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Robert Semple
Professor of Translational Molecular Medicine
Email: rsemple@ed.ac.uk
Phone: 0131 242 6051
Research Area
My overarching interest is in the causes and consequences of abnormal insulin/PI 3-Kinase/AKT signalling in human disease. I aim ultimately to gain insights into the nature and mechanisms of "common" insulin resistance, and into potentially modifiable mechanisms linking it to major diseases such as type 2 diabetes, fatty liver, dyslipidaemia, subfertility and cancer. To achieve this, my lab focuses first on the genetic, cellular and molecular basis of extreme human disorders of insulin action, whether genetic or antibody-mediated, and ranging from severe insulin resistance to spontaneous non insulin-dependent hypoglycaemia. Many of the conditions we study feature primary abnormalities either the insulin receptor (INSR) or downstream phosphoinositide-3-kinase (PI3K). As well as undertaking mechanistically informative studies of relevance to common disease, I have a major translational interest in improving diagnostic pathways and therapy for patients with these rare disorders. Core approaches include physiological phenotyping of humans with rare genetic syndromes, dissection of insulin action in primary cells from affected patients ex vivo, and identification of causative genetic defects using hypothesis-led and non hypothesis-driven genetic approaches.
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A second major interest of my lab arose from opportunistic discovery of postzygotic mosaic PIK3CA mutations in a family of asymmetric growth disorders in 2013. Having built a cohort of affected patients and led or contributed to pilot clinical trials, interest is now focused on collaborative studies exploiting the complementary power of human tissue transcriptomics, zebrafish and induced pluripotent stem cell modelling to seek novel mechanisms of disease, and novel therapeutic targets. These studies are focusing in particular on endothelial cell models
Profile
Robert Semple is Professor of Translational Molecular Medicine at the University of Edinburgh, where he has been Dean of Postgraduate Research for the College of Medicine and Veterinary Medicine since 2018. He trained in Biochemistry and then Medicine at the University of Cambridge, with clinical postgraduate training in London and Cambridge, including a PhD in the laboratory of Prof. Sir Stephen O’Rahilly. He is clinically active in both diabetes and endocrinology, as well as leading a translational research programme. Other activities have included a 4 year term as Associate Editor for Diabetologia, 6 years as Deputy Editor of the European Journal of Endocrinology, and 6 years serving on the MRC Population and Systems Medicine Board. He also leads the MRC Edinburgh/Glasgow Precision Medicine Doctoral Training. Programme, and is chair of the Oversight Board for the MRC/NIHR National Rare Disease Platform
Selected publications
​Primary Research Publications
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The metabolically protective energy expenditure increase of Pik3r1-related insulin resistance is not explained by Ucp1-mediated thermogenesis. Luijten I, Onishi A, McKay EJ, Bengtsson T, Semple RK. bioRxiv [Preprint]. 2024.02.12.579851
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Deep mutational scanning of the human insulin receptor ectodomain to inform precision therapy for insulin resistance. Aslanzadeh V, Brierley GV, Kumar R, Çubuk H, Vigouroux C, Matreyek KA, Kudla G, Semple RK. bioRxiv [Preprint] 2024.09.07.611782
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Female Alms1-deficient mice develop echocardiographic features of adult but not infantile Alström Syndrome cardiomyopathy McKay EL, Luijten I, Broadway-Stringer S, Thomson A, Weng X, Gehmlich K, Gray GA, Semple RK. Dis Model Mech. 2024 Jun 1;17(6):dmm050561.
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Mesenchymal-specific Alms1 knockout in mice recapitulates key metabolic features of Alström Syndrome. McKay EJ, Luijten I, Weng X, Martinez de Morentin PB, De Frutos González E, Gao Z, Kolonin MG, Heisler LK, Semple RK. Molecular Metabolism (2024) Jun;84:101933.
