NPH insulin

From Wikipedia, the free encyclopedia

Neutral Protamine Hagedorn was created in 1946 when Nordisk formulated "isophane" porcine insulin by adding Neutral Protamine to regular insulin. It was dubbed Neutral Protamine Hagedorn or NPH.

This is a suspension of crystalline zinc insulin combined with the positively charged polypeptide, protamine. When injected subcutaneously, it has an intermediate duration of action, meaning longer than that of regular insulin, but shorter than ultralente, glargine or detemir.

[edit] History

Hans Christian Hagedorn (1888-1971) and August Krogh (1874-1949) obtained the rights for insulin from Banting and Best in Toronto. In 1923 they formed Nordisk Insulinlaboratorium, and in 1926 with August Kongsted he obtained a Danish Royal Charters as a non-profit foundation.

In 1936 Hagedorn and B. Norman Jensen discovered that the effects of injected insulin could be prolonged by the addition of protamine obtained from the "milt" or semen of river trout. The insulin would be added to the protamine, but the solution would have to be brought to pH 7 for injection. Canada later produced PZI insulin, a mixture of zinc, protamine and porcine insulin. This mixture only needed to be shaken before injection.

In 1946 Nordisk was able to form crystals of protamine and insulin and marketed it in 1950 as NPH insulin. NPH insulin has the advantage that it can be mixed with an insulin that has a faster onset to complement its longer lasting action.

Eventually all animal insulins made by Novo Nordisk were replaced by synthetic, recombinant 'human' insulin. Synthetic 'human' insulin is also complexed with NPH by adding synthetic protamine.

[edit] Timeline

• 1926 Nordisk receives Danish charter to produce insulin
• 1936 Hagedorn discovers that adding protamine to insulin prolongs the effect of insulin
• 1936 Canadians D.M. Scott and A.M. Fisher formulate zinc insulin mixture and license to Novo
• 1946 Nordisk crystallizes a protamine and insulin mixture
• 1950 Nordisk markets NPH insulin
• 1953 Nordisk markets "Lente" zinc insulin mixtures

[edit] See also

• Insulin analogue

v • d • e Oral antidiabetic drugs and Insulin analogs (A10) Biguanides Metformin Sulfonylureas Carbutamide, Chlorpropamide, Glibenclamide (Glyburide), Gliclazide, Glimepiride, Glipizide, Gliquidone, Tolazamide, Tolbutamide Alpha-glucosidase inhibitors Acarbose, Miglitol, Voglibose Thiazolidinediones (TZD) Pioglitazone, Rivoglitazone†, Rosiglitazone, Troglitazone‡ Meglitinides Nateglinide, Repaglinide, Mitiglinide Dipeptidyl peptidase-4 (DPP-4) inhibitors Alogliptin†, Saxagliptin†, Sitagliptin, Vildagliptin Glucagon-like peptide-1 analog Exenatide, Liraglutide†, Albiglutide† Amylin analog Pramlintide Insulin analogs fast acting (Insulin lispro, Insulin aspart, Insulin glulisine), long acting (Insulin glargine, Insulin detemir), Inhalable insulin (Exubera) Dual PPAR agonists Aleglitazar†, Muraglitazar§, Tesaglitazar§ SGLT2 inhibitor Dapagliflozin†, Remogliflozin†, Sergliflozin† †Undergoing clinical trials. ‡ Withdrawn from market. §Development halted.