Aspects of humoral immunity in a prospective study of type I (insulin-dependent) diabetic subjects treated with insulins of different purity

Diabetologia, Jan 1983

In 41 Type 1 (insulin-dependent) diabetic patients, islet cell antibodies, anti-insulin antibodies, and immune complexes measured by two different methods (the C1q solid phase assay and the conglutinin binding test) were studied at diagnosis, and the influence of treatment with insulins of different purity was investigated during the first year of treatment. Twenty subjects were treated with conventional insulins (group 1) while 21 were treated with monocomponent porcine insulins (group 2). The prevalence of islet cell antibodies significantly decreased during the 12-month study period in the 41 patients. From the first month anti-insulin antibodies were always significantly higher in group 1 than in group 2. At diagnosis the prevalence of both types of immune complexes in the 41 patients was higher than in normal subjects. The immune complexes measured by the C1q solid phase method showed a significant and progressive reduction during the follow-up period, whereas the immune complexes assayed by conglutinin showed no significant variation in the same period. The presence of C1q immune complexes was found to correlate with the occurrence of islet cell antibodies both at diagnosis and during the follow-up period. The presence of conglutinin immune complexes, on the other hand, tended to parallel the increase of anti-insulin antibody levels.

A PDF file should load here. If you do not see its contents the file may be temporarily unavailable at the journal website or you do not have a PDF plug-in installed and enabled in your browser.

Alternatively, you can download the file locally and open with any standalone PDF reader:

https://link.springer.com/content/pdf/10.1007%2FBF00275943.pdf

Aspects of humoral immunity in a prospective study of type I (insulin-dependent) diabetic subjects treated with insulins of different purity

Diabetologia Aspects of Humoral Immunity in a Prospective Study of Type I (Insulin-Dependent) Diabetic Subjects Treated with Insulins of Different Purity M. Iavicoli 0 1 L. Ventriglia 0 1 U. Di Mario 0 1 C. Galfo a n d D. A n d r e a n i 0 1 0 I Cattedra di MedicinaCostituzionaleed Endocrinologia,Universitfidegli Studi di Roma , Rome , Italy 1 Dr. M. Iavicoli II Clinica Medica Policlinico Umberto l 00161 Rome Italy Summary. In 41 Type 1 (insulin-dependent) diabetic patients, islet cell antibodies, anti-insulin antibodies, and immune complexes measured by two different methods (the Clq solid phase assay and the conglutinin binding test) were studied at diagnosis, and the influence of treatment with insulins of different purity was investigated during the first year of treatment. Twenty subjects were treated with conventional insulins (group 1) while 21 were treated with monocomponent porcine insulins (group 2). The prevalence of islet cell antibodies significantly decreased during the 12-month study period in the 41 patients. From the first month anti-insulin antibodies were always significantly higher in group 1 than in group 2. At diagnosis the prevalence of both types of immune complexes in the 41 patients was higher than in normal subjects. The ira- Type 1 diabetes; anti-insulin antibodies; islet cell antibodies; immune complexes; Clq solid phase assay; conglutinin binding test; monocomponent insulins - 9 Springer-Verlag1983 Islet cell antibodies, anti-insulin antibodies a n d imm u n e complexes have been demonstrated in the sera of diabetic subjects. Islet cell antibodies have been f o u n d in Type 1 (insulin-dependent) diabetic patients at diagnosis a n d in non-diabetic patients with other autoimm u n e diseases. The role of these antibodies in the pathogenesis o f Type I diabetes remains to be elucidated [ 1-3 ]. Anti-insulin antibodies are present in most insulin-treated diabetic patients. It has been established that anti-insulin antibodies m a y play a role in the transient complications o f insulin treatment (i. e. allergic reactions, insulin resistance, etc.), whereas no influence on late diabetic complications has yet been demonstrated [ 4-9 ]. It has been suggested that the presence o f islet cell a n d anti-insulin antibodies in the circulation m a y reflect the presence o f circulating i m m u n e complexes [ 10, 11 ]. Circulating i m m u n e complexes have been described in a large percentage o f Type I diabetic patients at the time o f diagnosis [12] and in some cases with severe complications [ 13 ]. Detection methods based u p o n different principles have also revealed the presence o f heterogeneous populations of i m m u n e complexes [14, rnune complexes measured by the Clq solid phase method showed a significant and progressive reduction during the follow-up period, whereas the immune complexes assayed by conglutinin showed no significant variation in the same period. The presence of Clq immune complexes was found to correlate with the occurrence of islet cell antibodies both at diagnosis and during the follow-up period. The presence of conglutinin immune complexes, on the other hand, tended to parallel the increase of anti-insulin antibody levels. 15]. A correlation was recognized in some of these studies between i m m u n e complexes detected by the solid phase C l q binding test a n d the presence of islet cell antibodies [ 16 ], whilst in others a correlation appeared to exist between i m m u n e complexes detected by conglutinin binding assay a n d insulin treatment [ 17 ]. The present investigation was carried out in a group o f patients at the time o f clinical diagnosis o f Type I diabetes. These patients were treated with either conventional insulin or m o n o c o m p o n e n t insulin a n d were observed at regular intervals for one year. The aim of the present study was to attempt to correlate circulating i m m u n e complexes (detected by C l q a n d conglutinin) a n d the presence o f islet cell a n d antiinsulin antibodies, bearing in m i n d the type a n d duration o f the diabetes a n d antigenicity o f the insulin used in the treatment. Patients and Methods Forty-onenewlydiagnosedTypeI diabeticpatients,with age at onset < 30 years, were included in the study before insulin treatment was started. Twenty of these patients (12 males and eight females,mean 1 0 M. Iavicoli et al.: Humoral Immunity in Type I Diabetic Subjects age 9 years, range 5-11 years) were treated with conventional insulins (group 1), whereas 21 (15 males and six females, mean age 13 years, range 8-22 years) were treated with monocomponent porcine insulins (group 2). Patients were randomly assigned to each group. Blood samples were collected at diagnosis and 1, 3, 6 and 12 months later in all patients. A series of 189 blood donors was also studied to determine the normal range of the immune complex assays. Islet cell antibodies were assayed by indirect immunofluorescence on cr (...truncated)


This is a preview of a remote PDF: https://link.springer.com/content/pdf/10.1007%2FBF00275943.pdf

M. Iavicoli, L. Ventriglia, U. Di Mario, C. Galfo, D. Andreani. Aspects of humoral immunity in a prospective study of type I (insulin-dependent) diabetic subjects treated with insulins of different purity, Diabetologia, 1983, pp. 26-29, Volume 24, Issue 1, DOI: 10.1007/BF00275943