Immunologic reaction to insulin and other proteins

Immunologic reactions have been known to occur in response to pharmacologic administration of nonhuman and human recombinant proteins. IgE-mediated type I hypersensitivity is the most common, but type III immune complex disease has also been described. Other immunologic reactions such as induction of anti-protein antibody and resultant inactivation of protein have also been described. Hypersensitivity reactions to recombinant human proteins are most likely caused by alterations in tertiary protein structure because the primary amino acid sequence of rDNA proteins is identical to the endogenously produced human proteins. Skin testing and desensitization protocols have been reported for many protein pharmacologic agents. As more pharmacologic, recombinant human proteins become available, they will likely cause similar immunologic reactions.