In recent years, accumulating evidence indicates a biological function for proinsulin C-peptide. These results challenge the traditional view that C-peptide is essentially inert and only useful as a surrogate marker of insulin release. Accordingly, it is now clear that C-peptide binds with high affinity to cell membranes, probably to a pertussis-toxin-sensitive G-protein-coupled receptor. Subsequently, multiple signalling pathways are potently and dose-dependently activated in multiple cell types by C-peptide with the resulting activation of gene transcription and altered cell phenotype. In diabetic animals and Type 1 diabetic patients, short-term studies indicate that C-peptide also enhances glucose disposal and metabolic control. Furthermore, results derived from animal models and clinical studies in Type 1 diabetic patients suggest a salutary effect of C-peptide in the prevention and amelioration of diabetic nephropathy and neuropathy. Therefore a picture of Type 1 diabetes as a dual-hormone-deficiency disease is developing, suggesting that the replacement of C-peptide alongside insulin should be considered in its management.
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Review Article| March 02 2009
Cellular and physiological effects of C-peptide
Claire E. Hills;
Nigel J. Brunskill
*Department of Infection, Immunity and Inflammation. University of Leicester School of Medicine, Leicester LE1 7RH, U.K.
†Department of Nephrology, Leicester General Hospital, Leicester LE5 4PW, U.K.
Correspondence: Professor Nigel J. Brunskill (email firstname.lastname@example.org).
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Claire E. Hills, Nigel J. Brunskill; Cellular and physiological effects of C-peptide. Clin Sci (Lond) 1 April 2009; 116 (7): 565–574. doi: https://doi.org/10.1042/CS20080441
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