Dozio N, Sodoyez-Goffaux F, Koch M, Ziegler B, Sodoyez J C
Department of Internal Medicine, University of Liege, Belgium.
Clin Exp Immunol. 1991 Aug;85(2):282-7. doi: 10.1111/j.1365-2249.1991.tb05719.x.
Insulin antibodies in six patients with immune hypoglycaemic syndrome were studied. The antibodies displayed a higher affinity for bovine insulin in two patients, were specific for human insulin in one patient and non-species specific in the other three patients. The predominant IgG subclass of the insulin antibodies was IgG4 in two patients, IgG3 in two and IgG1 in two. In one of these, the other three subclasses were also detectable. Insulin autoantibodies of four patients were homogeneous with regard to light chains (kappa), and those of the other two contained both kappa and gamma light chains. Analysis of insulin immune complex size by fast protein liquid chromatography was possible in three patients and demonstrated immune complexes with elution profile close to that of IgG, although not exactly superimposable to the one obtained with a mouse monoclonal insulin antibody. In two patients, avidity was too low to permit chromatography of the immune complexes, and, moreover, in these two cases insulin antibodies were of the IgG3 isotype and spontaneously formed aggregates independently of insulin binding. We conclude that insulin antibodies of the insulin immune syndrome are polymorphic but different from those generated by insulin therapy.
对6例免疫性低血糖综合征患者的胰岛素抗体进行了研究。在2例患者中，抗体对牛胰岛素表现出更高的亲和力，1例患者的抗体对人胰岛素具有特异性，而在另外3例患者中则是非种属特异性的。胰岛素抗体的主要IgG亚类在2例患者中为IgG4，2例为IgG3，2例为IgG1。其中1例患者还可检测到其他三种亚类。4例患者的胰岛素自身抗体轻链（κ）均一，另外2例患者的胰岛素自身抗体同时含有κ链和γ链。3例患者可通过快速蛋白质液相色谱法分析胰岛素免疫复合物的大小，结果显示免疫复合物的洗脱图谱与IgG接近，尽管与用小鼠单克隆胰岛素抗体获得的图谱不完全重叠。在2例患者中，亲和力过低，无法对免疫复合物进行色谱分析，此外，在这2例患者中，胰岛素抗体为IgG3同种型，且在不依赖胰岛素结合的情况下自发形成聚集体。我们得出结论，胰岛素免疫综合征的胰岛素抗体具有多态性，但与胰岛素治疗产生的抗体不同。