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Paradoxical dominant negative activity of an immunodeficiency-associated activating PIK3R1 variant. Tomlinson PR, Knox R, Perisic O, Su HC, Brierley GV, Williams RL, Semple RK. eLife. 2024 [in press]
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An expanded clinical spectrum of hypoinsulinemic hypoketotic hypoglycaemia Welters A, Leiter SM, Bachmann N, Bergmann C, Hoermann H, Korsch E, Meissner T, Payne F, Williams R, Hussain K, Semple RK*, Kummer S* Orphanet J Rare Dis. 2023 Nov 16;18(1):360. [*co-corresponding]
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Genotype-stratified treatment for monogenic insulin resistance: a systematic review. Semple RK, Patel KA, Auh S; ADA/EASD PMDI; Brown RJ. Commun Med (Lond). 2023 Oct 5;3(1):134
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Diagnosis and treatment of anti-insulin antibody-mediated labile glycaemia in insulin-treated diabetes. Church DS, Barker P, Burling KA, Shinwari SK, Kennedy C, Smith D, Macfarlane DP, Kernohan A, Stears A, Karamat MA, Whyte K, Narendran P, Halsall DJ, Semple RK. Diabet Med. 2023 Nov;40(11):e15194
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Mann JP, Duan X, Patel S, Alvarez-Guaita A, Haider A, Luijten I, Page M, Scurria F, Protasoni M, Tábara LC, Lim K, Virtue S, O’Rahilly S, Armstrong M, Prudent J, *Semple RK, *Savage DB A mouse model of human mitofusin 2-related lipodystrophy exhibits adipose-specific mitochondrial stress and reduced leptin secretion. Elife. 2023 Feb 1;12:e82283. doi: 10.7554/eLife.82283.
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Atallah I, McCormick D, Good JM, Barigou M, Fraga M, Sempoux C, Superti-Furga A, Semple RK*, Tran C*. Partial lipodystrophy, severe dyslipidaemia and insulin resistant diabetes as early signs of Werner syndrome. J Clin Lipidol. 2022 Sep- Oct;16(5):583-590. doi: 10.1016/j.jacl.2022.06.004. Epub 2022 Jun 19. PMID: 35780059. [*co-corresponding]
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Mericq V, Huang-Doran I, Al-Naqeb D, Basaure J, Castiglioni C, de Bruin C, Hendriks Y, Bertini E, Alkuraya FS, Losekoot M, Al-Rubeaan K, Semple RK, Wit JM. Biallelic POC1A variants cause syndromic severe insulin resistance with muscle cramps. Eur J Endocrinol. 2022 Mar 1:EJE-21-0609. doi: 10.1530/EJE-21-0609. Online ahead of print.
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Madsen RR, Erickson EC, Rueda OM, Robin X, Caldas C, Toker A, Semple RK, Vanhaesebroeck B Positive correlation between transcriptomically-inferred stemness and PI3K/AKT/mTOR signalling scores in breast cancer, and a counterintuitive relationship with PIK3CA genotype PLoS Genetics, 2021 Nov 11;17(11):e1009876. doi: 10.1371/journal.pgen.1009876
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Douzgou S, Rawson M, Baselga E, Danielpour M, Faivre L, Kashanian A, Keppler-Noreuil KM, Kuentz P, Mancini GMS, Maniere M-C, Martinez-Glez V, Parker VE, Semple RK, Srivastava S, Vabres P, de Wit M-CY, Graham JM, Clayton-Smith J, Mirzaa GM, Biesecker LG A standard of care for individuals with PIK3CA-related disorders: an international expert consensus statement Clin Genet. 2022 Jan;101(1):32-47. doi: 10.1111/cge.14027.
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Luu M, Vabres P, Devilliers H, Loffroy R, Phan A, Martin L, Morice-Picard F, Petit F, Willems M, Bessis D, Jacquemont ML, Maruani A, Chiaverini C, Mirault T, Clayton-Smith J, Carpentier M, Fleck C, Maurer A, Yousfi M, Parker VER, Semple RK, Bardou M, Faivre L Safety and efficacy of low-dose PI3K inhibitor taselisib in adult patients with CLOVES and KLIPPEL TRENAUNAY SYNDROME (KTS): the TOTEM trial, a phase 1/2 multicentre, open-label, single-arm study Genet Med. 2021 Dec;23(12):2433-2442. doi: 10.1038/s41436-021-01290-y.
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Cottrell CE, Bender NR, Zimmermann MT, Heusel JW, Corliss M, Evenson MJ, Magrini V, Corsmeier DJ, Avenarius M, Dudley JN, Johnston JJ, Lindhurst MJ, Vigh-Conrad K, Davies OMT, Coughlin CC, Frieden IJ, Tollefson M, Zaenglein AL, Ciliberto H, Tosi LL, Semple RK, Biesecker LG, Drolet BA Somatic PIK3R1 variation as a cause of vascular malformations and overgrowth. Genet Med. 2021 Oct;23(10):1882-1888. doi: 10.1038/s41436-021-01211-z.
