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Insulin modulates glucose uptake into adipocytes by regulating the trafficking of the GLUT4 glucose transporter. GLUT4 is mostly excluded from the surface of unstimulated cells because it is much more slowly exocytosed than it is endocytosed. GLUT4 traffics through an adipocyte-specific, specialized endosomal recycling pathway that only partially overlaps with compartments of the general endosomal recycling pathway. Insulin stimulates GLUT4 exocytosis and partially inhibits its endocytosis, resulting in GLUT4 redistribution to the cell surface. Insulin does not stimulate glucose uptake into adipocytes lacking the CCAAT/enhancer-binding protein alpha (C/EBPalpha) transcription factor. Here we show that these adipocytes do not properly traffic GLUT4. In these adipocytes, GLUT4 was rapidly exocytosed in basal conditions, resulting in an accumulation of GLUT4 on the plasma membrane. Although the kinetics of GLUT4 trafficking were altered, GLUT4 was still targeted to specialized intracellular compartments in adipocytes lacking C/EBPalpha, demonstrating an uncoupling of the targeting of GLUT4 to a specialized, adipocyte-specific insulin-regulated pathway from the regulation of the movement of GLUT4 through this pathway. Re-expression of C/EBPalpha in adipocytes lacking C/EBPalpha restored normal GLUT4 trafficking. We propose that C/EBPalpha controls the expression of the proteins that determine the basal, slow exocytosis of GLUT4, but not the proteins required to make the adipocyte-specific compartments through which GLUT4 traffics. Furthermore, these data support a model in which insulin stimulates GLUT4 exocytosis by releasing an inhibitor of GLUT4 movement to the cell surface, and it is this clamp on basal exocytosis that is missing in adipocytes lacking C/EBPalpha.

The cellular pathways involved in the impairment of insulin signaling by cellular stress, triggered by the inflammatory cytokine tumor necrosis factor-alpha (TNF) or by translational inhibitors like cycloheximide and anisomycin were studied. Similar to TNF, cycloheximide and anisomycin stimulated serine phosphorylation of IRS-1 and IRS-2, reduced their ability to interact with the insulin receptor, inhibited the insulin-induced tyrosine phosphorylation of IRS proteins, and diminished their association with phosphatidylinositol 3-kinase (PI3K). These defects were partially reversed by wortmannin and LY294002, indicating that a PI3K-regulated step is critical for the impairment of insulin signaling by cellular stress. Induction of cellular stress resulted in complex formation between PI3K and ErbB2/ErbB3 and enhanced PI3K activity, implicating ErbB proteins as downstream effectors of stress-induced insulin resistance. Indeed, stimulation of ErbB2/ErbB3 by NDFbeta1, the ErbB3 ligand, inhibited IRS protein tyrosine phosphorylation and recruitment of downstream effectors. Specific inhibitors of the ErbB2 tyrosine kinase abrogated the activation of ErbB2/ErbB3 and in parallel prevented the reduction in IRS protein functions. Taken together, our results suggest a novel mechanism by which cellular stress induces cross-talk between two different signaling pathways. Stress-dependent transactivation of ErbB2/ErbB3 receptors triggers a PI3K cascade that induces serine phosphorylation of IRS proteins culminating in insulin resistance.