Vnitr Lek 1995, 41(2):146-150

[Anti-insulin antibodies and insulin resistance].

D Wichterle, P Stolba, B Bendlová, A Krnáková: 3. interní klinika, 1. LF UK, Praha.

The submitted review deals with the phenomenon of immunological insulin resistance in insulin dependent diabetics which develops as a result of the presence of circulating anti-insulin antibodies as a response of the organism to administered insulin. This phenomenon is a liminal situation when anti-insulin antibodies exceed as to their concentration and affinity a certain arbitrary limit and the increasingly impaired pharmacokinetics of insulin cause a clinically manifest metabolic decompensation of the disease with the necessity of large daily doses of exogenous insulin. The authors discuss factors ensuing from the type of the administered insulin preparation, as well as the biological predisposition of the patient which potentiates the production of anti-insulin antibodies. Some laboratory methods are discussed which are used for the assessment of anti-insulin antibodies in vitro and the authors summarize individual physical variables which characterize the antibody system and which can be extracted by special mathematical procedures from experimental radioimmunoanalytical data. Only a detailed characterization of the antibody system makes it possible to evaluate the influence of this system on the pharmacokinetics of insulin.