Resistance and allergy to recombinant human insulin

Michael A. Ganz, Terry Unterman, Mary Roberts, Rogelio Uy, Sindarshan Sahgal, Max Samter, Leslie C. Grammer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Insulin allergy and antibody-mediated resistance may complicate therapy with animal insulins. We describe a 53-year-old man manifesting both resistance and persistent systemic allergy despite treatment with recombinant human insulin. Insulin resistance and symptoms of allergy appeared in this patient several months after initiating therapy with mixed beef-pork insulin, as is often the case. Symptoms initially improved, but persisted, and then worsened again, despite continuous human insulin therapy. Total insulin-binding capacity by Scatchard analysis, high plasma insulin-binding capacity, and specific anti-insulin antibody levels were consistent with an immunologic form of insulin resistance. Glucocorticoid therapy was required both to reduce allergic findings and to restore glycemic control. Although recently available human insulins may be less immunogenic than animal forms, immune responses to exogenous human insulin still may pose significant clinical problems.

Original languageEnglish (US)
Pages (from-to)45-51
Number of pages7
JournalThe Journal of Allergy and Clinical Immunology
Volume86
Issue number1
DOIs
StatePublished - Jan 1 1990

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

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