Cellular Resistance describes a state where target cells exhibit a diminished functional response to the binding of a specific signaling molecule, most frequently observed with insulin or thyroid hormones. This diminished responsiveness impairs the cell’s ability to execute the intended physiological action, even when the ligand concentration is adequate or elevated. We see this as a critical failure point in maintaining metabolic homeostasis. Understanding the locus of resistance is key to restoring endocrine efficacy.
Origin
The concept is rooted in endocrinology, specifically receptor theory, where sustained high ligand exposure can lead to downregulation of surface receptors. Historically, it was characterized in the context of Type 2 Diabetes Mellitus concerning insulin action. The term highlights the failure at the cellular interface rather than a deficiency in hormone production.
Mechanism
The primary mechanism often involves post-receptor defects, where ligand binding occurs, but the subsequent intracellular signaling cascade is attenuated or blocked. For instance, in insulin resistance, defects in IRS-1 phosphorylation prevent the proper translocation of GLUT4 transporters to the plasma membrane. This functional impairment results in reduced glucose clearance despite circulating hyperinsulinemia. Such resistance can also occur with glucocorticoid or sex hormone signaling pathways.
The earliest indicators of insulin resistance are measurable biochemical shifts, like a high HOMA-IR, that reveal cellular stress before symptoms arise.
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