Immunologic aspects of human proinsulin therapy
Immunologic aspects of human proinsulin therapy. S E Fineberg , M J Rathbun , S Hufferd , N S Fineberg , C T Spradlin , J A Galloway and B H Frank Indiana University School of Medicine, Indianapolis. Abstract We investigated the immunogenicity of human proinsulin (HPI) when used as the sole or princ...
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Published in | Diabetes (New York, N.Y.) Vol. 37; no. 3; pp. 276 - 280 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
American Diabetes Association
01.03.1988
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Online Access | Get full text |
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Summary: | Immunologic aspects of human proinsulin therapy.
S E Fineberg ,
M J Rathbun ,
S Hufferd ,
N S Fineberg ,
C T Spradlin ,
J A Galloway and
B H Frank
Indiana University School of Medicine, Indianapolis.
Abstract
We investigated the immunogenicity of human proinsulin (HPI) when used as the sole or principal insulin agonist in insulin-naive
patients with insulin-dependent (type I) and non-insulin-dependent (type II) diabetes mellitus. Sixty-one patients (13 type
I, 48 type II) were treated with rDNA human insulin (NPH HI with or without regular HI) and 53 were treated with HPI (8 type
I, 45 type II). At 6 mo, virtually identical levels of HbA1c (5.2 vs. 5.3%, P = NS) were achieved. However, regular HI was
added less often to the treatment regimen in HPI-treated patients (16 vs. 32 patients, P less than .001). Overall, there was
no significant increase in proinsulin-specific antibodies in either treatment group. However, 8 of 51 (1 transiently) patients
in the HPI group developed low levels of binding of HPI (highest percentage bound was 5%). Two patients in the HI group developed
very low levels of HPI binding (1.2 and 1.9%). Binding of HI (greater than 2.4%) was seen in both treatment groups; however,
the prevalence of HI binding was less in the HPI group at 6 mo (39 of 60 in HI group vs. 20 of 51 in HPI group, P = .008).
Concomitant treatment with regular HI did not affect the prevalence or level of binding of HPI or HI. We conclude that human
proinsulin is a weak immunogen when used as the principal insulin agonist and may reduce both the formation of anti-HI antibodies
and the need for concomitant therapy with regular HI. |
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ISSN: | 0012-1797 1939-327X 0012-1797 |
DOI: | 10.2337/diabetes.37.3.276 |