Identification of unusually disulphide-bonded insulin forms using mass spectrometry and thermolysin cleavage

Insulin is an essential hormone made by the pancreatic beta-cells in the islets of Langerhans. Beta-cells produce more insulin protein than virtually all other cellular proteins combined. Dysfunction in the process of insulin synthesis can lead to disease, including rare forms of monogenic diabetes. Specifically, aberrant intra-insulin and inter-insulin disulphide bonds have been implicated in the pathology of type 1 diabetes and type 2 diabetes, respectively. In type 1 diabetes, misprocessed insulin isoforms may be neoepitopes that kick-start and/or exacerbate the auto-immune response. In type 2 diabetes, aberrant disulphides form insulin dimers that can clog the endoplasmic reticulum and contribute to beta cell dysfunction. To facilitate the study of novel and known insulin neoepitopes and dimers, we present an unbiased and rapid technique for identifying insulin disulphide patterns from pancreatic islet extracts. The basis of this method is the cleavage between insulins cysteine residues with the metalloprotease, thermolysin, and subsequent identification of cysteine containing fragments and their partner peptides by LC-MS/MS. Using this technique, we identify 6 aberrant disulphide bonded insulin species, including a previously described type 1 diabetes neoepitope, as well as inter-chain disulphide bonded insulin dimers. Furthermore, using the endoplasmic stress inducer, thapsigargin, we observe increased disulphide errors in a patient donor sample. This approach lays foundations to identify the scope and cause of aberrant insulin disulphide formation in health and disease.