Genetic Control of the Immune Response to Insulin in Man and Experimental Animals

  • Alan S. Rosenthal
  • Dean Mann
  • C. Ronald Kahn


For most patients with juvenile-onset diabetes mellitus and many patients with maturity-onset diabetes mellitus, replacement therapy with insulin is required. Because commerical insulin is obtained by acid—ethanol extraction of animal pancreas, one is not surprised to find that after as little as 2 months many diabetic patients give indication of immunity to insulin. Although most such immune responses are not significant, a certain number of insulin-taking diabetics will present clinically with signs and symptoms of allergy. Obviously the exact form of these allergic reactions will depend on which pathway(s) in the immune system are dominant (Fig. 1). The various types of immune response which have been noted after insulin administration are listed in Table 1. A broad perspective on the basic and clinical aspects of immunity to insulin has been recently published (Keck and Erb, 1981). It is obvious that a desire to lessen the likelihood of such untoward immunological reactions as well as projected supply problems with a nonallergic form of human insulin by recombinant DNA technology (Rosenthal, 1981). This review will focus only on two aspects of the problem of insulin immunogenicity. The first will briefly describe studies of insulin as an antigen in experimental animals. The second and major portion of this report will consider HLA associations of the more common types of insulin immune responses in man


Major Histocompatibility Complex Amino Acid Difference Immune Response Gene Skin Test Reaction Insulin Allergy 


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Copyright information

© Plenum Publishing Corporation 1984

Authors and Affiliations

  • Alan S. Rosenthal
    • 1
  • Dean Mann
    • 2
  • C. Ronald Kahn
    • 3
  1. 1.Merck, Sharp and Dohme Research LaboratoriesRahwayUSA
  2. 2.Immunology BranchNational Cancer Institute, National Institutes of HealthBethesdaUSA
  3. 3.Joslin Diabetes Center, and Department of MedicineBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA

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