Programmed cell death is an essential, highly regulated process in neural development. Although the role of insulin-like growth factor I in supporting the survival of neural cells has been well characterized, studies on proinsulin/insulin are scarce. Here, we characterize proinsulin/insulin effects on cell death in embryonic day 15.5 mouse retina. Both proinsulin mRNA and proinsulin/insulin immunoreactivity were found in the developing retina. Organotypic embryonic day 15.5 retinas cultured under growth factor deprivation showed an increase in cell death that was reversed by proinsulin, insulin and insulin-like growth factor I, with similar median effective concentration values via phosphatidylinositol-3-kinase activation. Although insulin and insulin-like growth factor I provoked a sustained Akt phosphorylation, proinsulin-induced phosphorylation of Akt was not found. Analysis of the growth factor deprivation-induced cell death mechanisms, using caspase and cathepsin inhibitors, demonstrated that both protease families were required for the effective execution of cell death. The insulin survival effect, which decreased the extent and distribution of cell death to levels similar to those found in vivo, was not enhanced by simultaneous treatment with caspase and cathepsin inhibitors, suggesting that insulin interferes with these protease pathways in the embryonic mouse retina. The mechanisms characterized in this study provide new details on early neural cell death and its genuine regulation by insulin/ proinsulin. Keywords: Akt, apoptosis, insulin-like growth factor I, neurogenesis, phosphatidylinositol-3-kinase, programmed cell death. In vitro approaches using transfected cell lines have elucidated several regulatory mechanisms of programmed cell death, although analysis in primary systems has been limited (Strasser et al. 2000;Joza et al. 2002). The vertebrate neuroretina, a part of the central nervous system, provides a model system to study the regulation of cell death, recognized as apoptosis, in a physiological context. Of the defined developmental periods of apoptosis in the vertebrate retina, the best characterized is a late phase in the second half of retinal development, which coincides with neuronal connectivity and synaptogenesis (Glücksmann 1940;Young 1984;Provis and van Driel 1985;Maslim et al. 1997;Marin-Teva et al. 1999). An earlier, less well-characterized phase of programmed cell death takes place in the first half of retinal development (Penfold and Provis 1986;Hensey and Gautier 1998;Diaz et al. 1999Diaz et al. , 2000Laemle et al. 1999;Biehlmaier et al. 2001). Address correspondence and reprint requests to Enrique J. de la Rosa, Centro de Investigaciones Bioló gicas, CSIC, C/Ramiro de Maeztu 9, 28040 Madrid, Spain. E-mail: ejdelarosa@cib.csic.esAbbreviations used: BrdU, bromodeoxyuridine; E, day of embryonic development; EC 50 , median effective concentration; GAPDH, glyceraldehyde-3-phosphate dehydrogenase; IGF, insulin-like growth factor; IR, insulin receptor; PI3K, phosphatidylinos...