A Preliminary Study On The Role Of Cytokines In The Pathogenesis Of Insulin Allergy

Insulin allergy is a concomitant problem in the treatment of clinical diabetes.After the discovery of human recombinant insulin,the prevalence of insulin allergy has decreased significantly,but the diagnosis and treatment of it have become more difficult.At present,most discussions about the disease are mainly focused on its diagnosis and treatment,and there is still a lack of investigations into its etiology.The purpose of this study is to summarize the diagnosis and treatment plan for inpatients with insulin allergy of Peking Union Medical College Hospital,and give a brief analysis and preliminary discussion about the cytokine pattern in the serum of patients with this disease.Methods:1 Collect the cases of inpatients with insulin allergy diagnosed in Peking Union Medical College Hospital.After excluding medical records that did not meet the enrollment criteria,summarize and analyze the characteristics of the relevant medical records and clinical diagnosis and treatment of 87 patients included in the study.2 For patients those with type-1 hypersensitivity reaction to insulin and had positive intradermal test,blood samples were collected and medical records were matched to find the same number of diabetic patients who had long-term use of insulin without experience allergic reactions as control group,and the cytokines of both parties involved were analyzed.Results:1 This study included 87 patients,whom were 35 males and 52 females,with an average age of 53.5�11.9 years old.Type 1 diabetes patients accounted for 6.9%,50 people had history of allergies,18 of whom were allergic to penicillin-In the process of desensitization treatment with HIA,the success rate of CSII is slightly higher than traditional desensitization.2 The patient group included 24 people,10 were males.The control group matched the patient group in terms of gender,age and type of diabetes.The measured cytokines IL-2,IL-4,IL-5,IL-6,IL-10,IL-12p70,IL-21,IL-17A,IL-22,IFN-?,GM-CSF,CCL20/MIP3a,IL-9,IL-15,IL-17E/IL-25,IL-1?,IL-23,IL-27,IL-31,IL-33,TNF-?,TNF-? and the ratio of IL-4/IFN-? and IL-17A/IL-10.All results are analyzed by t test,and multiple cytokines are different between the two groups.Conclusion:1 Insulin allergy is a rare adverse drug reaction.Usually,desensitization therapy can achieve satisfactory results.Some patients still cannot tolerate subcutaneous insulin injections after desensitization treatment,but the administration of CSII can maintain insulin therapy.2 Compared with diabetic patients who have been using insulin for a long time without allergic reactions,the concentration of serum IL-4,GM-CSF,and ratios of IL-4/IFN-y and IL-17A/IL-10 of patients group are elevated,but the level of serum IL-5,IFN-?,IL-12p70,IL-2,IL-21,IL-17A,IL-9,IL-15,IL-17E/IL-25,IL-1?,IL-23,IL-27,IL-31 and TNF-?are decreased.And as for the levels of IL-6,IL-22,IL-10,CCL20/MIP3a,IL-33 and TNF-?,there was no difference between the two groups.3 The levels of IL-4,IFN-?,IL-21,IL-12,and IL-27 in serum and the ratio of IL-4/IFN-?,which could be used to identify patient with insulin allergy,with a good sensitivity and specificity.And the detection of their serum concentration may be helpful for the diagnosis of insulin allergy.