Insulin antibodies prevent insulin-receptor interactions

The study was carried out to investigate whether insulin bound to antibody is able to bind the insulin receptor of target tissues. Three specific rabbit anti-insulin sera as well as sera from eight diabetic patients with insulin antibodies were incubated, free of insulin, with labelled insulin for 48 h at 4 degrees C; following incubation labelled insulin was employed in binding experiments on monocytes, erythrocytes and placenta membranes. Using rabbit sera, receptor binding was absent when insulin was totally combined with antibody, and appeared in increasing amounts as the percentage of free insulin increased to reach a maximum when no insulin was combined with antibody. The same experiment using sera from diabetic patients showed a close negative relationship (r = 0.95) between the amount of insulin bound to the antibody and the amount bound to receptors. The influence of the insulin-antibody complex on the insulin receptor interaction was evaluated by exposing the insulin-antibody complex to the receptor in pH, temperature and competition-inhibition curve experiments. The complex had no effect on receptor affinity or on the pH and temperature relationship influence with insulin-receptor interaction. The findings suggest that insulin resistance in the presence of insulin antibodies is due only to an alteration occurring before the interaction of insulin with its receptor, and demonstrate that the insulin-antibody complex does not influence the insulin receptor interaction.