Glargine blood biotransformation: in vitro appraisal with human insulin immunoassay

• Published in: Diabetes & metabolism 2007-06, Vol.33 (3), p.205-212
• Main Authors: Agin, A, Jeandidier, N, Gasser, F, Grucker, D, Sapin, R
• Format: Article
• Language: English
• Subjects: Amino Acid Sequence; Biological and medical sciences; Biotransformation; Cross-reactivity; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Glargine metabolism; Humans; Hypoglycemic Agents - blood; Hypoglycemic Agents - pharmacokinetics; Immunoassay; Immunodosage; Insulin - analogs & derivatives; Insulin - blood; Insulin - chemistry; Insulin - pharmacokinetics; Insulin Glargine; Insulin, Long-Acting; Inter-individual variability; Internal Medicine; Kinetics; Medical sciences; Molecular Sequence Data; Métabolisme de la glargine; Peptide Fragments - chemistry; Reproducibility of Results; Réactivité croisée; Variabilité interindividuelle
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2006.12.002

Abstract Aim Glargine, a long-acting insulin analogue, is metabolized in the bloodstream and in subcutaneous tissue. Glargine metabolism and its implications for diabetes therapy remain poorly understood. The aim of our study was to assess in vitro the glargine blood biotransformation and its inter-individual variability. Methods Formation of M1 glargine metabolite in vitro was studied with Elecsys Insulin immunoassay in pools of sera and sera from patients spiked with glargine. Elecsys Insulin assay is specific of human insulin, does not recognize glargine and its M2 metabolite but does recognize its M1 metabolite. Results Glargine incubation with serum resulted in M1 metabolite formation which was detected and characterized as an enzymatic process: metabolite kinetics were dependant on temperature, substrate concentration and serum proportion. Carboxypeptidase inhibitors and chelating agents partially inhibited the activity of the enzyme(s). Glargine biotransformation was decreased when blood was collected on EDTA tubes. After 30 min incubation of glargine (100 mU/l) in 69 sera at 37 °C, percentage of glargine converted into M1 ranged from 46% to 98% (mean 72%; S.D. 11%). Conclusion Glargine blood biotransformation is an enzymatic process probably involving serum carboxypeptidase(s). Metabolite formation is rapid and non negligible. Inter-individual variability of glargine biotransformation is noteworthy and should be confronted to M1 metabolite bioactivity which has not been fully documented yet.