting
enzyme in the synthesis of UDP-N-acetylglucosamine,
and/or pretreatment of cells with glucosamine, a precursor of
UDP-N-acetylglucosamine, inhibited both insulin- and
hyperosmolarity-stimulated GLUT4 translocation. Glucosamine did not
alter any of the known proximal insulin signal transduction events.
These data suggest that although the hyperosmolarity-induced signal
bypasses the initial insulin signal transduction steps, it is likely to
induce GLUT4 translocation through activation of a common convergent
signal transduction step, targeted by
UDP-N-acetylglucosamine, downstream of and/or in
parallel to PI3K/Akt.
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Introduction
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UNDER NORMAL physiological conditions,
excess glucose in the circulation is transported into muscle and fat
cells by an insulin-stimulated process. This process requires
transduction of an insulin signal(s), trafficking of the glucose
transporter 4 (GLUT4) vesicle and a soluble
N-ethylmaleimide-sensitive fusion protein
attachment protein receptor (SNARE)-mediated
docking and fusion event (1, 2, 3, 4). With regard to signal
transduction, it is well documented that insulin binding to the insulin
receptor results in tyrosine autophosphorylation of the ß-subunit and
activation of its intrinsic tyrosine kinase (4, 5, 6).
Subsequently, the insulin receptor tyrosine kinase phosphorylates
several intracellular proteins on tyrosine residues. In particular,
tyrosine phosphorylation of the insulin receptor substrate (IRS)
proteins provides docking sites for p85, the regulatory subunit of type
I PI3K, resulting in activation of the catalytic p110 subunit
(4, 5, 6). It is well documented that activation of PI3K is a
necessary step for the stimulation of GLUT4 translocation by insulin
(7, 8, 9, 10, 11, 12, 13). The distal targets of PI3K, which mediate GLUT4
translocation, remain unclear, but Akt serine/threonine kinase isoforms
1 and 2 are candidate proteins that could be the downstream targets
mediating the process (14, 15, 16, 17).
Although the exact molecular mechanisms linking the insulin receptor to
GLUT4 translocation are uncertain, several pathophysiological events
are well recognized to be potential causative factors that can induce
insulin resistance by causing postreceptor defects in the insulin
signaling pathway (18, 19, 20). Two events in particular are
obesity and hyperglycemia. With regard to obesity, it has been
postulated that adipose tissue secretes factors that impair insulin
action. For example, TNF
is synthesized and secreted from
adipocytes. TNF
stimulates sphingomyelinase activity to produce
ceramides in cells, and it appears to be the ceramides that decrease
insulin sensitivity. Although chronic TNF
treatment periods (24 d)
decrease the tyrosine phosphorylation of IRS1, the decrease in
insulin-stimulated glucose uptake observed at 224 h after treatment
with cell-permeable C2-ceramides occurs without a decrease in tyrosine
phosphorylation of the insulin receptor or IRS1 or a decrease in the
interaction of IRS1 with PI3K (21, 22, 23). It has been
demonstrated that C2-ceramide inhibits Akt activation independently of
any effect on the insulin receptor, IRS1, and PI3K (24).
Recent studies demonstrate that C2-ceramide prevented the membrane
localization of the pleckstrin homology (PH) domains for Akt and the
general receptor for phosphoinositides-1 (Grp1), which bind
PI(3, 4, 5)P3, but not the PH domain for PLC
, which binds PI(4, 5)P2
(25). The accumulation of 3'-phosphoinositides was not
altered by C2-ceramide, indicating that this inhibition occurs via a
previously undefined mechanism unrelated to 3'-phosphoinositide
generation. In addition, the results indicate that cells lacking the
PI(3, 4, 5)P3 phosphatase PTEN retained sensitivity to ceramide,
indicating that the sphingolipid is unlikely to mediate its effects by
targeting PTEN to a selected pool of PI(3, 4, 5)P3 (25).
Together the data suggest a general mechanism by which ceramide
antagonizes PI3K-dependent signaling at the level of Akt
activation.
Hyperglycemia-induced insulin resistance is postulated to result from
an increased flux of glucose through the hexosamine biosynthesis
pathway, which, in turn, increases the tissue concentration of a
hexosamine metabolite, UDP-N-acetylglucosamine (UDP-GlcNAc)
(26, 27). Recent observations indicate that although
UDP-GlcNAc induces defects in proximal insulin signaling, the variable
times required for these effects could be compatible with more than one
UDP-GlcNAc-induced defect in the insulin effector cascade (28, 29). A consideration, however, is that direct administration of
glucosamine (GlcN; a precursor of UDP-GlcNAc) can rapidly lower
cellular ATP levels and affect insulin action in fat cells by
mechanisms independent of increased intracellular UDP-GlcNAc
(30). However, data argue against the possibility that ATP
depletion (to the extent that it impairs insulin receptor function) is
the major mechanism for GlcN-induced insulin resistance in 3T3-L1
adipocytes (31, 32, 33). Although the exact molecular
mechanisms inducing insulin resistance are not defined, increases in
the hexosamine biosynthetic pathway appear to render insulin-stimulated
GLUT4 translocation ineffective at a distal site(s) in the signaling
cascade.
It is now clear that GLUT4 translocation can be activated by a variety
of agents by a mechanism not involving the proximal steps of the
insulin signaling cascade. For example, exercise/contraction,
hyperosmolarity, guanosine 5'-[
-thio]triphosphate (GTP
S; a
nonhydrolyzable GTP analog), endothelin-1, expression of
constitutively active Gq
(Gq/Q209L), and sphingolipids all have been
reported to stimulate GLUT4 translocation and glucose transport by a
novel mechanism independent of PI3K activation (34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45).
