Renal and vascular benefits of C-peptide: Molecular mechanisms of C-peptide action

Review

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Authors: Lina Nordquist, Fredrik Palm, Bradley T Andresen

Published Date September 2008 Volume 2008:2(3) Pages 441 - 452

DOI: http://dx.doi.org/10.2147/BTT.S3221

Lina Nordquist¹, Fredrik Palm^1,2, Bradley T Andresen^3,4

¹Department of Medical Cell Biology, Division of Integrative Physiology, Uppsala University, Uppsala, Sweden; ²Georgetown University Medical Center, Department of Medicine, Division of Nephrology and Hypertension, Georgetown University, Washington, DC, USA; ³University of Missouri, Department of Internal Medicine, Division of Endocrinology, HSC Diabetes Center, Columbia, MO, USA; ⁴Harry S Truman VA Medical Center, Columbia, MO, USA

Abstract: C-peptide has long been thought to be an inert byproduct of insulin production, but it has become apparent, and accepted, that C-peptide has important biological properties. C-peptide displays beneficial effects in many tissues affected by diabetic complications, such as increased peripheral blood flow and protection from renal damage. However, the mechanisms mediating these effects remain unclear. C-peptide interacts with cellular membranes at unidentified sites distinctive of the insulin family of receptors, and signals to multiple targets known to play a role in diabetes and diabetic complications, such as Na⁺/K⁺-ATPase and NOS. In general, the physiological and molecular effects of C-peptide resemble insulin, but C-peptide also possesses traits separate from those of insulin. These basic studies have been confirmed in human studies, suggesting that C-peptide may lend itself to clinical applications. However, the molecular and physiological properties of C-peptide are not completely elucidated, and large clinical studies have not begun. In order to further these goals, we critically summarize the current state of knowledge regarding C-peptide’s renal and vascular effects and the molecular signaling of C-peptide.

Keywords: C-peptide, insulin, diabetes mellitus, nephropathy, vascular, signaling

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