Frequent induction of insulin autoantibodies by D-penicillamine in patients with rheumatoid arthritis.
D-Penicillamine is a drug known to induce various immunological abnormalities. We used a competitive radiobinding assay, to evaluate the presence of insulin autoantibodies in 42 patients with rheumatoid arthritis (RA), under various treatment modalities. In 11/42 (26.2%) patients, the levels of insulin autoantibodies (range 59-1970 nU/ml) exceeded our upper limit of normal range (50 nU/ml). Nine of these 11 (81.8%) insulin autoantibodies positive patients had been treated with D-penicillamine. Out of 21 D-penicillamine treated patients, 9 (42.9%) were insulin autoantibodies positive (range 80 to 1970 nU/ml). An inverse correlation was found between the concentration of insulin autoantibodies and the time interval since the last drug administration, R = -0.58 (p < 0.05). No correlation was found between the autoantibodies levels and age, or duration of D-penicillamine treatment. In summary, elevated concentration of serum insulin autoantibodies are most probably induced by D-penicillamine therapy in patients with RA and tend to decrease after the drug withdrawal.
Vardi
P
P
Department of Rheumatology, Rambam Medical Center, Technion School of Medicine, Haifa, Israel.
Brik
R
R
Barzilai
D
D
Lorber
M
M
Scharf
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000917:Antibody Formation / Q000187:drug effects*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy* / Q000276:immunology*; D001323:Autoantibodies / Q000032:analysis* / Q000378:metabolism; D005260:Female; D006801:Humans; D007330:Insulin Antibodies / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010396:Penicillamine / Q000627:therapeutic use*; D011869:Radioligand Assay
D001323:Autoantibodies; D007330:Insulin Antibodies; D010396:Penicillamine