Even though these alternative signaling pathways leading to GLUT4
translocation apparently bypass the initial insulin signal transduction
steps, they are likely to induce GLUT4 translocation through activation
of a common convergent signal transduction step downstream of and/or in
parallel to PI3K. To further address the relationship between
insulin- and hyperosmolarity-stimulated GLUT4 translocation, this study
examined the effects of exposure of cells to either C2-ceramide or GlcN
and also the effects of overexpression of
glutamine:fructose-6-phosphate amidotransferase (GFAT), the
rate-limiting enzyme in the synthesis of UDP-GlcNAc, on insulin- and
hyperosmolarity-induced GLUT4 translocation. We found that GLUT4
translocation induced by hyperosmolarity was not affected by
C2-ceramide, whereas increases in the hexosamine biosynthetic pathway
blocked this insulinomimetic action of hyperosmolarity.
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Materials and Methods
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Cell culture
Murine 3T3-L1 preadipocytes were obtained from American Type
Culture Collection (Manassas, VA) and were cultured in DMEM containing
25 mM glucose and 10% calf serum at 37 C in an 8%
CO2 atmosphere. Confluent cultures were induced
to differentiate into adipocytes as previously described
(39). All studies were performed on adipocytes, between
812 d after differentiation. Before all experimental treatments, the
differentiated adipocytes were serum-starved in DMEM containing 25
mM glucose or 5.5 mM glucose (GlcN studies) and
with 0.5% fatty acid-free BSA (C2-ceramide studies) for 3 h at 37
C.
Induction of insulin resistance
Ceramide treatment. The effects of ceramide on insulin- and
hyperosmolarity-mediated events were investigated as described by
Summers et al. (24). Briefly, cells were
pretreated with either 0.1% dimethylsulfoxide (DMSO) vehicle control
or 100 µM of the short-chain ceramide analog
C2-ceramide for 2 h at 37 C. This concentration and treatment
duration of C2-ceramide were documented to induce insulin resistance
without a decrease in the tyrosine phosphorylation of the insulin
receptor or IRS1 or a decrease in the interaction of IRS1 with PI3K or
the enzymes in vitro activity (21, 22, 23, 24, 45).
Consistent with these previous reports, preliminary experiments
established that the concentration and treatment duration of
C2-ceramide induced insulin resistance independently of any effect on
the insulin receptor and IRS1 (data not shown). Thirty minutes before
the end of C2-ceramide exposure, the cells were left untreated or were
treated with insulin or sorbitol as described in the figure
legends.
Transfection of GFAT. To first directly compare the effects
of hexosamine metabolism on insulin- and hyperosmolarity-induced GLUT4
translocation, we performed cotransfection experiments with either
empty vector control or GFAT plasmid cDNA (provided by Dr. Donald A.
McClain, University of Utah) with GLUT4-enhanced green fluorescent
protein (EGFP) plasmid cDNA as described below under Transient
transfection. After transfection, the cells were allowed to
recover for 16 h in the presence of 6 nM
insulin and 25 mM glucose before experimental
treatments.
GlcN treatment. As insulin resistance induced by GlcN
exposure has been suggested to be secondary to depletion of ATP pools
(30), we used a GlcN-induced model described by Ross
et al. (31) that induces insulin resistance
without affecting either the cellular ATP levels or the early
insulin-regulated phosphorylation of substrates. Briefly, before
induction of insulin resistance, adipocytes were treated with DMEM/5.5
mM glucose medium containing 10% FBS for 2
d. Cells were then treated with DMEM containing 10% FBS and 2
mM GlcN and lacking glucose, glutamine, and
insulin for 1214 h. The culture medium contained 1
mM pyruvate as an additional energy source. Also,
2 mM L-glucose was added to
adjust the osmolarity of sugars in control groups.
Transient transfection
Differentiated adipocytes were electroporated (0.16 kV and 960
µF) as previously described (46). As indicated in the
figure legends, transfection or cotransfected experiments were
performed with 50 µg EGFP-tagged plasmid DNA or with 50 µg
EGFP-tagged plasmid DNA plus 200 µg of additional plasmid DNA for
analysis of EGFP fluorescence, respectively. After electroporation, the
adipocytes were replated on glass coverslips and allowed to recover for
1618 h before use.
Plasma membrane sheet assay
The preparation of plasma membrane sheets from the adipocytes
was performed essentially by the method of Robinson et al.
(41) with minor modifications as previously described
(39). After the isolation of plasma membrane sheets, these
purified membranes were used for indirect immunofluorescence. The
plasma membrane sheets were fixed for 20 min at 25 C in a solution
containing 2% paraformaldehyde, 70 mM KCl, 30
mM HEPES (pH 7.5), 5 mM
MgCl2, and 3 mM EGTA as
previously described (39). The membrane sheets were then
blocked in 5% donkey serum for 60 min at 25 C and incubated for 60 min
at 25 C with a 1:1000 dilution of polyclonal rabbit GLUT4 antibody
(provided by Dr. Jeffrey E Pessin, University of Iowa, Iowa City, IA),
followed by incubation with a 1:50 dilution of rhodamine
red-X-conjugated donkey antirabbit IgG (Jackson ImmunoResearch Laboratories, Inc., West Grove, PA) for 60 min at 25 C.
