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Animal insulin therapy induces a biased insulin antibody response that persists for years after introduction of human insulin.

Abstract：

:Administration of exogenous insulin for the treatment of diabetes is often accompanied by the development of insulin antibodies (IA). These antibodies may affect the patient's requirement for insulin by acting as an insulin binding reservoir. The improvement of insulin purification in the 1970s and the development of human recombinant insulin both reduced the incidence of IA and their binding levels. This study investigates the parameters affecting IA frequency and binding levels in a cohort of type 1 diabetes (T1D) patients. All patients were treated with human recombinant insulin. About half of the patients had received animal insulin prior to the introduction of human recombinant insulin. We tested the IA frequency and binding level for all serum samples. IA were further analyzed for their epitope specificity comparing human and porcine insulin binding. We found that T1D patients who received animal insulin in the past show significantly higher IA binding levels as compared to patients treated exclusively with human recombinant insulin (IA binding level of 0.9 and 0.25 index, respectively, P = 0.005). T1D patients who received animal insulin in the past showed a relative bias towards porcine insulin, as compared to T1D patients who were treated with human recombinant insulin exclusively (P < 0.0001). We conclude that IA binding level and epitope specificity are biased by treatment with animal insulin. This bias remains for over 20 years after animal insulin treatment is terminated.

journal_name

Acta Diabetol

journal_title

Acta diabetologica

authors

Oak S,Phan TH,Gilliam LK,Hirsch IB,Hampe CS

doi

10.1007/s00592-009-0135-2

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

131-5

issue

2

eissn

0940-5429

issn

1432-5233

journal_volume

47

pub_type

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