6HN4

Leucine-zippered human insulin receptor ectodomain with single bound insulin - "lower" membrane-proximal part

External Resource: Annotation

Domain Annotation: SCOP2 Classification
Domain Annotation: ECOD Classification
Protein Family Annotation
Gene Ontology: Gene Product Annotation
InterPro: Protein Family Classification
Pharos: Disease Associations

Domain Annotation: SCOP2 Classification SCOP2 Database Homepage

Chains	Type	Family Name	Domain Identifier	Family Identifier	Provenance Source (Version)
B [auth F]	SCOP2B Superfamily	L domain-like	8032830	3001010	SCOP2B (2022-06-29)
B [auth F]	SCOP2B Superfamily	Growth factor receptor domain-like	8032837	3000398	SCOP2B (2022-06-29)

Domain Annotation: ECOD Classification ECOD Database Homepage

Chains	Family Name	Domain Identifier	Architecture	Possible Homology	Homology	Topology	Family	Provenance Source (Version)
A [auth E]	fn3_1	e6hn4E2	A: beta sandwiches	X: Immunoglobulin-like beta-sandwich	H: Immunoglobulin-related	T: Immunoglobulin/Fibronectin type III/E set domains/PapD-like	F: fn3_1	ECOD (1.6)
A [auth E]	fn3	e6hn4E1	A: beta sandwiches	X: Immunoglobulin-like beta-sandwich	H: Immunoglobulin-related	T: Immunoglobulin/Fibronectin type III/E set domains/PapD-like	F: fn3	ECOD (1.6)
B [auth F]	fn3_1	e6hn4F3	A: beta sandwiches	X: Immunoglobulin-like beta-sandwich	H: Immunoglobulin-related	T: Immunoglobulin/Fibronectin type III/E set domains/PapD-like	F: fn3_1	ECOD (1.6)
B [auth F]	fn3	e6hn4F4	A: beta sandwiches	X: Immunoglobulin-like beta-sandwich	H: Immunoglobulin-related	T: Immunoglobulin/Fibronectin type III/E set domains/PapD-like	F: fn3	ECOD (1.6)
B [auth F]	Recep_L_domain	e6hn4F2	A: beta duplicates or obligate multimers	X: Single-stranded right-handed beta-helix	H: Leucine-rich repeats (From Topology)	T: Leucine-rich repeats	F: Recep_L_domain	ECOD (1.6)
B [auth F]	Furin-like_5	e6hn4F1	A: few secondary structure elements	X: EGF-like	H: Growth factor receptor domain (From Topology)	T: Growth factor receptor domain	F: Furin-like_5	ECOD (1.6)

Protein Family Annotation Pfam Database Homepage

Chains	Accession	Name	Description	Comments	Source
A [auth E], B [auth F]	PF00757	Furin-like cysteine rich region (Furin-like)	Furin-like cysteine rich region	-	Domain
A [auth E], B [auth F]	PF01030	Receptor L domain (Recep_L_domain)	Receptor L domain	-	Repeat
A [auth E], B [auth F]	PF17870	Insulin receptor trans-membrane segment (Insulin_TMD)	Insulin receptor trans-membrane segment	This entry represents the trans-membrane domain (TMD) found in insulin receptor proteins. The TMD of the insulin receptor is within the beta-subunit and contains 23 amino acids. Mutations in the TMD were shown to have effects on receptor biosynthetic ...	This entry represents the trans-membrane domain (TMD) found in insulin receptor proteins. The TMD of the insulin receptor is within the beta-subunit and contains 23 amino acids. Mutations in the TMD were shown to have effects on receptor biosynthetic processing and kinase activation. Substitution of the entire TMD of the insulin receptor (IR) resulted in constitutive kinase activation in vitro, while replacing the TMD with that of glycophorin A inhibited insulin action. Structural studies show that TMD contains a helix and a kink when it is purified in dodecylphosphocholine (DPC) micelles. The residues 942-948 preceding the TMD have a propensity to be a short helix and may interact with membrane [1].	Domain
A [auth E], B [auth F]	PF00041	Fibronectin type III domain (fn3)	Fibronectin type III domain	-	Domain

