title: Identification of monoclonal insulin autoantibodies in insulin autoimmune syndrome associated with HLA-DRB1*0401.
abstract: We have characterized HLA and insulin autoantibodies in a Japanese female patient with insulin autoimmune syndrome. Serological HLA typing demonstrated the patient had HLA-DR4, and DNA typing showed she had HLA-DRB1*0401 which has not been reported in patients with insulin autoimmune syndrome in Japan. A single binding affinity of insulin autoantibodies was demonstrated by Scatchard analysis and immunoglobulin class of insulin autoantibodies was exclusively IgG-kappa. HLA-DRB1*0406 is strikingly associated with patients with insulin autoimmune syndrome who have polyclonal insulin autoantibodies. The present report demonstrated the first Japanese patient with insulin autoimmune syndrome carrying HLA-DRB1*0401 who was revealed to have monoclonal insulin autoantibodies. The present results indicate that HLA molecules are the major determinants of polyclonal insulin autoantibodies and monoclonal insulin autoantibodies in insulin autoimmune syndrome.
authors.affiliation: First Department of Internal Medicine, Gunma University School of Medicine, Maebashi 371-8511, Japan. mmurakam@showa.gunma-u.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Murakami
authors.forename: M
authors.initials: M
authors.lastname: Mizuide
authors.forename: K
authors.initials: K
authors.lastname: Kashima
authors.forename: A
authors.initials: A
authors.lastname: Kojima
authors.forename: S I
authors.initials: SI
authors.lastname: Tomioka
authors.forename: T
authors.initials: T
authors.lastname: Kohama
authors.forename: O
authors.initials: O
authors.lastname: Araki
authors.forename: T
authors.initials: T
authors.lastname: Ogiwara
authors.forename: H
authors.initials: H
authors.lastname: Mizuma
authors.forename: M
authors.initials: M
authors.lastname: Mori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D005260:Female; D006684:HLA-DR Antigens / Q000235:genetics*; D059811:HLA-DRB1 Chains; D006650:Histocompatibility Testing; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology; D007070:Immunoglobulin A / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007328:Insulin / Q000097:blood; D007330:Insulin Antibodies / Q000097:blood*; D007564:Japan; D012016:Reference Values; D013577:Syndrome
chemical_list: D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; C553505:HLA-DRB1*04:01 antigen; D007070:Immunoglobulin A; D007075:Immunoglobulin M; D007328:Insulin; D007330:Insulin Antibodies