Velcovsky H G, Beringhoff B, Federlin K
Immun Infekt. 1978 Aug;6(4):146-52.
Allergic reactions of the immediate type to insulin are known since its introduction of the treatment of diabetes mellitus. After the development of the chromatographically purified insulins they are to be found significantly reduced, though still particular cases are observed. The simultaneous occurrence of insulin allergy and insulin resistance seems to be not too rare. The immediate type allergy to insulin is mostly released by the presence of IgE-antibodies. Another but not at all rare allergic reaction is the Arthus phenomenon, released by IgG-antibodies. For diagnosis of these allergic states intradermal skin tests with various insulins are used. Also specific IgE-antibodies are to be measured radioimmunologically lately. There is a strong correlation between the outcome of the allergic reactions and the definite degree of the specific IgE-antibodies. Low levels of specific IgE are found in insulin treated diabetics without any visible allergic reactions to insulin. This fact proves that the hormone, though being a clean insulin of a very high degree, is the antigen itself. Not only immunologic mechanism, but also other exogenic influences cause allergic reactions of the immediate type to insulin.
自胰岛素用于治疗糖尿病以来，就已知其会引发速发型过敏反应。在色谱纯化胰岛素出现后，此类反应显著减少，不过仍有个别病例被观察到。胰岛素过敏与胰岛素抵抗同时出现的情况似乎并不罕见。胰岛素速发型过敏大多由IgE抗体的存在引发。另一种虽不罕见但有别的过敏反应是由IgG抗体引发的阿瑟斯现象。对于这些过敏状态的诊断，会使用不同胰岛素进行皮内皮肤试验。近来也通过放射免疫法检测特异性IgE抗体。过敏反应的结果与特异性IgE抗体的明确程度之间存在很强的相关性。在接受胰岛素治疗且对胰岛素无任何明显过敏反应的糖尿病患者中，发现特异性IgE水平较低。这一事实证明，该激素尽管是高度纯净的胰岛素，但本身就是抗原。不仅免疫机制，其他外源性影响也会导致对胰岛素的速发型过敏反应。