Gene Ontology: Gene Product Annotation Gene Ontology Database Homepage

Chains	Polymer	Molecular Function	Biological Process	Cellular Component
A [auth E], B [auth F]	Insulin receptor,Insulin receptor,General control protein GCN4	TFIID-class transcription factor complex binding transcription factor binding basal transcription machinery binding protein-containing complex binding protein binding binding basal RNA polymerase II transcription machinery binding general transcription initiation factor binding RNA polymerase II general transcription initiation factor binding RNA polymerase II-specific DNA-binding transcription factor binding DNA-binding transcription factor binding DNA binding sequence-specific DNA binding double-stranded DNA binding TFIID-class transcription factor complex binding transcription factor binding basal transcription machinery binding protein-containing complex binding protein binding binding basal RNA polymerase II transcription machinery binding general transcription initiation factor binding RNA polymerase II general transcription initiation factor binding RNA polymerase II-specific DNA-binding transcription factor binding DNA-binding transcription factor binding DNA binding sequence-specific DNA binding double-stranded DNA binding nucleic acid binding RNA polymerase II transcription regulatory region sequence-specific DNA binding cis-regulatory region sequence-specific DNA binding sequence-specific double-stranded DNA binding transcription cis-regulatory region binding organic cyclic compound binding transcription regulatory region nucleic acid binding RNA polymerase II cis-regulatory region sequence-specific DNA binding chromatin binding transcription regulator activity DNA-binding transcription factor activity mediator complex binding DNA-binding transcription factor activity, RNA polymerase II-specific DNA-binding transcription activator activity, RNA polymerase II-specific DNA-binding transcription activator activity identical protein binding insulin receptor substrate binding amide binding amyloid-beta binding peptide binding peptide hormone binding hormone binding insulin binding molecular transducer activity catalytic activity, acting on a protein kinase activity protein kinase activity signaling receptor activity transferase activity phosphotransferase activity, alcohol group as acceptor transferase activity, transferring phosphorus-containing groups protein tyrosine kinase activity transmembrane receptor protein tyrosine kinase activity protein-hormone receptor activity transmembrane receptor protein kinase activity transmembrane signaling receptor activity insulin receptor activity catalytic activity PTB domain binding protein domain specific binding phosphatidylinositol 3-kinase binding adenyl ribonucleotide binding nucleotide binding purine ribonucleotide binding purine ribonucleoside triphosphate binding nucleoside phosphate binding ion binding purine nucleotide binding anion binding adenyl nucleotide binding ATP binding heterocyclic compound binding carbohydrate derivative binding ribonucleotide binding small molecule binding insulin-like growth factor receptor binding signaling receptor binding insulin-like growth factor binding insulin-like growth factor II binding growth factor binding cargo receptor activity guanyl nucleotide binding GTP binding guanyl ribonucleotide binding insulin-like growth factor I binding	response to nutrient levels response to stimulus response to stress response to amino acid starvation response to starvation cellular response to stimulus cellular response to nutrient levels cellular process positive regulation of cellular response to amino acid starvation regulation of response to nutrient levels regulation of cellular process positive regulation of biological process regulation of cellular response to stress cellular response to amino acid starvation response to nutrient levels response to stimulus response to stress response to amino acid starvation response to starvation cellular response to stimulus cellular response to nutrient levels cellular process positive regulation of cellular response to amino acid starvation regulation of response to nutrient levels regulation of cellular process positive regulation of biological process regulation of cellular response to stress cellular response to amino acid starvation positive regulation of response to stimulus cellular response to stress regulation of response to stress positive regulation of cellular process regulation of biological process biological regulation cellular response to starvation regulation of response to stimulus regulation of cellular response to amino acid starvation positive regulation of response to nutrient levels transcription preinitiation complex assembly positive regulation of macromolecule biosynthetic process regulation of primary metabolic process cellular component biogenesis nucleobase-containing compound metabolic process DNA-templated transcription positive regulation of metabolic process regulation of DNA-templated transcription initiation regulation of RNA metabolic process cellular component assembly transcription by RNA polymerase II positive regulation of macromolecule metabolic process regulation of nucleobase-containing compound metabolic process transcription initiation at RNA polymerase II promoter regulation of transcription by RNA polymerase II positive regulation of nucleobase-containing compound metabolic process cellular metabolic process primary metabolic process regulation of cellular metabolic process positive regulation of transcription by RNA polymerase II positive regulation of DNA-templated transcription initiation positive