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Fig. 7. A model for IGFBP regulation of apoptosis. IGFBP-5 is secreted from the
basal surface of mammary epithelial cells where it is suitably placed to
interact with IGFs. This interaction prevents IGF-mediated activation of the
type I IGF receptor (IGF-IR) and inhibits (-) phosphorylation of insulin
receptor substrate-1 (IRS-1), phosphatidylinositol 3-kinase (PI3K) and protein
kinase B (PKB). In the inactive state, PKB is unable to phosphorylate
downstream effectors such as forkhead transcription factors (e.g. FKHRL1)
leading to FKHRL1 activation (+), induction of apoptosis and subsequently,
involution.