TY - JOUR
T1 - AUTOIMMUNITY IN DIABETICS INDUCED BY HORMONAL CONTAMINANTS OF INSULIN
AU - Adrian, T. E.
AU - Polak, T. M.
AU - Bloom, S. R.
AU - Barnes, A. J.
N1 - Funding Information:
We thank the numerous people (especially Prof. J. A. N. Corsellis, Prof. W. Blackwood, Prof. A. N. Exton-Smith, Prof. Lindsay Symon, Dr I. V. Allen, Dr L. H. Carrasco, Dr 1. Janota, and Dr M. McKee) who assisted in the collection and classification of the specimens; Dr C. R. Hiley, Dr M. J. of Leach, and and Dr D. R. Riddall for measuring the high affinity binding atropine, muscimol, naloxone, respective- ly ; Mr R. H. A. Flack for expert technical help; and Miss E. A. Paul for computer programming. The work was partly supported by the Miriam Marks Trust and the Medical Research Council. Requests for reprints should be addressed to D. M. B., Neurology, 33 John’s Mews, London WC 1N 2NS.
PY - 1979/1/6
Y1 - 1979/1/6
N2 - Several commercial insulin preparations were found to contain significant quantities of pancreatic glucagon, pancreatic polypeptide (P.P.), vasoactive intestinal peptide (V.I.P.)) and somatostatin, though these substances were effectively absent from the new highly purified or monocomponent insulins. Of 448 insulin-dependent diabetics receiving conventional insulins, 63% had circulating antibodies to human P.P., 6% antibodies to V.I.P., 6% to glucagon, and 0·5% to somatostatin. The antibodies were of high affinity and were commonest in the younger diabetics. No antibodies were detected in 167 maturity-onset diabetics, in 125 healthy controls, or in 22 patients treated only with monocomponent insulin. Immunocythochemical testing showed that antibody-positive diabetic plasmas reacted specifically against the corresponding hormone-producing pancreatic endocrine cells, against enteroglucagon and somatostatin cells outside the pancreas, and against V.I.P.-containing autonomic nerves throughout the body. The finding of iatrogenic auto-immunity to naturally occuring hormones in large numbers of insulin-dependent diabetics raises important questions about long-term treatement.
AB - Several commercial insulin preparations were found to contain significant quantities of pancreatic glucagon, pancreatic polypeptide (P.P.), vasoactive intestinal peptide (V.I.P.)) and somatostatin, though these substances were effectively absent from the new highly purified or monocomponent insulins. Of 448 insulin-dependent diabetics receiving conventional insulins, 63% had circulating antibodies to human P.P., 6% antibodies to V.I.P., 6% to glucagon, and 0·5% to somatostatin. The antibodies were of high affinity and were commonest in the younger diabetics. No antibodies were detected in 167 maturity-onset diabetics, in 125 healthy controls, or in 22 patients treated only with monocomponent insulin. Immunocythochemical testing showed that antibody-positive diabetic plasmas reacted specifically against the corresponding hormone-producing pancreatic endocrine cells, against enteroglucagon and somatostatin cells outside the pancreas, and against V.I.P.-containing autonomic nerves throughout the body. The finding of iatrogenic auto-immunity to naturally occuring hormones in large numbers of insulin-dependent diabetics raises important questions about long-term treatement.
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U2 - 10.1016/S0140-6736(79)90455-0
DO - 10.1016/S0140-6736(79)90455-0
M3 - Article
C2 - 83463
AN - SCOPUS:84920236401
SN - 0140-6736
VL - 313
SP - 14
EP - 17
JO - The Lancet
JF - The Lancet
IS - 8106
ER -