Preparation of total cell extracts and immunoprecipitation
Total cell extracts were prepared from 100-mm plates of 3T3-L1
adipocytes after the appropriate treatment. Cells from each plate were
washed twice with ice-cold PBS and scraped into 1 ml lysis buffer [25
mM Tris (pH 7.4), 50 mM NaF, 10 mM
Na3P2O7,
137 mM NaCl, 10% glycerol, and 1% Nonidet P-40]
containing 1.0 mM phenylmethylsulfonylfluoride, 2
mM Na3VO4, 1
µg/ml aprotinin, 10 mM leupeptin, and 1 mM
pepstatin A by rotation for 15 min at 4 C. Insoluble material was
separated from the soluble extract by microcentrifugation for 15 min at
4 C. Protein concentration was determined, and samples were either
directly subjected to SDS-PAGE (as described below) or
immunoprecipitated for Cbl. Briefly, 35 mg cellular protein were
immunoprecipitated with 5 µg Cbl polyclonal antibody (Santa Cruz Biotechnology, Inc., Santa Cruz, CA) for 2 h at 4 C.
Immune complexes were recovered by the addition of protein A-Sepharose
(Amersham Pharmacia Biotech, Arlington Heights, IL) and
subjected to SDS-PAGE (as described below).
PI3K activity assay
Whole-cell detergent lysates were immunoprecipitated overnight
(1216 h) at 4 C with phosphotyrosine antibody (PT-66) conjugated to
agarose (Sigma, St. Louis, MO). The immunoprecipitated
lipid kinase activity was determined as previously described (47, 48). Briefly, the immunoprecipitates were incubated with 40
µCi [
-32P]ATP plus 20 µg
phosphatidylinositol (Avanti Polar Lipids, Birmingham, AL) for 15 min
at room temperature. The radiolabeled phospholipid product was spotted
onto silica plates (Analtech, Newark, DE), subjected to TLC, and
visualized by autoradiography.
Electrophoresis and immunoblotting
Whole cell lysates were separated by 7.5% SDS-PAGE. The
resolved proteins were transferred to an Immobilon P membrane
(Millipore Corp., Bedford, MA) and immunoblotted with a
monoclonal phosphotyrosine antibody (PY20:HRPO; Transduction Laboratories, Inc., Lexington, KY), the phosphoserine-specific
Akt antibody (New England Biolabs, Inc., Beverley, MA), or
an anti-Akt2-specific antibody (provided by Dr. Morris J. Birnbaum,
University of Pennsylvania, Philadelphia, PA). All immunoblots were
subjected to enhanced chemiluminescence detection (Amersham Pharmacia Biotech).
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Results
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Insulin-stimulated, but not hyperosmolarity-stimulated, GLUT4
translocation is inhibited by C2-ceramide
The involvement of ceramides in modulating insulin signaling is
well documented (24, 45, 49, 50). As typically observed,
both insulin- and sorbitol-induced osmotic shock resulted in the
translocation of GLUT4 to the cell surface membrane, as detected by
increased GLUT4 immunofluorescence in isolated plasma membrane sheets
(Fig. 1
, panels 13). Exposure of 3T3-L1
adipocytes with 100 µM C2- ceramide for 2 h had
no effect on the basal state level of plasma membrane-localized GLUT4
(Fig. 1
, panel 4), but inhibited insulin-stimulated GLUT4 translocation
(Fig. 1
, panel 5). In contrast, 100 µM C2-ceramide for
2 h had no effect on sorbitol-induced GLUT4 translocation (Fig. 1
, panel 6). It is noteworthy that the insulin-stimulated level of plasma
membrane GLUT4 immunofluorescence was not completely abolished in the
presence of C2-ceramide.

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Figure 1. C2-ceramide decreases insulin-stimulated, but not
hyperosmolarity-stimulated, GLUT4 translocation. Cells were incubated
in the presence of vehicle control (V; 0.1% DMSO; panels 13) or 100
µM C2-ceramide (panels 46) for 2 h. The cells were
then left untreated (C; control; panels 1 and 4) or were treated with 1
nM insulin (I; panels 2 and 5) or with 600 mM
sorbitol (S; panels 3 and 6) during the final 30 min of C2-ceramide
exposure. Plasma membrane sheets were prepared and subjected to
immunofluorescence microscopy as described in Materials
and Methods. These data are representative
observations from three independent experiments.
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To further investigate the apparent specificity of C2- ceramide on
insulin, but not osmotic shock, signaling, we took advantage of the
fact that expressed GLUT4-EGFP displays identical subcellular
distribution and insulin-stimulated translocation as the endogenous
GLUT4 protein (51). As typically observed for the
endogenous GLUT4 protein, in the basal state GLUT4-EGFP was localized
to the perinuclear region and small vesicles scattered throughout the
cytoplasm (Fig. 2A
, panel 1). This
distribution was identical to that in cells pretreated with 100
µM C2-ceramide for 2 h (Fig. 2A
, panel 4). As
expected, both insulin stimulation and osmotic shock resulted in the
translocation of the GLUT4-EGFP protein to the plasma membrane detected
as a continuous rim of cell surface fluorescence (Fig. 2A
, panels 2 and
3). Consistent with the effect of C2-ceramide treatment on GLUT4
translocation elicited by insulin and osmotic shock, as assessed by the
plasma membrane sheet assay (Fig. 1
), insulin-induced, but not osmotic
shock-induced, GLUT4-EGFP translocation was inhibited (Fig. 2
, panels 5
and 6). Quantitation of these data by scoring the transfected cells for
GLUT4-EGFP plasma membrane rim fluorescence is presented in Fig. 2B
. As
previously reported (38), sorbitol treatment was not as
effective as insulin in stimulating GLUT4 translocation (Figs. 1
and 2
). In agreement with the incomplete inhibition observed by the plasma
membrane sheet assay (Fig. 1
), in the presence of C2-ceramide, insulin
mediates GLUT4 translocation to a magnitude similar to that induced by
hyperosmolarity.

