J. Mirouze
Sep 1, 1983
Citations
1
Influential Citations
12
Citations
Journal
Diabetologia
Abstract
Ever since its introduction [1-3], insulin has provided a major stimulus for scientific research in numerous fields, including intermediary metabolism, protein chemistry, polymer biochemistry, crystallography, molecular genetics, cellular biology and endocrinology. Insulin has also been a reference model in numerous studies concerning such diverse topics as peptide hormones, viral capsid proteins, serum albumin complexes, connective tissue collagen, and toxic peptides of bee and viper venoms. Research into insulin has also made major contributions to current concepts on protein structure and biosynthesis, radioimmunoassay and sequestration of presecretory protein precursors. The target cells for insulin have provided an excellent model for the study of receptor-ligand interactions, and thus of transmitters and transmitter uptake and internalization. Insulin is also the first therapeutic agent prepared by genetic engineering. Of course its great value, and the only one to be considered here, is its spectacular therapeutic efficacy. Indeed, insulin constitutes a unique therapeutic agent which, over the past 60 years, has provided a major improvement in the prognosis of a serious disease, diabetes mellitus. It has led to the opening up of hitherto unsuspected approaches to numerous branches of medicine. Availability of insulin has altered the natural history of diabetes mellitus with progressive malnutrition, substituting a new disease entity: insulin-dependent diabetes. A clearer view of the general consequences of diabetes has become possible, in particular the humoral and vascular repercussions. Work is currently under way concerning the degenerative complications, in particular to determine the specific roles of abnormal blood glucose levels, hormonal disturbances independent of insulin secretion and those associated with therapeutic insulin administration, direct effects upon the vascular endothelium and platelets (including their