Immunologic reactivity to insulin: animal models and clinical syndromes.

Immunologic responses to insulin can be manifested by both laboratory animals immunized with insulin as a known modifiable model antigen and by patients receiving heterologous insulin as a mainstay of therapy for insulin dependent diabetes mellitus. The use of purified insulin as a model antigen for the study of cellular interactions, T cell antigen recognition, and the mechanism and specificity of Ir gene action in experimental animals has given us great insight into the potential workings of these complex functions. In humans with IDDM, immune cofactors may play a role in both the pathogenesis of disease as well as the obvious complications of therapy. Intense study of cellular, genetic, biochemical, and immunologic parameters in these patients with IDDM may provide us with unique insights into the complex regulatory interactions between the immunologic and endocrine-metabolic systems.