一例胰岛素过敏病例：结晶人胰岛素可能掩盖其抗原性。

A case of insulin allergy: the crystalline human insulin may mask its antigenicity.

作者信息

Takatsuki H, Ishii H, Yamauchi T, Nakashima N, Nagase S, Hisatomi A, Umeda F, Nawata H

机构信息

Third Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

出版信息

Diabetes Res Clin Pract. 1991 May;12(2):137-9. doi: 10.1016/0168-8227(91)90091-q.

DOI:10.1016/0168-8227(91)90091-q

PMID:1879305

Abstract

We report an unusual case of insulin allergy. A 48-year-old man with non-insulin-dependent diabetes mellitus receiving biosynthetic isophane human insulin (Humulin N) developed itchy wheal-and-flare reactions at the sites of injection. When Humulin N was changed to a semi-synthetic crystalline human insulin zinc (Novolin U), the allergic reactions completely disappeared. Evaluation of his serum showed a high level of insulin-specific IgE. Skin testing with all commercially available insulins showed immediate local reactions to all agents tested except for Novolin U. In addition, decrystallized Novolin U prepared by lowering the pH with acetic acid also induced a positive reaction. These observations suggest that the crystallized structure of human insulin may mask its antigenicity for allergic reactions.

摘要

我们报告了一例罕见的胰岛素过敏病例。一名48岁的非胰岛素依赖型糖尿病男性患者，在接受生物合成低精蛋白人胰岛素（优泌林N）治疗时，注射部位出现了瘙痒性风团及潮红反应。当将优泌林N换为半合成结晶人胰岛素锌（诺和灵U）时，过敏反应完全消失。对其血清的评估显示胰岛素特异性IgE水平较高。用所有市售胰岛素进行皮肤试验，结果显示除诺和灵U外，所有受试药物均引起即时局部反应。此外，用乙酸降低pH值制备的脱结晶诺和灵U也引发了阳性反应。这些观察结果表明，人胰岛素的结晶结构可能掩盖了其在过敏反应中的抗原性。