Desensitization‐resistant insulin allergy

Frigerio, C.; Aubry, M. C.; Gómez, Fulgencio; Graf, I.; Dayer, E.; Kalbermatten, N. de; Gaillard, R. C.; Spertini, François

doi:10.1111/j.1398-9995.1997.tb00988.x

Cited by 25 publications

(12 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been demonstrated in monkeys that the synthetic insulin analogue insulin Lispro (Humalogue, Lilly) had lower immunogenicity than biosynthetic human or porcine insulin 15 . Lispro has been used successfully in a patient with allergy to human insulin 16 . Little information is available concerning the natural history of insulin allergy.…”

Section: Discussionmentioning

confidence: 99%

Generalised allergic reaction to human insulin

et al. 2000

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Generalised allergic reaction to human insulin

et al. 2000

View full text Add to dashboard Cite

“…However, if reactions continue for more than 14 days, the following strategies should be considered: 1) desensitization with human insulin [16], 2) co-administration with glucocorticoid plus antihistamines [14], 3) continuous subcutaneous insulin infusion [6,17], and 4) administration of human insulin analogue in place of human insulin [18,19] . Since our case was advanced in age and we could not use insulin analogue at that time, it was difficult to implement these strategies.…”

Section: Discussionmentioning

confidence: 99%

Immediate-Type Allergy against Human Insulin Associated with Marked Eosinophilia in Type 2 Diabetic Patient.

et al. 2001

View full text Add to dashboard Cite

Abstract.We describe a type 2 diabetic patient who showed immediate-type allergy against human insulin associated with marked eosinophilia at initial insulin therapy. Three months after initiation of insulin therapy, he noticed itchy skin wheals at the site of the insulin injection.Laboratory data at that time showed marked eosinophilia (2512 /mm3) and progression of renal dysfunction.Skin test with semisynthetic human insulin and protamine sulfate resulted in local immediate skin reactions such as itchy erythema and wheals. Histopathology of the biopsy specimen from skin showed perivascular infiltration of lymphocytes and numerous eosinophils in the dermis and subcutaneous fat. Although the titer of total IgE antibody was within normal range, that of insulin-specific IgE antibody was high. Insulin administration was discontinued to preserve his insulin secretion, and stable control of his hyperglycemia was obtained by initiating nateglinide treatment (360 mg/day).His itchy skin lesions disappeared within two weeks after cessation of the insulin therapy and both eosinophilia and renal dysfunction gradually improved.Although the widespread use of human insulin in diabetic patients has greatly reduced the incidence of insulin allergy, the possibility of human insulin allergy should be kept in mind when initiating such therapy.

show abstract

“…In intradermal tests, the initial wheal-flare response generated by insulin lispro was 50% less intense than human insulin, which progressively declined and vanished by week 25 (9). This reduced immunogenic response may be attributable to the rapid monomeric state of insulin lispro after injection (10). Additionally, a reduction in insulin autoantibodies has been observed after treatment with insulin lispro (41).…”

Section: Fineberg and Associatesmentioning

confidence: 99%

“…Case reports indicate that insulin lispro seems to have lower immunogenic potency (9,10,24,40). In intradermal tests, the initial wheal-flare response generated by insulin lispro was 50% less intense than human insulin, which progressively declined and vanished by week 25 (9).…”

Section: Fineberg and Associatesmentioning

confidence: 99%

Effect of Long-Term Exposure to Insulin Lispro on the Induction of Antibody Response in Patients With Type 1 or Type 2 Diabetes

et al. 2003

View full text Add to dashboard Cite

OBJECTIVE -To determine the long-term effects of insulin lispro on inducing lisprospecific, insulin-specific, and cross-reactive (reactive with both insulin lispro and human insulin) antibodies. RESEARCH DESIGN AND METHODS-A multinational, multicenter combination of controlled and noncontrolled, open-label studies of 4.5 years' duration was designed to evaluate the long-term immunologic profile of subcutaneously administered insulin lispro. A total of 1,221 patients (men and women; 12-81 years of age) with type 1 or type 2 diabetes were enrolled. Circulating anti-insulin antibodies were measured using radioimmunoassays.RESULTS -Insulin-specific and lispro-specific antibody responses were within the background noise levels of the assays. Significant elevations of antibody were confined to a crossreactive antibody response. Antibody levels resulting from prior exposure to long-and shortacting insulins changed little after transfer to insulin lispro and remained within or near the baseline levels. De novo exposure to insulin lispro resulted in increases in cross-reactive but not insulin-or lispro-specific antibody levels. Cross-reactive insulin antibodies developed more readily in patients with type 1 diabetes than in those with type 2 diabetes. Long-term antibody responses tended to decrease over time and returned to baseline or near-baseline levels by the end of the long-term studies. No evidence of an anamnestic antibody response could be found in individuals treated intermittently with insulin lispro.CONCLUSIONS -The immunogenic profile of patients treated with insulin lispro was comparable to that of patients treated with recombinant human insulin. Inductions of significant levels of specific or cross-reactive antibodies were not observed in patients who had received insulin previously. No significant antibody-dependent increases in insulin dosage requirements were noted in these patients. The incidence of insulin allergy was not different from that in patients treated with recombinant regular human insulin. Diabetes Care 26:89 -96, 2003

show abstract

Desensitization‐resistant insulin allergy

Cited by 25 publications

References 5 publications

Generalised allergic reaction to human insulin

Generalised allergic reaction to human insulin

Immediate-Type Allergy against Human Insulin Associated with Marked Eosinophilia in Type 2 Diabetic Patient.

Effect of Long-Term Exposure to Insulin Lispro on the Induction of Antibody Response in Patients With Type 1 or Type 2 Diabetes

Contact Info

Product

Resources

About