Soto-Aguilar M C, deShazo R D, Morgan J E, Mather P, Ibrahim G, Frentz J M, Lauritano A A
Department of Medicine, Tulane University of New Orleans, Louisiana.
Ann Allergy. 1991 Nov;67(5):499-503.
Abnormal antibody responses to insulin in diabetic patients have been associated with syndromes of insulin hypersensitivity and abnormal insulin pharmacokinetics. In this study, we evaluated total and IgG subclass antibody responses to insulin in 70 diabetic subjects on insulin distributed into five clinical groups, and in two control groups using ELISAs with CDC/WHO recommended monoclonal antibodies. As expected, levels of total IgG insulin antibody were greater in diabetic patients treated with insulin than in the control group of diabetic patients on oral agents or nondiabetic controls. Insulin antibody responses of the IgG2 subclass were negligible to absent in all groups. Adult diabetic patients on insulin without complications and those with insulin associated anaphylaxis had mean values of IgG1, IgG3, and IgG4 insulin antibodies no different from those of controls. Patients with local hypersensitivity had elevated IgG1 responses. Type I diabetic patients had elevated IgG3 responses. A group of Type II diabetic patients selected for high levels of total IgG insulin antibodies had elevated levels of IgG1, IgG3, and IgG4 antibody responses. Thus, the IgG subclass response to insulin primarily involves IgG subclasses 1, 3, and 4 and varies with the type of diabetes and complications of insulin therapy.
糖尿病患者对胰岛素的异常抗体反应与胰岛素超敏综合征及胰岛素异常药代动力学有关。在本研究中，我们使用疾病预防控制中心/世界卫生组织推荐的单克隆抗体通过酶联免疫吸附测定法（ELISA）评估了70名接受胰岛素治疗的糖尿病受试者（分为五个临床组）以及两个对照组中对胰岛素的总抗体反应和IgG亚类抗体反应。正如预期的那样，接受胰岛素治疗的糖尿病患者的总IgG胰岛素抗体水平高于口服药物治疗的糖尿病患者对照组或非糖尿病对照组。在所有组中，IgG2亚类的胰岛素抗体反应微乎其微或不存在。无并发症的成年胰岛素治疗糖尿病患者和伴有胰岛素相关过敏反应的患者，其IgG1、IgG3和IgG4胰岛素抗体的平均值与对照组无异。局部超敏反应患者的IgG1反应升高。I型糖尿病患者的IgG3反应升高。一组因总IgG胰岛素抗体水平高而入选的II型糖尿病患者，其IgG1、IgG3和IgG4抗体反应水平升高。因此，对胰岛素的IgG亚类反应主要涉及IgG1、IgG3和IgG4亚类，且因糖尿病类型和胰岛素治疗并发症而异。
