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单组分胰岛素或常规胰岛素治疗患者体内抗胰岛素、抗A组分及抗胰岛素原抗体的产生及特性

The production and characteristics of anti-insulin, anti-A-component and anti-proinsulin antibodies in patients treated with monocomponent or conventional insulin.

作者信息

Kawazu S, Kanazawa Y, Miki E, Hayashi M, Sando H, Kajinuma H, Iwamoto Y, Akanuma Y, Kosaka K

出版信息

Acta Diabetol Lat. 1979 Oct-Dec;16(4):339-51. doi: 10.1007/BF02587655.

Abstract

Highly purified pork monocomponent insulin produced less anti-insulin antibody than conventional insulins in diabetic patients. The smaller amount of anti-insulin antibody produced by MC insulin bound pork insulin more strongly than beef insulin in both displacement and direct binding studies of 125I-insulin. On the contrary, anti-insulin antibody which was produced by conventional insulins (beef insulin or mixture of pork and beef insulin) bound beef insulin more strongly. No significant anti-a-component and anti-proinsulin antibodies were detected in diabetics treated with highly purified monocomponent pork insulin about two years, compared to significant production of these antibodies in diabetics treated with conventional insulins. These results suggest that the species difference of the insulin molecule itself plays a significant role for the production of anti-insulin antibody, as the impurities do, in insulin-treated diabetic patients. The production of anti-insulin and anti-a-component antibodies decreased clearly after switching to highly purified monocomponent from conventional insulin. No effect of the switching on insulin requirement was found; however, better control of diabetes was accomplished in relation to the level of fasting blood sugar.

摘要

在糖尿病患者中,高纯度猪单组分胰岛素产生的抗胰岛素抗体比传统胰岛素少。在对125I-胰岛素的置换和直接结合研究中,单组分胰岛素产生的较少抗胰岛素抗体与猪胰岛素的结合比与牛胰岛素的结合更强。相反,传统胰岛素(牛胰岛素或猪胰岛素与牛胰岛素的混合物)产生的抗胰岛素抗体与牛胰岛素的结合更强。在用高纯度单组分猪胰岛素治疗约两年的糖尿病患者中,未检测到明显的抗a组分和抗胰岛素原抗体,而在用传统胰岛素治疗的糖尿病患者中则大量产生这些抗体。这些结果表明,在胰岛素治疗的糖尿病患者中,胰岛素分子本身的种属差异与杂质一样,在抗胰岛素抗体的产生中起重要作用。从传统胰岛素改用高纯度单组分胰岛素后,抗胰岛素和抗a组分抗体的产生明显减少。未发现换药对胰岛素需求量有影响;然而,就空腹血糖水平而言,糖尿病得到了更好的控制。

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