Lispro Analog for Treatment of Generalized Allergy to Human Insulin
- Dinesh Kumar, MD
- Department of Medicine, Division of Endocrinology, Diabetes, and Hypertension, University of Southern California School of Medicine, Los Angeles County Medical Center Los Angeles, California
- Address correspondence and reprint requests to Dinesh Kumar, MD, Box 393, Diabetes Section, LAC-USC Medical Center, Los Angeles, CA 90033.
Abstract
OBJECTIVE To evaluate the clinical usefulness of the human insulin analog lispro in a patient with generalized allergy to human insulin.
RESEARCH DESIGN AND METHODS A 34-year-old obese female patient developed systemic allergic reactions to human insulin but tolerated insulin lispro. Sequential analyses of the anti-insulin IgE and IgG immunoglobulins were performed.
RESULTS On intradermal test, the lispro insulin produced a 50% less intense wheal-flare response, compared with human insulin, which was presumed to be due to lispro's molecular form. The intradermal reactivity to both human and lispro insulins decreased with time and disappeared by week 25.125I-labeled lispro and human insulin binding antibody titers of both the IgE and IgG immunoglobulins were high initially, but decreased progressively, becoming very low by the end of 1 year. In in vitro immunoassay, thelispro and human insulins show a complete cross-reactivity.
CONCLUSIONS Lispro may be useful for the management of allergy to human insulin. This analog of human insulin appears to have a reduced immunogenic potency.
- Received January 31, 1997.
- Accepted May 23, 1997.
- Copyright © 1997 by the American Diabetes Association
