Diabetes and rheumatoid factor.

Previous work from this laboratory (Oreskes and Spiera, 1966) as well as that of many other investigators (Bartfeld, 1969) has shown that the anti gamma globulin antibodies, otherwise known as rheumatoid factor (RF), are found in many persons with a wide variety of diseases other than rheumatoid arthritis. Indeed, it appears that a majority of individuals exhibiting RF activity do not have rheumatoid arthritis (Oreskes and Spiera, 1966, 1967). Presence of RF has been noted in the aged (Heimer, Levin, and Rudd, 1963), and this observation has been associated with higher levels of chronic disease in such groups, notably parkinsonism and diabetes (Litwin and Singer, 1965), In some individuals RF production appears to be due to immune stimulation by isologous yG immunoglobulin. Thus multiple transfusions (Vierucci, 1965), vaccination (Aho, Konttinen, Rajasalmi, and Wager, 1962), and transplacental transfer of ;'G from mother to child (Steinberg and Wilson, 1963), or child to mother (Fudenberg and Fudenberg, 1964), have all been implicated in the stimulation of RF activity. Diabetic individuals maintained on insulin therapy are perforce subjected to repeated 'immunization' by a foreign protein. Production of anti-insulin-antibodies by many such individuals appears likely (Berson and Yalow, 1966). In view of the findings cited above, as well as the possibility that circulating antigen-antibody conm,plexes may also stimulate RF production, it was considered that individuals receiving injections of exogenous insulin might exhibit an increased frequency of RF activity as compared to control groups. Formation of RF-like antibodies has been noted in rabbits after hyperimmunization with bacterial antigens (Abruzzo and Christian, 1961) or ovalbumin (Aho and Wager, 1961).