We describe an enzyme-linked two-site immunoassay for quantitation of
intact insulin in human serum and plasma. The method uses two murine m
onoclonal antibodies that bind to two different epitopes on the insuli
n molecule. The immunoassay is specific. Human proinsulin is not bound
by the antibodies, and the binding of partially processed proinsulin
intermediates is believed to be of minor clinical importance. The rela
tive response of human, bovine, and porcine insulin is 1, 1, and 3, re
spectively. The assay is sensitive (detection limit 5 pmol/L), accurat
e (101% recovery with 50 pmol/L insulin added to samples, 95% with 100
pmol/L, and 89% with 300 pmol/L), and fast (results within 3 h), and
has a high analytical capacity (done in microtiter plates). The workin
g assay range selected is 5-600 pmol/L, corresponding to a clinically
useful range. Because of its specificity, this two-site immunoassay gi
ves results that are lower than those obtained by using a competitive
radioimmunoassay, both in normal individuals and in non-insulin-depend
ent diabetics.