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Figure 2. C2-ceramide decreases insulin-stimulated,
but not hyperosmolarity-stimulated, translocation of GLUT4-EGFP. A,
Differentiated 3T3-L1 adipocytes were electroporated with 50 µg
GLUT4-EGFP cDNA (panels 16). The cells were allowed to recover for
16 h, then were incubated in serum-free medium for 2 h and
incubated in the presence of vehicle control (V; 0.1% DMSO; panels
13) or 100 µM C2-ceramide (panels 46) for 2 h.
Cells were subsequently left untreated (C; control; panels 1 and 4) or
were treated with 1 nM insulin (I; panels 2 and 5) or 600
mM sorbitol (S; panels 3 and 6) during the final 30 min of
C2-ceramide exposure. Cells were fixed and subjected to confocal
fluorescence microscopy, and representative images were obtained. B,
Quantitation of the number of GLUT4-EGFP-expressing cells displaying
rim fluorescence indicative of GLUT4 translocation. These data
represent scoring of 50 cells from 3 independent experiments. Each
bar represents the average number of cells displaying
cell surface fluorescence ± SEM.
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C2-ceramide reduces insulin-stimulated Akt activity
It is well documented that the antagonistic actions of ceramides
on insulin action occur without a decrease in the tyrosine
phosphorylation of the insulin receptor or IRS1 or a decrease in the
interaction of IRS1 with PI3K or the activity of PI3K (21, 22, 23, 24, 45). In full agreement, we observed that cells treated with 100
µM C2-ceramide for 2 h displayed no decrease in the
autophosphorylation of the insulin receptor ß-subunit or the protein
tyrosine phosphorylation of IRS (data not shown). Furthermore,
C2-ceramide did not affect the amount of insulin-stimulated PI3K
activity in antiphosphotyrosine immunoprecipitates (Fig. 3
). To confirm whether C2-ceramide
inhibits the phosphorylation of Akt, we used an
antiphospho-Ser473 antibody specific for the
serine-phosphorylated activated Akt1 isoform and an Akt2-specific
antibody that specifically allows detection of the mobility of that
isoform indicative of a phosphorylation activation state (24, 52). C2-ceramides effect on insulin-stimulated Akt1 activity
was apparent by a marked inhibition of the phosphorylation of serine
473, a regulatory phosphorylation site on Akt (Fig. 4A
, lanes 3 and 4). Moreover, an
insulin-induced mobility shift in the Akt2 isoform protein was
decreased by C2-ceramide (Fig. 4B
, lanes 3 and 4). As we previously
reported (38), sorbitol-induced osmotic shock did not
result in phosphorylation of either Akt isoform (Figs. 4A
and 3B
, lane
5). C2-ceramide had no apparent effect on the phosphorylation and
mobility of Akt1 and Akt2, respectively, in nontreated and
sorbitol-treated cells (Fig. 4
, A and B, lanes 1 and 2, and 5 and
6).

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Figure 3. C2-ceramide does not antagonize insulin-stimulated
immunoprecipitable PI3K activity. 3T3-L1 adipocytes were incubated in
the presence of vehicle control (V; 0.1% DMSO; lanes 1, 3, and 5) or
100 µM C2-ceramide (lanes 2, 4, and 6) for 2 h.
Cells were subsequently left untreated (C; control; lanes 1 and 2) or
were treated with 1 nM insulin (I; lanes 3 and 4) or 600
mM sorbitol (S; lanes 5 and 6) during the final 30 min of
C2-ceramide exposure. Whole cell detergent lysates were prepared,
immunoprecipitated with the PT66 phosphotyrosine antibody, and assayed
for the presence of PI3K activity as described in Materials and
Methods. The radioactivity incorporated into
phosphatidylinositol 3-phosphate was visualized by autoradiography
(upper panel). The spot corresponding to
phosphatidylinositol 3-phosphate was scraped, and its
radioactivity was quantified by liquid scintillation counting
(lower panel). Each bar is expressed as a
percentage of control activity in the absence of C2-ceramide
pretreatment and represents the mean ± SEM of five
determinations.
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Figure 4. C2-ceramide inhibits insulin-stimulated
phosphorylation of Akt. 3T3L1 adipocytes were incubated in the presence
of vehicle control (-; 0.1% DMSO; lanes 1, 3, and 5) or 100
µM C2-ceramide (+; lanes 2, 4, and 6) for 2 h. Cells
were subsequently left untreated (C; control; lanes 1 and 2) or were
treated with 1 nM insulin (I; lanes 3 and 4) or 600
mM sorbitol (S; lanes 5 and 6) during the final 30 min of
C2-ceramide exposure. Western blots of total cell detergent lysates
were probed with antiphosphoserine 473-specific Akt antibody (A;
pSer-Akt) or anti-Akt-2 antibody (B). These are representative
immunoblots independently performed three times.
