Insulin Quality Control Mechanism in ER Unveiled

Calcium (Ca2+) drives many cellular functions, though the way it controls quality of proteins in the endoplasmic reticulum (ER), a cellular organelle that synthesizes and transports proteins, is widely unknown. This control system of protein quality, known as proteostasis, was put under a microscope by researchers to find a more thorough understanding of the process, potentially revealing clues about how to prevent Type 2 diabetes, Alzheimer's and amyotrophic lateral sclerosis (ALS).

The team consisted of researchers across multiple disciplines, lead by Distinguished Associate Professor Masaki Okumura of the Tohoku University Frontier Research Institute for Interdisciplinary Sciences (FRIS) and Graduate School of Life Sciences, in an international collaborative study involving 17 research teams from Japan, Korea, and the UK. Results were published in Nature Cell Biology on November 11, 2025.

With the goal of elucidating Ca2+ driven proteostasis in the ER in mind, they found that Ca2+ can induce a phase separation in PDIA6, a gene that codes for a specific, ER-localized protein responsible for protein folding and function. Therefore, if this protein loses its function, misfolding can occur. The consequences for improperly folded proteins can be dire - such as diabetes.

Calcium-dependent phase separation of PDIA6. Top: Discovery of the "phase separation" phenomenon of PDIA6 in a test tube experiment: Addition of calcium to a PDIA6 solution leads to the formation of droplets. Bottom: Highly PDIA6 assembly observed within the endoplasmic reticulum, one of the organelles. PDIA6 exists not only as a single molecule but also as a large assembly. © Masaki Okumura

However, not all is lost if there are mistakes in protein folding. They found that a process called calcium-driven phase separation in the ER essentially creates liquid-like droplets through condensation that can make corrections to proinsulin. Proinsulin is the insulin precursor, and too much of it can indicate a risk for Type 2 diabetes.

"To keep everything running smoothly, we need these condensation-like droplets to ensure proinsulin is properly folded - as opposed to forming large, aggregate clumps that can disrupt the normal pathways and cause negative health outcomes," said Okumura.

This knowledge meaningfully contributes to our understanding of other calcium-driven processes within cells. In addition, this research could potentially be used in drug development for difficult-to-cure diseases like ALS, Alzheimer's and Type 2 diabetes.

Highly efficient insulin secretion by PDIA6 assembly. Difference in insulin production with and without PDIA6 assembly: When PDIA6 assembles in the cell, a large amount of insulin is produced. On the other hand, when only dispersed PDIA6 is present, misfolded insulin is accumulated, resulting in low efficiency of insulin production. ©Masaki Okumura
Publication Details:

Title: Ca2+-driven PDIA6 biomolecular condensation ensures proinsulin folding

Authors: Young-Ho Lee, Tomohide Saio, Mai Watabe, Motonori Matsusaki, Shingo Kanemura, Yuxi Lin, Taro Mannen, Tsubura Kuramochi, Yuka Kamada, Katsuya Iuchi, Michiko Tajiri, Kotono Suzuki, Yan Li, Yunseok Heo, Kotone Ishii, Kenta Arai, Kazunori Ban, Mayuko Hashimoto, Shuichiro Oshita, Satoshi Ninagawa, Yoshikazu Hattori, Hiroyuki Kumeta, Airu Takeuchi, Shinji Kajimoto, Hiroya Abe, Eiichiro Mori, Takahiro Muraoka, Takakazu Nakabayashi, Satoko Akashi, Tsukasa Okiyoneda, Michele Vendruscolo, Kenji Inaba, and Masaki Okumura.

Journal: Nature Cell Biology

DOI: 10.1038/s41556-025-01794-8

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