title: Immunologic studies of patients with diabetes mellitus who have received long term insulin therapy: lymphocyte reactivity to insulin is correlated with impaired immunoglobulin secretion in vitro.
abstract: To investigate the influence of chronic antigen stimulation on immune response, 31 diabetics who had been treated from 4 to 39 years with various types of insulin were studied. Of the 31 patients, 22 had an elevated lymphocyte blastogenic response to insulin (beef/pork regular or protamine containing types). There were approximately equal numbers of patients with insulin dependent and noninsulin dependent diabetes whose lymphocytes reacted to the insulin. Of 24 patients who were also studied for the ability of their lymphocytes to secrete immunoglobulin secondary to pokeweed mitogen, 14 were significantly depressed compared to normal controls. Depressed responses tended to occur in both IgG and IgM secretion. Average immunoglobulin secretion of the diabetics' lymphocytes was 1843 and 2667 ng/ml, whereas for the normal subjects, the lymphocyte secretion was 3175 and 6013 ng/ml of IgG and IgM, respectively. (The normal secretion was based on the testing of 64 normal individuals.) Interestingly, 13 of 14 patients with impaired immunoglobulin secretion had a positive lymphocyte proliferative response to insulin (P less than 0.01). This statistically significant correlation between lymphocyte proliferative response to insulin and impaired polyclonal immunoglobulin secretion suggests the possibility that chronic antigen stimulation by insulin alters the normal immune response.
authors.affiliation: Department of Paediatrics, Faculty of Medicine, University of Calgary, Vancouver, Canada.
authors.forename: K R
authors.initials: KR
authors.lastname: Vandeligt
authors.forename: S A
authors.initials: SA
authors.lastname: Ross
authors.forename: D S
authors.initials: DS
authors.lastname: Matheson
mesh_terms: D000917:Antibody Formation; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007075:Immunoglobulin M / Q000378:metabolism; D007328:Insulin / Q000008:administration & dosage* / Q000276:immunology; D008213:Lymphocyte Activation; D011043:Pokeweed Mitogens / Q000494:pharmacology; D013601:T-Lymphocytes / Q000276:immunology; D013997:Time Factors
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007328:Insulin; D011043:Pokeweed Mitogens