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As the ability of C2-ceramide to decrease Akt activation has been
reported to result from a specific prevention of the recruitment of the
PI(3, 4, 5)P3-binding proteins Akt and Grp1 to the plasma membrane, we
next assessed the in vivo localization of the Grp1 PH domain
with PI(3, 4, 5)P3. This was accomplished by generating a fusion protein
consisting of EGFP fused to this PH domain (EGFP-PH/Grp1) as previously
described (48). In the absence of insulin, expression of
EGFP-PH/Grp1 resulted in a predominant nuclear localization, with a
smaller amount distributed throughout the cell cytoplasm in the absence
or presence of C2-ceramide (Fig. 5A
, panels 1 and 4). The accumulation of the EGFP-PH/Grp1 fusion protein in
the nucleus is a property of EGFP in 3T3-L1 adipocytes, as expression
of EGFP alone also results in predominant nuclear localization (data
not shown). In any case, insulin stimulation resulted in accumulation
of the EGFP-PH/Grp1 fusion protein at the cell surface membrane,
indicative of PI(3, 4, 5)P3 formation at the plasma membrane (Fig. 5A
, panel 2). Consistent with osmotic shock eliciting a PI3K-independent
signaling pathway, sorbitol incubation did not result in the formation
of PI(3, 4, 5)P3 (Fig. 5A
, panel 3). In agreement with Stratford et
al. (25), C2-ceramide clearly reduced the stimulated
translocation of EGFP-PH/Grp1 to the cell surface (Fig. 5A
, panel 5).
Quantification of these data demonstrated that insulin-stimulated cell
surface EGFP-PH/Grp1 fluorescence was markedly reduced in cells
pretreated with C2-ceramide (Fig. 5B
).

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Figure 5. C2-ceramide prevented the insulin-stimulated
translocation of insulin-stimulated EGFP-PH/Grp1 to the plasma
membrane. 3T3-L1 adipocytes were transfected with 50 µg EGFP-PH/Grp1
cDNA and allowed to recover for 16 h. The cells were then
incubated in the presence of vehicle control (V; 0.1% DMSO; panels
13) or 100 µM C2- ceramide (C; panels 46) for
2 h. Cells were subsequently left untreated (C; control; panels 1
and 4) or were treated with 1 nM insulin (I; panels 2 and
5) or 600 mM sorbitol (S; panels 3 and 6) during the final
30 min of C2-ceramide exposure and then fixed in 2% paraformaldehyde.
A, The distribution of the EGFP-PH/Grp1 fusion protein was visualized
by confocal fluorescence microscopy as described under Materials
and Methods. B, Quantitation of the number of cells displaying
EGFP-PH/Grp1 cell surface fluorescence was determined from counting of
50 cells from 3 independent experiments. Each point
represents the average number of cells displaying cell surface
fluorescence ± SEM.
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Increases in the hexosamine biosynthesis pathway inhibit both
insulin- and osmotic shock-stimulated GLUT4 translocation
Work by several laboratories has demonstrated that increases in
the hexosamine biosynthesis pathway inhibit insulin-stimulated GLUT4
translocation and glucose transport (28, 30, 31, 32, 33). This
insulin-resistant state can be induced experimentally by expression of
glutamine:fructose-6-phosphate amidotransferase, the rate-limiting
enzyme in the synthesis of UDP-GlcNAc and/or pretreatment of cells with
GlcN, a precursor of UDP-GlcNAc (Fig. 6A
). Recent data are consistent with the
concept that the mechanism by which increased hexosamine biosynthesis
pathway flux inhibits insulin-stimulated GLUT4 translocation and
glucose transport occurs at a target site(s) distal to PI 3-Kinase/Akt
(29, 31, 32). As hyperosmolarity appears to induce GLUT4
translocation by a signaling mechanism distal and/or parallel to
PI3K/Akt, we determined whether increased hexosamine biosynthesis
renders its signal ineffective. As expected, both insulin stimulation
and osmotic shock resulted in translocation of the GLUT4-EGFP protein
to the plasma membrane, detected as a continuous rim of cell surface
fluorescence (Fig. 6B
). In contrast, the ability of insulin and
sorbitol treatment to stimulate the translocation of GLUT4-EGFP in
cells coexpressing GFAT was decreased (Fig. 6B
).
The incomplete inhibition observed was not an entirely unexpected
result, because GFAT-stimulated production of UDP-GlcNAc is dependent
on substrate and insulin availability. For this reason we allowed our
electroporated 3T3-L1 adipocytes to recover in the presence of 6
nM insulin and 25 mM glucose for 16 h
before serum starvation and treatments. Rather than obtaining a more
significant inhibition with GFAT expression by modifying the incubation
conditions, we tested the effects of providing a direct precursor of
UDP-GlcNAc, GlcN (Fig. 7
). Insulin and
sorbitol treatment resulted in translocation of GLUT4 to the cell
surface membrane, as detected by increased GLUT4 immunofluorescence in
isolated plasma membrane sheets (Fig. 7A
, panels 13). Pretreatment of
3T3-L1 adipocytes with 2 mM GlcN for 12 h had no
effect on the basal state level of plasma membrane-localized GLUT4
(Fig. 7A
, panel 4), but markedly inhibited both insulin- and
sorbitol-induced GLUT4 translocation (Fig. 7A
, panels 5 and 6). We also
assessed the effects of GlcN on the distribution of GLUT4-EGFP. In the
basal state GLUT4-EGFP was localized to the perinuclear region and
small vesicles scattered throughout the cytoplasm. This distribution
was identical to that in cells pretreated with GlcN. As expected, both
insulin stimulation and sorbitol resulted in translocation of the
GLUT4-EGFP protein to the plasma membrane, detected as a continuous rim
of cell surface fluorescence. Consistent with the effect of GlcN
pretreatment on insulin- and sorbitol-induced GLUT4 translocation, as
assessed by the plasma membrane sheet assay (Fig. 7A
), insulin- and
sorbitol-induced GLUT4-EGFP translocation was markedly inhibited.