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Ovarian hyperandrogenism and its response to gonadotropin-releasing hormone analogue therapy in primary severe insulin resistance Huang-Doran I, Kinzer AB, Jimenez-Linan M, Thackray K, Harris J, Adams CL, de Kerdanet M, Stears A, O’Rahilly S, Savage DB, Gorden P, Brown RJ, Semple RK . J Clin Endocrinol Metab. 2021 Jul 13;106(8):2367-2383. doi: 10.1210/clinem/dgab275
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Forde K, Resta N, Ranieri C, Rea D, Kubassova O, Hinton M, Andrews KA, Semple R, Irvine AD, Dvorakova V. Clinical experience with the AKT1 inhibitor miransertib in two children with PIK3CA-related overgrowth syndrome. Orphanet J Rare Dis. 2021 Feb 27;16(1):109.
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Madsen RR, Longden J, Knox RG, Robin X, Völlmy F, Macleod KG, Moniz LS, Carragher NO, Linding R, Vanhaesebroeck B, Semple RK NODAL/TGFbeta signalling mediates the self-sustained stemness induced by PIK3CAH1047R homozygosity in pluripotent stem cells Dis Model Mech. 2021 Jan 28;14(3):dmm048298. doi: 10.1242/dmm.048298.
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Brierley GV, Webber H, Rasijeff E, Grocott S, Siddle K, Semple RK Anti-Insulin Receptor Antibodies Improve Hyperglycemia in a Mouse Model of Human Insulin Receptoropathy. Diabetes. 2020 Nov;69(11):2481-2489. doi: 10.2337/db20-0345.
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Kwok A, Zvetkova I, Virtue S, Luijten I, Isabel Huang-Doran I, Tomlinson P, Bulger DA, West J, Murfitt S, Griffin J, Alam R, Hart D, Knox R, Voshol P, Vidal-Puig A, Jensen J, O’Rahilly S, Semple RK. Truncation of Pik3r1 causes severe insulin resistance uncoupled from obesity and dyslipidemia by increased energy expenditure Mol Metab. 2020 Oct;40:101020. doi: 10.1016/j.molmet.2020.101020.
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Goh KJ, Chen JH, Rocha N, Semple RK. Human pluripotent stem cell-based models suggest preadipocyte senescence as a possible cause of metabolic complications of Werner and Bloom Syndromes. Sci Rep. 2020 May 4;10(1):7490. doi: 10.1038/s41598-020-64136-8.
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Madsen RR, Knox RG, Pearce W, Lopez S, Mahler-Araujo B, McGranahan N, Vanhaesebroeck B, Semple RK. Oncogenic PIK3CA promotes cellular stemness in an allele dose-dependent manner. Proc Natl Acad Sci U S A. 2019 Apr 23;116(17):8380-8389
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Logan CV, Murray JE, Parry DA, Robertson A, Bellelli R, ….[36 authors]…. Reijns M, Bober MB, Semple RK, Boulton SJ, Rios JJ, Jackson AP DNA Polymerase epsilon deficiency causes IMAGe Syndrome with variable immunodeficiency AJHG, 2018 Dec 6;103(6):1038-1044.
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Parker VER, Keppler-Noreuil KM, Faivre L, Luu M….[25 authors]…. Vabres P, Semple RK*, Biesecker LG Safety and efficacy of low-dose sirolimus in the PIK3CA-related overgrowth spectrum. Genet Med. 2018 Oct 1. doi:10.1038/s41436-018-0297-9. [*corresponding]
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Church D, Cardoso L, Kay RG, Williams CL, Freudenthal B, Clarke C, Harris J, Moorthy M, Karra E, Gribble FM, Reimann F, Burling K, Williams AJK, Munir A, Jones TH, Führer D, Moeller LC, Cohen M, Khoo B, Halsall D, Semple RK. Assessment and Management of Anti-Insulin Autoantibodies in Varying Presentations of Insulin Autoimmune Syndrome. J Clin Endocrinol Metab. 2018 1;103(10):3845-3855
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Brierley GV, Siddle K, Semple RK. Evaluation of anti-insulin receptor antibodies as potential novel therapies for human insulin receptoropathy using cell culture models. Diabetologia. 2018 Jul;61(7):1662-1675. doi: 10.1007/s00125-018-4606-2. Epub 2018 Apr 27.