regulation of RNA metabolic process regulation of gene expression biosynthetic process RNA polymerase II preinitiation complex assembly metabolic process regulation of macromolecule biosynthetic process macromolecule metabolic process regulation of DNA-templated transcription regulation of metabolic process regulation of RNA polymerase II transcription preinitiation complex assembly regulation of cellular component organization positive regulation of cellular component organization cellular biosynthetic process positive regulation of DNA-templated transcription RNA metabolic process positive regulation of cellular metabolic process cellular component organization protein-DNA complex organization RNA biosynthetic process nucleic acid biosynthetic process regulation of protein-containing complex assembly positive regulation of protein-containing complex assembly positive regulation of biosynthetic process protein-containing complex assembly cellular component organization or biogenesis regulation of RNA biosynthetic process regulation of biosynthetic process positive regulation of RNA polymerase II transcription preinitiation complex assembly protein-containing complex organization positive regulation of cellular component biogenesis positive regulation of transcription initiation by RNA polymerase II protein-DNA complex assembly regulation of macromolecule metabolic process nucleobase-containing compound biosynthetic process gene expression regulation of cellular component biogenesis macromolecule biosynthetic process DNA-templated transcription initiation nucleic acid metabolic process regulation of cellular biosynthetic process positive regulation of RNA biosynthetic process regulation of transcription initiation by RNA polymerase II positive regulation of cellular biosynthetic process protein localization localization cellular localization protein localization to organelle cellular macromolecule localization macromolecule localization protein localization to nuclear periphery protein localization to nucleus amino acid biosynthetic process amino acid metabolic process nitrogen catabolite regulation of transcription regulation of nitrogen utilization intracellular nitrogen homeostasis nitrogen catabolite activation of transcription from RNA polymerase II promoter chemical homeostasis response to chemical homeostatic process nitrogen catabolite activation of transcription intracellular chemical homeostasis nitrogen catabolite regulation of transcription from RNA polymerase II promoter response to nutrient nitrogen utilization cellular response to chemical stimulus cellular homeostasis cellular response to nutrient signaling signal transduction intracellular signal transduction cell communication negative regulation of biological process negative regulation of cellular metabolic process negative regulation of RNA biosynthetic process negative regulation of cellular process negative regulation of nucleobase-containing compound metabolic process negative regulation of macromolecule metabolic process negative regulation of DNA-templated transcription negative regulation of transcription by RNA polymerase II negative regulation of metabolic process negative regulation of cellular biosynthetic process negative regulation of biosynthetic process negative regulation of macromolecule biosynthetic process negative regulation of RNA metabolic process regulation of ribosomal protein gene transcription by RNA polymerase II negative regulation of ribosomal protein gene transcription by RNA polymerase II developmental process multicellular organismal process gonad development reproductive system development reproductive process sex differentiation animal organ development developmental process involved in reproduction male gonad development male sex differentiation multicellular organism development development of primary male sexual characteristics development of primary sexual characteristics anatomical structure development reproductive structure development system development regulation of nitric oxide biosynthetic process reactive nitrogen species metabolic process positive regulation of nitric oxide metabolic process nitric oxide metabolic process nitric oxide biosynthetic process regulation of nitric oxide metabolic process positive regulation of nitric oxide biosynthetic process cellular component disassembly protein-containing complex disassembly regulation of protein-containing complex disassembly positive regulation of protein-containing complex disassembly behavior system process learning learning or memory nervous system process cognition import into cell receptor internalization transport receptor-mediated endocytosis endocytosis establishment of localization vesicle-mediated transport positive regulation of phosphorylation regulation of catalytic activity regulation of transferase activity positive regulation of phosphate metabolic process regulation of phosphate metabolic process phosphate-containing compound metabolic process phosphorus metabolic process protein modification process positive regulation of protein phosphorylation protein phosphorylation positive regulation of phosphorus metabolic process phosphorylation regulation of protein metabolic process regulation of molecular function positive regulation of kinase activity regulation of kinase activity activation of protein kinase activity macromolecule modification regulation of phosphorus metabolic process regulation of protein modification process regulation of protein phosphorylation positive regulation of protein metabolic process positive regulation of molecular function positive regulation of protein modification process protein