Quantitation of these data by scoring the transfected cells for
GLUT4-EGFP plasma membrane rim fluorescence is presented in Fig. 7B
.

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Figure 7. GlcN exposure decreases both insulin- and
hyperosmolarity-stimulated GLUT4 translocation. As described in
Materials and Methods, cells were
incubated overnight in the absence (-) or presence (+) of 2
mM GlcN. After GlcN treatment, nontransfected cells (A) or
cells electroporated with 50 µg GLUT4-EGFP cDNA (B) were left
untreated (C; control) or were treated with 100 nM insulin
(I) or 600 mM sorbitol (S) for 30 min. A, Plasma membrane
sheets were prepared and subjected to immunofluorescence
microscopy. Representative observations from 3 independent
experiments are shown. B, Transfected cells were fixed and subjected to
confocal fluorescence microscopy, and representative images were
obtained and counted for the number of GLUT4-EGFP-expressing cells
displaying rim fluorescence indicative of GLUT4 translocation. These
data represent scoring of 50 cells from 3 independent experiments. Each
bar represents the average number of cells displaying
cell surface fluorescence ± SEM.
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Insulin receptor autophosphorylation, IRS1, and Cbl
phosphorylation
Based on the above observations, we next examined the effect of
GlcN on the early insulin receptor signal transduction events. There
was no significant difference in insulin receptor ß-subunit
autophosphorylation in the absence or presence of GlcN (Fig. 8
, lanes 3 and 4). Similarly, the
extent of IRS1 tyrosine phosphorylation was not significantly affected
(Fig. 8
, lanes 3 and 4). Osmotic shock has been reported to stimulate
GLUT4 translocation by a tyrosine kinase- dependent mechanism
(38). As previously reported, osmotic shock induced the
tyrosine phosphorylation of several proteins in the molecular mass
ranges of 5575, 120130, and 160180 kDa (38) (Fig. 8
, compare lanes 1 and 5). The extent of tyrosine phosphorylation of these
proteins was also not significantly affected by GlcN pretreatment (Fig. 8
, lane 6).

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Figure 8. GlcN treatment did not alter tyrosine
phosphorylation events elicited by insulin or hyperosmolarity. After
the overnight treatment without (-) or with (+) GlcN, performed as
described in Materials and Methods, cells
were left untreated (C; control) or were treated with 100
nM insulin (I) or 600 mM sorbitol (S) for 5
min. Whole cell detergent extracts were prepared, resolved on a 7.5%
polyacrylamide gel, and subjected to Western blotting with the PY20
monoclonal phosphotyrosine antibody. This is a representative
immunoblot from three independent experiments.
|
|
In addition to IRS proteins, in adipocytes the insulin receptor and the
osmotic shock-induced signal also tyrosine phosphorylate Cbl (38, 53, 54, 55). This can readily be detected by the immunoprecipitation
of Cbl, followed by phosphotyrosine immunoblotting (Fig. 9
). There was no significant
difference in insulin- and osmotic shock-stimulated tyrosine
phosphorylation of Cbl in the absence or presence of GlcN (Fig. 9A
).
Cbl immunoblotting of that same membrane demonstrated the presence of
equal amounts of Cbl protein (Fig. 9B
, lanes 16). Although the
signaling events distal to the Cbl cascade remain unclear, as
previously discussed a likely downstream candidate molecule of the IRS
cascade involved in GLUT4 translocation is the Akt serine/threonine
kinase. In contrast to the inhibitory effect of C2-ceramide on Akt1/2,
there was no apparent GlcN-induced effect on insulin-stimulated Akt1
and/or Akt2 activity, as assessed by the enzymes serine 473
phosphorylation state (Fig. 10A
, lanes
3 and 4) and/or its electrophoretic mobility (Fig. 10B
, lanes 3 and 4),
respectively. As depicted in Fig. 4
, sorbitol-induced osmotic shock did
not result in the activation of either Akt isoform (Fig. 10
, A and B,
lane 5). Glucosamine had no apparent effect on the phosphorylation
and/or the mobility of Akt from nontreated and sorbitol-treated cells
(Fig. 10
, A and B, lanes 1 and 2, and 5 and 6). Furthermore, GlcN
treatment did not affect insulin-stimulated PI(3, 4, 5)P3 formation, as
assessed by accumulation of the EGFP-PH/Grp1 fusion protein at the cell
surface membrane, in EGFP-PH/Grp1-expressing cells (data not
shown).