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Al-Olabi L, Polubothu, P, Dowsett K, Andrews K, Stadnik P ….[34 authors]….Biesecker LG, Barnacle A, Topf M, Semple R*, Patton EE*, Kinsler K* Mosaic RAS/MAPK variants cause sporadic vascular malformations which respond to targeted therapy J. Clin Inv 2018 Nov 1;128(11):5185 [* = equal contributions]
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Rocha N, Payne F, Huang-Doran I, Sleigh A, Fawcett K, Adams C, Stears A, Saudek V, O’Rahilly S, Barroso I, Semple RK The metabolic syndrome- associated small G protein ARL15 plays a role in adipocyte differentiation and adiponectin secretion Sci Reports Sci Rep. 2017 Dec 14;7(1):17593.
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Chen J-H, Goh KJ, Rocha N, Groeneveld MP, Minic M, Barrett TG, Savage DB, Semple RK Evaluation of human dermal fibroblasts directly reprogrammed to adipocyte-like cells as a metabolic disease model Disease Models and Mechanisms 2017 Dec 19;10(12):1411-1420
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Chen JH, Geberhiwot T, Barrett TG, Paisey R, Semple RK. Refining genotype-phenotype correlation in Alström syndrome through study of primary human fibroblasts. Mol Genet Genomic Med. 2017 May 15;5(4):390-404.
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Leiter SM, Parker VE, Welters A, Knox R, Rocha N, Clark GR, Payne F, Lotta L, Harris J, Guerrero-Fernández J, González-Casado I, García-Miñaur S, Gordo G, Wareham NJ, Martínez-Glez V, Allison M, O'Rahilly S, Barroso I, Meissner T, Davies S, Hussain K, Temple K, Barreda-Bonis AC, Kummer S, Semple RK. Hypoinsulinaemic, hypoketotic hypoglycaemia due to mosaic genetic activation of PI3-Kinase. Eur J Endocrinol. 2017 May 31. pii: EJE-17-0132. doi: 10.1530/EJE-17-0132.
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Minic M, Rocha N, Harris J, Groeneveld MP, Leiter S, Wareham N, Sleigh A, De Lonlay P, Hussain K, O'Rahilly S, Semple RK. Constitutive activation of AKT2 in humans leads to hypoglycemia without fatty liver or metabolic dyslipidemia. J Clin Endocrinol Metab. 2017 May 23. doi: 10.1210/jc.2017-00768. [Epub ahead of print]
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Rocha NM, Bulger DA, Frontini A, Titheradge H, Gribsholt SB ….[22 authoirs]….Maher ER, Richelsen B, Savage DB, Semple RK. Human biallelic MFN2 mutations induce mitochondrial dysfunction, upper body adipose hyperplasia, and suppression of leptin expression. Elife. 2017 Apr 17;6. pii: e23813. doi: 10.7554/eLife.23813. [Epub ahead of print]
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Bulger DA, Fukushige T, Yun S, Semple RK, Hanover JA, Krause MW. Caenorhabditis elegans DAF-2 as a Model for Human Insulin Receptoropathies. G3 (Bethesda). 2016 Nov 18. pii: g3.116.037184. doi: 10.1534/g3.116.037184. [Epub ahead of print]
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Huang-Doran I, Tomlinson P, Payne F, Gast A, Sleigh A, Bottomley W, Harris J, Daly A, Rocha N, Rudge S, Clark J, Kwok A, Romeo S, McCann E, Müksch B, Dattani M, Zucchini S, Wakelam M, Foukas LC, Savage DB, Murphy R, O’Rahilly S, Barroso I, Semple RK Insulin resistance uncoupled from dyslipidemia due to C-terminal PIK3R1 mutations JCI Insight. 2016 Oct 20;1(17):e88766.
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Church D, Cardoso L, Bradbury S, Clarke C, Stears A, Dover A, Halsall D, Semple R Diagnosis of insulin autoimmune syndrome using polyethylene glycol precipitation and gel filtration chromatography with ex vivo insulin exchange Clin Endocrinol (Oxf). 2016 Sep 2. doi: 10.1111/cen.13179.