metabolic process activation of protein kinase B activity positive regulation of protein kinase activity positive regulation of transferase activity positive regulation of catalytic activity regulation of protein kinase activity regulation of phosphorylation biological process involved in interspecies interaction between organisms symbiont entry into host cell viral process symbiont entry into host viral life cycle biological process involved in interaction with host biological process involved in symbiotic interaction regulation of growth regulation of developmental growth regulation of developmental process developmental growth growth positive regulation of developmental process positive regulation of growth positive regulation of developmental growth memory positive regulation of organelle organization regulation of mitotic nuclear division positive regulation of mitotic nuclear division mitotic cell cycle regulation of mitotic cell cycle positive regulation of cell cycle process cell cycle regulation of cell cycle cell cycle process mitotic nuclear division regulation of cell cycle process organelle fission positive regulation of nuclear division regulation of organelle organization positive regulation of cell cycle organelle organization nuclear division mitotic cell cycle process regulation of nuclear division protein autophosphorylation heart development heart morphogenesis circulatory system development anatomical structure morphogenesis animal organ morphogenesis digestive system development gland development exocrine pancreas development pancreas development exocrine system development positive regulation of respiratory burst respiratory burst regulation of respiratory burst regulation of meiotic cell cycle sexual reproduction regulation of reproductive process meiotic cell cycle positive regulation of meiotic cell cycle positive regulation of reproductive process circulatory system process vascular process in circulatory system vascular transport transport across blood-brain barrier glucose homeostasis carbohydrate homeostasis pyridine nucleotide catabolic process oxoacid metabolic process carbohydrate catabolic process carbohydrate derivative metabolic process organophosphate catabolic process regulation of generation of precursor metabolites and energy nucleoside phosphate catabolic process organic acid metabolic process regulation of ATP metabolic process cellular catabolic process regulation of purine nucleotide catabolic process regulation of small molecule metabolic process regulation of nucleotide metabolic process small molecule metabolic process purine ribonucleotide catabolic process nucleoside phosphate metabolic process pyruvate metabolic process purine nucleoside diphosphate metabolic process purine-containing compound catabolic process regulation of purine nucleotide metabolic process nucleobase-containing compound catabolic process positive regulation of ATP metabolic process nucleoside diphosphate metabolic process positive regulation of carbohydrate metabolic process monocarboxylic acid metabolic process pyridine-containing compound catabolic process ribose phosphate metabolic process ATP metabolic process positive regulation of purine nucleotide catabolic process nucleobase-containing small molecule metabolic process purine ribonucleoside triphosphate metabolic process purine nucleotide catabolic process carbohydrate derivative catabolic process positive regulation of glycolytic process purine-containing compound metabolic process positive regulation of catabolic process ADP metabolic process purine ribonucleoside diphosphate metabolic process purine ribonucleoside diphosphate catabolic process ribonucleotide catabolic process positive regulation of nucleotide catabolic process glycolytic process pyridine-containing compound metabolic process pyridine nucleotide metabolic process nicotinamide nucleotide metabolic process regulation of carbohydrate catabolic process nucleotide metabolic process purine nucleoside diphosphate catabolic process nucleoside diphosphate catabolic process regulation of nucleotide catabolic process nucleoside triphosphate metabolic process purine ribonucleotide metabolic process catabolic process positive regulation of nucleotide metabolic process purine nucleotide metabolic process ribonucleotide metabolic process ribonucleoside diphosphate metabolic process ribonucleoside diphosphate catabolic process regulation of carbohydrate metabolic process ribonucleoside triphosphate metabolic process nucleotide catabolic process purine nucleoside triphosphate metabolic process carbohydrate metabolic process ADP catabolic process carboxylic acid metabolic process generation of precursor metabolites and energy regulation of catabolic process regulation of glycolytic process positive regulation of purine nucleotide metabolic process organophosphate metabolic process regulation of cellular catabolic process positive regulation of cellular catabolic process positive regulation of small molecule metabolic process sex determination male sex determination positive regulation of glycogen metabolic process carbohydrate biosynthetic process hexose metabolic process positive regulation of glucose metabolic process positive regulation of glycogen biosynthetic process energy reserve metabolic process regulation of glycogen metabolic process monosaccharide metabolic process regulation of glycogen biosynthetic process glucan biosynthetic process energy derivation by oxidation of organic compounds regulation of glucan biosynthetic process regulation of polysaccharide metabolic process polysaccharide metabolic process glucan metabolic process regulation of glucose