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Figure 9. Insulin- and hyperosmolarity-stimulated Cbl
tyrosine phosphorylations were not affected by GlcN treatment. 3T3L1
adipocytes were treated without (-) or with (+) GlcN as described in
Materials and Methods and then left
untreated (C; control; lanes 1 and 2) or were treated with 100
nM insulin (I; lanes 3 and 4) or 600 mM
sorbitol (S; lanes 5 and 6) for 5 min. Whole cell detergent extracts
were prepared and immunoprecipitated with a Cbl antibody as described
in Materials and Methods. The samples were then resolved
by SDS-PAGE and subjected to PY20 phosphotyrosine (A) and Cbl (B)
immunoblotting. This is a representative immunoblot from three
independent experiments.
|
|

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Figure 10. Insulin-stimulated phosphorylation of Akt was
not altered by GlcN treatment. 3T3L1 adipocytes were treated without
(-) or with (+) GlcN as described in Materials and
Methods and then left untreated (C; control; lanes 1 and 2) or
treated with 100 nM insulin (I; lanes 3 and 4) or 600
mM sorbitol (S; lanes 5 and 6) for 5 min. Western blots of
total cell detergent lysates were probed with antiphosphoserine
473-specific Akt antibody (A; pSer-Akt) or anti-Akt-2 antibody (B).
These are representative immunoblots independently performed three
times.
|
|
 |
Discussion
|
|---|
This study used two models of insulin resistance as molecular
probes to better understand the relationship between insulin- and
osmotic shock-induced GLUT4 translocation. The main finding of this
work is that although insulin-stimulated GLUT4 translocation is
attenuated in cells exposed to C2-ceramide and GlcN and in cells
overexpressing GFAT, antagonism of GLUT4 translocation elicited by
hyperosmotic incubation conditions is only present in cells exposed to
GlcN or in cells overexpressing GFAT, not in cells treated with
C2-ceramide. This finding confirms that the hyperosmolarity-induced
signaling pathway bypasses initial insulin signal transduction steps
and suggests that it probably induces GLUT4 translocation through
activation of a common convergent signal transduction step downstream
of and/or in parallel to PI3K/Akt.
Our C2-ceramide results are consistent with those from the work of
Summer et al. (24), and demonstrate that C2-
ceramide inhibits insulin-stimulated GLUT4 translocation and Akt
phosphorylation by similar extents. It was also reported that
C2-ceramide, at concentrations that antagonized the activation of both
glucose uptake and Akt, had no effect on the tyrosine phosphorylation
of IRS1 or the levels of p85 protein and PI3K activity
(24). Moreover, C2-ceramide inhibited stimulation of Akt
by platelet-derived growth factor (PDGF), an event that is IRS1
independent. In agreement with these observations, we demonstrate in
this work that C2-ceramide did not inhibit insulin-stimulated events
such as autophosphorylation of the insulin receptor ß-subunit,
tyrosine phosphorylation of IRS1, or PI3K activation. Interestingly, we
observed that C2-ceramide markedly inhibited the insulin-stimulated
localization of EGFP-PH/Grp1 to the cell surface. This finding is in
full agreement with a recent study by Stratford et al.
(25), who reported that exposure of 3T3-L1 adipocytes to
C2-ceramide inhibits PDGF-stimulated translocation of full-length Akt
as well as truncated proteins encoding only the PH domains of Akt/PKB
or Grp1. Also, the membrane localization of the PH domain for PLC
,
which preferentially binds PI(4, 5)P2, or the PDGF-stimulated production
of PI(3, 4)P2 or PI(3, 4, 5)P3 was found not to be affected by
C2-ceramide. Although our work did not assess the effect of C2-ceramide
on PI(3, 4, 5)P3 levels, our data support the concept that C2-ceramide
affects the ability of insulin to activate GLUT4 translocation at the
level of Akt, and the mechanism for that inhibition appears to involve
a defect in some functional aspect of PH domain/PI(3, 4, 5)P3-directed
plasma membrane targeting.
In any case, C2-ceramide was clearly ineffective in blocking osmotic
shock-induced GLUT4 translocation. This is consistent with a
PI3K/Akt-independent pathway regulating GLUT4 translocation. In this
regard, it is clear that a variety of stimuli display insulinomimetic
properties and can induce the trafficking of GLUT4 to the plasma
membrane by a mechanism not involving PI3K/Akt. For example, in
addition to hyperosmolarity, exercise/contraction, GTP
S (a
nonhydrolyzable GTP analog), and endothelin-1 all have been reported to
stimulate GLUT4 translocation and glucose transport by a novel
mechanism independent of PI3K/Akt activation (34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44).
Interestingly, the PI3K/Akt-independent mechanism initiated by
hyperosmolarity and GTP
S requires tyrosine kinase activity
(38, 39, 43). Studies by Wu-Wong et al.
(44) are in full agreement and demonstrate that the
PI3K-independent insulinomimetic actions of endothelin-1 are also
tyrosine kinase dependent. Studies by Standaert et al.
(56) and Imamura et al. (57) also
observed the insulinomimetic actions of GTP
S and endothelin-1.
Although their results are in agreement with the ability of these
agents to stimulate GLUT4 translocation, their data indicate that
GTP
S and endothelin-1 are upstream activators of PI3K signaling.
Although the basis for this difference is not apparent, and it remains
unclear whether the signaling pathway used by hyperosmolarity, GTP
S,
and endothelin-1 are the same, this study clearly lends support to a
PI3K/Akt-independent signal mediating osmotic shock-induced GLUT4
translocation.
Even though the signaling pathway elicited by hyperosmolarity
presumably bypasses the initial insulin signal transduction steps, it
is likely to induce GLUT4 translocation through activation of a common
convergent signal transduction step downstream of and/or in parallel to
PI3K/Akt. In particular, the docking/fusion of GLUT4 vesicles with the
plasma membrane appear to use a similar mechanism, as expression of a
dominant interfering mutant of syntaxin-4 prevented both insulin- and
osmotic shock-induced GLUT4 translocation (38).
