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Journal of Clinical Endocrinology & Metabolism, Vol 62, 1130-1135, Copyright © 1986 by Endocrine Society


ARTICLES

Genetics of the insulin receptor defect in a patient with extreme insulin resistance

SI Taylor, B Marcus-Samuels, J Ryan-Young, S Leventhal and MJ Elders

A patient with extreme insulin resistance (leprechaun/Ark-1) had an 80- 90% decrease in the number of insulin receptors on her circulating monocytes. In contrast, while a normal number of insulin receptors was expressed on the surface of Epstein-Barr (EB) virus-transformed lymphocytes from the patient, the receptors had decreased sensitivity to changes in temperature and pH. The father, who had a moderate degree of insulin resistance, resembled the patient in that his monocytes had a 60-80% decrease in the number of insulin receptors. Binding to the father's EB virus-transformed lymphocytes was normal. The mother was normally sensitive to insulin and had a normal number of insulin receptors on her circulating monocytes. In contrast, insulin receptors on the mother's EB virus-transformed lymphocytes were qualitatively abnormal, closely resembling the daughter's cultured cells. These observations suggest that each parent has transmitted a different genetic defect to the patient. When both mutations coexist in the same individual, they fail to complement, but, rather, result in extreme insulin resistance.


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T Kadowaki, C. Bevins, A Cama, K Ojamaa, B Marcus-Samuels, H Kadowaki, L Beitz, C McKeon, and S. Taylor
Two mutant alleles of the insulin receptor gene in a patient with extreme insulin resistance
Science, May 6, 1988; 240(4853): 787 - 790.
[Abstract] [PDF]




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