We evaluated the production of
antibodies against
insulin in a genetically well-defined population. In the first study, 124 young patients with type I diabetes for longer than 6 mo were included. Anti-
insulin antibodies were detected by polyethyleneglycol (PEG) precipitation after incubation of acidified,
charcoal-stripped sera with 125I-labeled pork
insulin and were expressed as microunits
insulin bound per milliliter whole serum. For comparison, the patients were divided into six groups based on
HLA DR antigens: 3/3, 3/-, 4/4, 4/-, 3/4, and -/-(-is non-DR3 or -DR4). The mean age of the patients was 14.7 +/- 0.5 yr; the duration of diabetes was 5.8 +/- 0.4 yr; and the
glucose control, as measured by
hemoglobin A1c was average (7.6 +/- 0.2%). There were no significant differences in any of these parameters among the patients in any of the
HLA DR groups. Patients expressing DR3/3 had significantly lower
insulin binding than the rest of the groups (2.5 +/- 0.4 vs. 13.6 +/- 1.4 microU/ml, P less than 0.0001). Patients with DR3/ - did not differ in
insulin-binding capacity from the other groups. The type of
insulin used for replacement was not correlated with the serum
insulin-binding capacity. In a second study, sera from 48 children, newly diagnosed with type I diabetes, were examined for the presence of
insulin binding before treatment with exogenous
insulin and compared with sera from 80 children without diabetes or a family history of diabetes and from 103 unaffected HLA-identical or haploidentical siblings of a child with type I diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)