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Groeneveld MP, Brierley GV, Rocha NM, Siddle K, Semple RK. Acute knockdown of the insulin receptor or its substrates Irs1 and 2 in 3T3-L1 adipocytes suppresses adiponectin production. Sci Rep. 2016 Feb 18;6:21105. doi: 10.1038/srep21105.
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Chen JH, Segni M, Payne F, Huang-Doran I, Sleigh A, Adams C; UK10K Consortium, Savage DB, O'Rahilly S, Semple RK*, Barroso I. Truncation of POC1A associated with short stature and extreme insulin resistance. J Mol Endocrinol. 2015 Oct;55(2):147-58. [*corresponding]
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Payne F, Colnaghi R, Rocha N, Seth A, Harris J, Carpenter G, Bottomley W, Wheeler E, Wong S, Saudek V, Savage DB, O’Rahilly S, Carel J-C, Barroso I, O’Driscoll M, Semple RK Hypomorphism in human NSMCE2 linked to primordial dwarfism and insulin resistance J Clin Invest. 2014 Sep;124(9):4028-38
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Yaghootkar H, Scott RA, White CC …[16 authors]….Hivert MF, Dastani Z, Richards JB, Semple RK, Frayling TM. Genetic evidence for a normal-weight "metabolically obese" phenotype linking insulin resistance, hypertension, coronary artery disease and type 2 diabetes. Diabetes. 2014 Jul 21.
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Challis BG, Harris J, Sleigh A, Isaac I, Orme SM, Seevaratnam N, Dhatariya K, Simpson HL, Semple RK. Familial adult onset hyperinsulinism due to an activating glucokinase mutation: Implications for pharmacological glucokinase activation. Clin Endocrinol (Oxf). 2014 Jun 2. doi: 10.1111/cen.12517.
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Keppler-Noreuil KM, Sapp JC, Lindhurst MJ, Parker VE, Blumhorst C, Darling T, Tosi LL, Huson SM, Whitehouse RW, Jakkula E, Grant I, Balasubramanian M, Chandler KE, Fraser JL, Gucev Z, Crow YJ, Brennan LM, Clark R, Sellars EA, Pena LD, Krishnamurty V, Shuen A, Braverman N, Cunningham ML, Sutton VR, Tasic V, Graham JM Jr, Geer J J, Henderson A, Semple RK, Biesecker LG. Clinical delineation and natural history of the PIK3CA-related overgrowth spectrum. Am J Med Genet. 2014 Apr 29. doi: 10.1002/ajmg.a.36552. [Epub ahead of print]
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Weedon MN, Ellard S, Prindle MJ, Caswell R, Allen HL, Oram R, Godbole K, Yajnik CS, Sbraccia P, Novelli G, Turnpenny P, McCann E, Goh KJ, Wang Y, Fulford J, McCulloch LJ, Savage DB, O'Rahilly S, Kos K, Loeb LA, Semple RK, Hattersley AT. An in-frame deletion at the polymerase active site of POLD1 causes a multisystem disorder with lipodystrophy. Nature Genetics 2013 Aug;45(8):947-50.
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Lindhurst MJ, Parker VER, Payne F, Sapp JC, Rudge S, Harris J, Witkowski AM, Zhang Q, Groeneveld MP, Scott CE, Daly A, Huson SM, Tosi LL, Cunningham ML, Darling TN, Geer J, Gucev Z, Sutton VR, Tziotzios C, Dixon AK, Helliwell T, O’Rahilly S, Savage DB, Wakelam MJO, Barroso I, Biesecker LG, Semple RK Mosaic overgrowth with fibroadipose hyperplasia is caused by somatic activating mutations in PIK3CA Nature Genetics 2012 Jun 24;44(8):928-33.