Analogously, several lines of evidence have suggested such a signaling
scenario by which the GTP-binding protein Gq
and/or G11 couple to GLUT4 translocation. For
example, introduction of GDPßS into adipocytes, microinjection of a
Gq/G11-specific antibody,
and/or expression of RGS proteins inhibit insulin-stimulated GLUT4
translocation, thus suggesting that
Gq/G11 plays a necessary
role in insulin-stimulated glucose transport (39, 57, 58).
The fact that in the presence of C2-ceramide insulin-stimulated GLUT4
translocation was reduced to a magnitude similar to that induced by
hyperosmolarity provides suggestive evidence that insulin stimulates
both a ceramide-sensitive and a ceramide-insensitive pool of GLUT4
vesicles. The data could thus be interpreted that
hyperosmolarity-induced GLUT4 translocation is mediated by an
insulin-stimulated PI3K/Akt-independent pathway, such as the recently
described Cbl/CAP signaling pathway (59, 60). However,
this interpretation is complicated by the fact that the inhibitory
effect of C2-ceramide on Akt is not complete, and it is unclear how
much Akt activation is required for insulin-stimulated GLUT4
translocation.
In an alternative approach to examine the relationship between insulin-
and hyperosmolarity-activated signals, we assessed the insulin
resistance-inducing effects of the hexosamine biosynthesis pathway. The
involvement of this pathway in the regulation of insulin action was
originally discovered by Marshell et al. (61).
That work demonstrated the induction of insulin resistance in isolated
primary rat adipocytes with insulin, glucose, and glutamine. They
postulated and confirmed that the routing of incoming glucose through
the hexosamine biosynthesis pathway plays a key role in the development
of insulin resistance. Although both in vitro and in
vivo experimental evidence agree that increases in the hexosamine
biosynthesis pathway are accompanied by inhibition of the
insulin-stimulated GLUT4 translocation process (32, 33, 62), how the metabolic end products of this pathway inhibit
insulin-stimulated GLUT4 translocation remains unresolved. The current
studies strongly suggest that the GlcN-induced defect in the insulin
effector cascade occurs at a site(s) distal and/or parallel to Akt
and/or Cbl. The disabling effect of GlcN on the PI3K/Akt-independent
signal elicited by osmotic shock provides further support for a
GlcN-induced defect in a cellular target(s) distal to those enzymes.
Although this may imply that the osmotic shock-elicited signal
regulating GLUT4 translocation shares common insulin signal
transduction steps downstream of and/or in parallel to PI3K/Akt and/or
Cbl, it is possible that GlcN-induced resistance may involve the
existence of defects at more than one site.
The present data indicate that the ability of insulin to activate Akt
and GLUT4 translocation is attenuated in the presence of C2-ceramide,
whereas hyperosmolarity-induced GLUT4 translocation is intact under
similar exposure to C2-ceramide. As experimentally induced increases in
the hexosamine biosynthetic pathway in 3T3-L1 cells rendered both the
PI3K/Akt-dependent and the PI3K/Akt-independent pathways ineffective,
the GLUT4 translocation defect lies distal and/or parallel to PI3K/Akt.
Presumably, increased flux into the GlcN pathway could alter some
aspect of the newly described Cbl/CAP signaling pathway (59, 60). We found that both insulin- and osmotic shock-elicited
tyrosine phosphorylations of Cbl are intact with GlcN exposure. Taken
together, the data suggest that ceramide-induced defects in GLUT4
translocation result from a specific alteration early in the insulin
signal transduction cascade at the level of Akt activation, whereas end
products of the hexosamine biosynthetic pathway may target more distant
and/or parallel insulin signaling cascade events. Interestingly, this
work clearly demonstrates that increases in the hexosamine biosynthetic
pathway rendered both insulin and osmotic shock signals ineffective.
Although it remains to be determined whether hyperosmolarity-induced
GLUT4 translocation uses the Cbl/CAP pathway, it is documented that
insulin- and hyperosmolarity-activated signals involve common SNARE
proteins. Whether increases in the hexosamine biosynthetic pathway
influences the Cbl/CAP pathway and/or any SNARE proteins involved in
GLUT4 vesicular trafficking awaits further experimentation.
 |
Acknowledgments
|
|---|
We are grateful to Drs. Morris J. Birnbaum, Donald A. McClain,
and Jeffrey E. Pessin for generously providing us with GLUT4 and
Akt2-specific antibodies and GLUT4-EGFP, EGFP-PH/Grp1, and GFAT plasmid
cDNAs. We thank Drs. Robert V. Considine, and Scott A. Summers for
helpful discussion of the data.
 |
Footnotes
|
|---|
This work was supported by an American Diabetes Foundation Career
Development Award.
1 S.K. and P.L. contributed equally to this study. 
Abbreviations: DMSO, Dimethylsulfoxide; EGFP, enhanced green
fluorescent protein; GFAT, glutamine:fructose-6-phosphate
amidotransferase; GlcN, glucosamine; GLUT4, the insulin-responsive
glucose transporter; GTP
S, guanosine 5'-[
-thio]triphosphate;
IRS, insulin receptor substrate; PDGF, platelet-derived growth factor;
PH, pleckstrin homology; PI(3 4 5 )P3,
phosphaditylinositol-3,4,5-trisphosphate; SNARE, soluble
N-ethylmaleimide-sensitive fusion protein
attachment protein receptor;
UDP-GlcNAc, UDP-N-acetylglucosamine.
Received February 26, 2001.
Accepted for publication September 27, 2001.
 |
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