metabolic process polysaccharide biosynthetic process glycogen metabolic process glycogen biosynthetic process regulation of polysaccharide biosynthetic process regulation of carbohydrate biosynthetic process glucose metabolic process regulation of localization regulation of receptor internalization positive regulation of endocytosis positive regulation of receptor-mediated endocytosis regulation of endocytosis regulation of transport regulation of receptor-mediated endocytosis regulation of vesicle-mediated transport positive regulation of receptor internalization positive regulation of transport amyloid-beta clearance epidermis development tissue development positive regulation of cell communication regulation of phosphatidylinositol 3-kinase/protein kinase B signal transduction positive regulation of signal transduction regulation of signal transduction regulation of intracellular signal transduction intracellular signaling cassette regulation of signaling positive regulation of intracellular signal transduction positive regulation of phosphatidylinositol 3-kinase/protein kinase B signal transduction regulation of cell communication phosphatidylinositol 3-kinase/protein kinase B signal transduction positive regulation of signaling regulation of gonad development development of primary female sexual characteristics regulation of female gonad development regulation of multicellular organismal process regulation of multicellular organismal development female gonad development female sex differentiation cell population proliferation positive regulation of cell population proliferation regulation of cell population proliferation peptidyl-tyrosine modification peptidyl-amino acid modification peptidyl-tyrosine phosphorylation regulation of MAP kinase activity positive regulation of protein serine/threonine kinase activity positive regulation of MAP kinase activity positive regulation of MAPK cascade regulation of MAPK cascade regulation of protein serine/threonine kinase activity MAPK cascade dendritic spine maintenance dendritic spine organization postsynapse organization plasma membrane bounded cell projection organization cell projection organization cellular component maintenance cell junction organization neuron projection organization synapse organization adrenal gland development endocrine system development cellular response to nitrogen compound response to peptide hormone insulin receptor signaling pathway cell surface receptor protein tyrosine kinase signaling pathway cellular response to endogenous stimulus response to hormone enzyme-linked receptor protein signaling pathway cellular response to hormone stimulus cell surface receptor signaling pathway response to endogenous stimulus response to oxygen-containing compound cellular response to peptide hormone stimulus response to nitrogen compound cellular response to oxygen-containing compound response to insulin cellular response to insulin stimulus cellular response to growth factor stimulus response to growth factor positive regulation of locomotion regulation of cell motility positive regulation of cell migration regulation of locomotion positive regulation of cell motility regulation of cell migration cell migration cell motility locomotion regulation of embryonic development embryo development G protein-coupled receptor signaling pathway neuron projection maintenance hexose transmembrane transport D-glucose import carbohydrate transport positive regulation of D-glucose transmembrane transport positive regulation of transmembrane transport regulation of D-glucose import positive regulation of D-glucose import transmembrane transport regulation of transmembrane transport D-glucose transmembrane transport regulation of D-glucose transmembrane transport monosaccharide transmembrane transport carbohydrate transmembrane transport	RNA polymerase II transcription regulator complex membrane-bounded organelle protein-containing complex intracellular anatomical structure nucleus nuclear protein-containing complex transcription regulator complex intracellular membrane-bounded organelle cellular anatomical entity intracellular organelle organelle cell periphery cell surface membrane RNA polymerase II transcription regulator complex membrane-bounded organelle protein-containing complex intracellular anatomical structure nucleus nuclear protein-containing complex transcription regulator complex intracellular membrane-bounded organelle cellular anatomical entity intracellular organelle organelle cell periphery cell surface membrane plasma membrane external side of plasma membrane side of membrane extracellular exosome extracellular vesicle extracellular organelle extracellular region extracellular space vesicle extracellular membrane-bounded organelle receptor complex endosome membrane endosome intracellular vesicle endomembrane system cytoplasmic vesicle membrane bounding membrane of organelle vesicle membrane cytoplasmic vesicle cytoplasm organelle membrane somatodendritic compartment neuronal cell body membrane cell body cell body membrane neuronal cell body axon cell projection neuron projection plasma membrane bounded cell projection membrane microdomain membrane raft plasma membrane raft plasma membrane region caveola lytic vacuole vacuole lysosome cell leading edge leading edge membrane neuron projection membrane dendrite membrane dendrite dendritic tree cell projection membrane catalytic complex plasma membrane protein complex membrane protein complex transferase complex protein kinase complex transferase complex, transferring phosphorus-containing groups insulin receptor complex plasma membrane signaling receptor complex late endosome

