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. Author manuscript; available in PMC: 2010 Nov 1.
Published in final edited form as: Trends Endocrinol Metab. 2009 Oct 1;20(9):429–435. doi: 10.1016/j.tem.2009.06.004

Figure 1.

Figure 1

Two major insulin signaling pathways. (i) The IRS/PI3K/Akt pathway is initiated by phosphorylation of the insulin receptor (IR). This results in the phosphorylation of the IRSs, increased interaction between IRSs and PI3K, and phosphorylation/activation of Akt. This insulin-stimulated metabolic signaling pathway is severely impaired by trauma and hemorrhage (TH) potentially at several steps along the pathway. (ii) Insulin signaling also activates the MEK/ERK pathway, which is only modestly affected by trauma and hemorrhage. Hashed arrows indicate possible cross signaling/effects of the two different pathways. Ins, insulin; IR, insulin receptor; PY, phospho-tyrosine; TH, trauma and hemorrhage; PI3K, phosphatidylinositol 3-kinase; IRSs, insulin receptor substrates; AKT, protein kinase B; MEK, mitogen activated protein kinase kinase; ERK, extracellular signal-regulated kinase; Grb2, growth factor binding protein 2; Sos, son of sevenless complex; Shc, sequence homology of collagen; Ras, rat sarcoma protein; Raf, Ras binding protein.