We studied in detail the anti-insulin autoantibodies in 29 nondiabetic
relatives of patients with type I diabetes. The affinity of the autoa
ntibodies for [I-125]human insulin was high (1.34 x 10(9)-20.71 x 10(9
) L/mol), and the capacity was low (0.84 x 10(-12)-37.80 x 10(-12) M).
The product of affinity x capacity of each relative's antibodies dire
ctly correlated (r = 0.99) with the level of antibodies determined in
our standard radioassay. The autoantibodies from each of the subjects
studied had the same rank order of affinities for insulin from differe
nt species. Guinea pig, fish insulin, and insulin containing Trp rathe
r than Leu in position 13 of the A-chain inhibited minimally the human
insulin binding. Human proinsulin, insulin containing Gln rather than
Glu in position 17 of the A-chain, and desoctapeptide insulin (des B2
3-30) all inhibited binding effectively. Insulin autoantibodies in rel
atives of patients with type I diabetes share common epitope(s), which
suggests a common pathogenic mechanism for production of such antibod
ies. The epitopes from this initial analysis appear to include amino a
cids B1-B3 and A8-A13. The region recognized can be distinguished from
the insulin receptor binding domain.