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Hussain K, Challis B, Rocha N, Payne F, Minic M, Thompson A, Daly A, Scott C, Harris J, Smillie BJL, Savage DB, Ramaswami U, De Lonlay P, O’Rahilly S, Barroso I, Semple RK An Activating Mutation of AKT2 and Human Hypoglycemia Science, 2011 Oct 28;334(6055):474
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Sleigh A, Raymond-Barker P, Thackray K, Porter D, Hatunic M, Vottero A, Burren C, Mitchell C, McIntyre M, Brage S, Carpenter TA, Murgatroyd PR, Brindle KM, Kemp GJ, O’Rahilly S, Semple RK*, Savage DB* Mitochondrial dysfunction in patients with primary congenital insulin resistance J Clin Invest., 2011 Jun 1;121(6):2457-61 [*= co-corresponding]
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Huang-Doran I, Bicknell LS, Finucane FM, Rocha N, Porter KM, Tung YCL, MOPD Study Group, Szekeres F, Krook A, Nolan JJ, O’Driscoll M, Bober M, O’Rahilly S, Jackson AP, Semple RK Genetic Defects in Human Pericentrin are Associated with Severe Insulin Resistance and Diabetes Mellitus. Diabetes 2011 Mar;60(3):925-35
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Rashid ST, Corbineau S, Hannan N, Marciniak SJ, Miranda E, Alexander G, Huang-Doran I, Griffin J, Ahrlund-Richter L, Skepper J, Semple R, Weber A, Lomas DA, Vallier L. Modeling inherited metabolic disorders of the liver using human induced pluripotent stem cells. J Clin Invest. 2010 Sep 1;120(9):3127-36
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Selected Peer-reviewed Review Articles, Editorials and Commentaries (since 2010)
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Semple RK. Insulin Resistance and Adrenal Androgen Synthesis Viewed Through a Monogenic Lens. J Clin Endocrinol Metab. 2022 Nov 23;107(11):e4326-e4327. doi: 10.1210/clinem/dgac475. PMID: 35961312; PMCID: PMC9681616.
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Bonnefond A, Semple RK Achievements, Prospects and Challenges in Precision Care for Monogenic Insulin-Deficient and Insulin-Resistant Diabetes Diabetologia 2022 (in press)
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Madsen RR, Semple RK. PIK3CA-related overgrowth: silver bullets from the cancer arsenal? Trends Mol Med. 2022 Mar 7:S1471-4914(22)00050-8. doi: 10.1016/j.molmed.2022.02.009. Online ahead of print.
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Brierley GV, Semple RK Insulin at 100 years – is rebalancing its action key to fighting obesity-related disease? Disease Models and Mechanisms Dis Model Mech. 2021 Nov 1;14(11):dmm049340. doi: 10.1242/dmm.049340. Epub 2021 Nov 29.
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Wake DJ, Gibb FW, Kar P, Kennon B, Klonoff DC, Rayman G, Rutter MK, Sainsbury C, Semple RK. ENDOCRINOLOGY IN THE TIME OF COVID-19: Remodelling diabetes services and emerging innovation. Eur J Endocrinol. 2020 Aug;183(2):G67-G77
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Madsen RR, Vanhaesebroeck B, Semple RK. Cancer-Associated PIK3CA Mutations in Overgrowth Disorders. Trends Mol Med. 2018 Oct;24(10):856-870
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Semple RK. EJE PRIZE 2015: How does insulin resistance arise, and how does it cause disease? Human genetic lessons. Eur J Endocrinol. 2016 May;174(5):R209-23.
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Parker VE, Semple RK. Genetic Forms of Severe Insulin Resistance: What Endocrinologists Should Know. Eur J Endocrinol. 2013 Jul 15. [Epub ahead of print]
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Groeneveld MP, Huang-Doran I., Semple RK Adiponectin and leptin in human severe insulin resistance - diagnostic utility and biological insights Biochimie 2012 (in press)
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Parker VER, Savage DB, O’Rahilly S, Semple RK Mechanistic Insights into Insulin Resistance in the Genetic Era Diabetic Medicine 2011 Dec;28(12):1476-86
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Semple RK, Savage DB, Cochran EK, Gorden P, O’Rahilly S Genetic Syndromes of Severe Insulin Resistance Endocrine Reviews, 2011 Aug;32(4):498-514
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Savage DB, Semple RK Recent Insights into Fatty Liver, Metabolic Dyslipidaemia and their Links to Insulin Resistance Curr. Opin Lipidol. 2010 Aug;21(4):329-36
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Semple RK, Williams R, Dunger DB What is the best management strategy for patients with severe insulin resistance? Clin Endocrinol (Oxf), 2010 Sep;73(3):286-90
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Cook JR, Semple RK Hypoadiponectinemia – Cause or Consequence of Human “Insulin Resistance” J Clin Endocrinol Metab. 2010 Apr;95(4):1544-54
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Semple RK, Topaloglu AK. The Recent Genetics of Hypogonadotrophic Hypogonadism – Novel Insights and New Questions Clin Endocrinol (Oxf), 2010 Apr;72(4):427-35