Transfer from purified porcine insulins to semisynthetic human insulins decreases insulin antibodies and circulating immune complexes in diabetic children and adolescents. A two-year follow-up.
Transfer from purified porcine insulins to semisynthetic human insulins decreases insulin antibodies and circulating immune complexes in diabetic children and adolescents. A two-year follow-up.
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从纯化猪胰岛素转移到半合成人胰岛素可降低糖尿病儿童和青少年的胰岛素抗体和循环免疫复合物。
DOI：
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发表时间：
1989
期刊：
影响因子：
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通讯作者：
D. D’Hooge
中科院分区：
文献类型：
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作者：
H. Dorchy;J. Duchateau;D. Bosson;D. D’Hooge
在这项长期前瞻性研究中，包括45名20岁以下的糖尿病儿童和青少年，胰岛素抗体和其他免疫因素（循环免疫复合物、自身抗体等）在从单组分猪胰岛素转换为单组分半合成人胰岛素后的两年随访期间和之前进行比较。45名儿童中有21名（47%）检测到IgG胰岛素抗体，平均水平为0.96 mU/ml（0.77-1.15）。转换后18个月，观察到具有胰岛素抗体的患者数量和胰岛素抗体水平均显着且重要的下降。24个月后，仅5例患者（11%）出现IgG胰岛素抗体，平均水平降低一半（0.53 mU/ml; p <0.05）。5名患者中有4名（80%）具有HLA-DR 3 DR 4抗原，而这种表型仅在26%的初始患者队列中流行。另一方面，转移后3个月，非特异性免疫复合物显著且持续减少（减半）（39%的猪胰岛素患者），这似乎与胰岛素抗体水平无关。自身抗体和抗核因子的患病率无显着变化。这些发现的实际意义是，半合成人胰岛素的使用可能对既往接受过猪胰岛素治疗的患者有意义。
In this long-term prospective study, including 45 diabetic children and adolescents under the age of 20 years, insulin antibodies and other immunological factors (circulating immune complexes, autoantibodies, etc.) were compared before and during a two-year follow-up after a switch-over from monocomponent porcine insulins to monocomponent semisynthetic human insulins. IgG insulin antibodies were detected in 21 children out of 45 (47%) at a mean level of 0.96 mU/ml (0.77-1.15). A significant and important decrease of both the number of patients having insulin antibodies and the level of insulin antibodies was observed 18 months after the switch-over. After 24 months, IgG insulin antibodies were only present in 5 patients (11%) at a mean level reduced by half (0.53 mU/ml; p less than 0.05). Four patients out of the five (80%) had HLA-DR3 DR4 antigens while this phenotype was only prevalent in 26% of the initial patient cohort. On the other hand, 3 months after the transfer, there was a significant and persistent decrease (by half) of non-specific immune complexes (39% of the patients with porcine insulins) which did not appear to correlate with the level of insulin antibodies. The prevalence of autoantibodies and of antinuclear factors showed no significant variations. The practical implication of these findings is that the use of semisynthetic human insulins could be of interest in patients previously treated by porcine insulins.