Author response to letter to editor: Hyperinsulinemia adversely affects lung structure and function

Abstract

to the editor: We appreciate the interest shown by Wolff et al. (17) regarding our recent publication in the American Journal of Physiology Lung Cellular and Molecular Physiology (11). We acknowledge the convenience of an inhaled insulin formulation, the extensive safety data required by the FDA prior to approval, and also the inherently unknown nature of long-term side effects of any drug despite appropriate safety studies and extensive financial investment by the parent company, academia and various organizations. Accordingly, given clinical introduction of inhaled insulin formulations, the intent of our study was to explore the effects of inhaled insulin in a mouse model and to dissect out some of the mechanisms by which insulin influences human airway epithelial and smooth muscle cells in vitro. In this regard, the polemic arguments notwithstanding, via this letter in response to that by Wolff et al. (17), we look forward to stimulating a healthy debate on the subject of long-term risks vs. benefits of inhaled insulin.