InterPro: Protein Family Classification InterPro Database Homepage

Chains	Accession	Name	Type
A [auth E], B [auth F]	IPR004827	Basic-leucine zipper domain	Domain
A [auth E], B [auth F]	IPR050946	AP-1 Transcription Factor bZIP	Family
A [auth E], B [auth F]	IPR046347	Basic-leucine zipper domain superfamily	Homologous Superfamily
A [auth E], B [auth F]	IPR008266	Tyrosine-protein kinase, active site	Active Site
A [auth E], B [auth F]	IPR020635	Tyrosine-protein kinase, catalytic domain	Domain
A [auth E], B [auth F]	IPR000719	Protein kinase domain	Domain
A [auth E], B [auth F]	IPR036941	Receptor L-domain superfamily	Homologous Superfamily
A [auth E], B [auth F]	IPR006212	Furin-like repeat	Repeat
A [auth E], B [auth F]	IPR013783	Immunoglobulin-like fold	Homologous Superfamily
A [auth E], B [auth F]	IPR000494	Receptor L-domain	Domain
A [auth E], B [auth F]	IPR017441	Protein kinase, ATP binding site	Binding Site
A [auth E], B [auth F]	IPR001245	Serine-threonine/tyrosine-protein kinase, catalytic domain	Domain
A [auth E], B [auth F]	IPR002011	Tyrosine-protein kinase, receptor class II, conserved site	Conserved Site
A [auth E], B [auth F]	IPR003961	Fibronectin type III	Domain
A [auth E], B [auth F]	IPR011009	Protein kinase-like domain superfamily	Homologous Superfamily
A [auth E], B [auth F]	IPR006211	Furin-like cysteine-rich domain	Domain
A [auth E], B [auth F]	IPR009030	Growth factor receptor cysteine-rich domain superfamily	Homologous Superfamily
A [auth E], B [auth F]	IPR050122	Receptor Tyrosine Kinase	Family
A [auth E], B [auth F]	IPR016246	Tyrosine-protein kinase, insulin-like receptor	Family
A [auth E], B [auth F]	IPR040969	Insulin receptor, trans-membrane domain	Domain
A [auth E], B [auth F]	IPR036116	Fibronectin type III superfamily	Homologous Superfamily

Pharos: Disease Associations Pharos Homepage Annotation

Chains	Drug Target	Associated Disease
A [auth E], B [auth F]	Pharos: P06213	Donohue syndrome type 2 diabetes mellitus hyperinsulinism due to INSR deficiency Rabson-Mendenhall syndrome Insulin Resistance Alzheimer disease glucose intolerance hyperinsulinism insulin-resistance syndrome type A polycystic ovary syndrome Parkinson disease diabetic autonomic neuropathy diabetic neuropathy congenital diaphragmatic hernia hyperglycemia Donohue syndrome type 2 diabetes mellitus hyperinsulinism due to INSR deficiency Rabson-Mendenhall syndrome Insulin Resistance Alzheimer disease glucose intolerance hyperinsulinism insulin-resistance syndrome type A polycystic ovary syndrome Parkinson disease diabetic autonomic neuropathy diabetic neuropathy congenital diaphragmatic hernia hyperglycemia diabetic polyneuropathy Lewy body dementia diabetes mellitus psoriasis spina bifida intellectual disability substance-related disorder lung disease acquired metabolic disease drug dependence malignant glioma maturity-onset diabetes of the young osteogenesis imperfecta glioblastoma pancreatic ductal adenocarcinoma hyperinsulinemic hypoglycemia hypertensive disorder substance dependence large cell medulloblastoma type 1 diabetes mellitus malignant mesothelioma esophageal adenocarcinoma osteosarcoma atypical teratoid rhabdoid tumor pancreatic intraductal papillary-mucinous neoplasm plasma cell myeloma dermatomyositis hypothyroidism Sjogren syndrome substance abuse malignant ependymoma malignant pancreatic neoplasm exocrine pancreatic carcinoma astrocytic tumor gastric adenocarcinoma ovarian cancer breast cancer pancreatic intraductal papillary-mucinous neoplasm with low grade dysplasia