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Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms

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Human insulin analog--induced lipoatrophy.

Ximena Lopez¹, Mariana Castells, Alyne Ricker

¹Joslin Diabetes Center, Boston, Massachusetts, USA.

|December 29, 2007

Summary

Recombinant human insulin can cause lipoatrophy due to mast cell degranulation. Topical sodium cromolyn (mast cell stabilizer) may prevent and reverse these insulin injection site lesions.

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Published on: March 20, 2017

Area of Science:

Immunology
Dermatology
Endocrinology

Background:

Insulin-induced lipoatrophy is a complication of diabetes treatment.
The exact mechanism of lipoatrophy development is not fully understood.

Purpose of the Study:

To investigate the pathophysiology of recombinant human insulin-induced lipoatrophy.
To evaluate the efficacy of topical sodium cromolyn in managing lipoatrophy.

Main Methods:

Immunologic evaluation and skin testing in type 1 diabetes patients with lipoatrophy.
Histopathological examination of subcutaneous adipose tissue biopsies.
Treatment with topical sodium cromolyn on affected and new insulin administration sites.

Main Results:

Biopsies revealed increased degranulated mast cells (tryptase-positive, chymase-positive).
Topical sodium cromolyn prevented new lipoatrophic lesions in all treated patients.
Four out of five patients showed improvement in existing lipoatrophic sites.

Conclusions:

Degranulated mast cells sensitive to sodium cromolyn may mediate insulin-induced lipoatrophy.
Mast cell stabilization with topical cromolyn shows potential for reversing and preventing lipoatrophic lesions.