Autoantibodies to Insulin Are Present in Sera of Patients With Autoimmune Thyroid Disease

Abstract

It has been clinically suspected that patients with autoimmune thyroid disease are at an increased risk of developing other autoimmune diseases later in life. To determine the presence and potential importance of a more generalized deregulation of immune response in patients with Grave's disease and Hashimoto's disease, sera from 33 patients with Graves' disease and 16 patients with Hashimoto's disease were screened for the presence of anti-insulin antibodies and anti-insulin-receptor antibodies. An enzyme-linked immunosorbent assay was used to identify the presence of IgG against human insulin. The optical density indicating the presence of IgG against insulin in sera from patients with Graves' disease averaged .172 +/- .024 (mean +/- SE; range .010-.802), compared to the mean normal value of .098 +/- .0009 (range .012-.238) in 33 control subjects. Ten of 33 patients with Graves' disease had values greater than .200, whereas control sera values were less than .200 in all but one case (P less than .005, Graves' sera vs. controls). The sera from patients with Hashimoto's disease had a mean optical density of .110 +/- .016, with 15 of 16 values between .010 and .200. These values were not significantly different from controls with an insulin-binding inhibition assay. Anti-insulin-receptor antibodies were not detected in any of 33 patients with Graves' disease, and cytoplasmic islet cell antibodies were not detected in sera from seven patients with Graves' disease who had insulin-binding antibodies. These data support the hypothesis that the immunologic response in autoimmune thyroid disease may be more heterogeneous and polyclonal than previously believed.

Anti-pancreatic autoimmunity and Graves' disease: study of a cohort of 600 Caucasian patients

“…In endocrine autoimmune patients, the presence of IAA could correspond to autoimmunity epiphenomena (45). However, the IAA positivity, especially when associated with ICA positivity, could also suggest an implication of insulin as an autoantigen in the autoimmune aggression.…”

Clonally restricted insulin autoantibodies in a cohort of 2200 healthy blood donors

“…Insulin-autoantibodies in blood donors probably more closely resemble those described in patients affected with other autoimmune diseases [31,32] but it should be stressed that our blood donors were free of such disease on a clinical basis (see exclusion criteria for blood donors) and according to laboratory tests (absence of other autoantibodies).…”

Autoimmune Insulin Syndrome in a Patient with Progressive Systemic Sclerosis Receiving Penicillamine

“…Insulin antibodies appear to exist in the context of autoimmune disorders [4,5]. A recent survey of patients with autoimmune diseases demonstrated values of insulin autoantibodies above the limit of detection in 32.4% of all sera investigated [6].…”

“…The syn drome is characterized by the presence of insulin-binding autoantibodies in serum, and concomitant hypoglycaemia in patients never exposed to exogenous insulin [2], Autoantibodies to insulin have been detected in insulindependent diabetic patients prior to the institution of insulin therapy [3], in patients with autoimmune disor ders [4][5][6], in normal subjects after viral infections [7] and. rarely, in the general population [8.…”