Cytokines and the pathogenesis of insulin-dependent diabetes mellitus
Ben H. Brouhard, MDAddress reprint requests to B.H.B., Department of Pediatrics, A120, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.
Insulin-dependent diabetes mellitus is an autoimmune phenomenon in humans. At onset, the diabetic pancreas shows a well-characterized insulitis. The inflammatory cells are specifically directed toward beta cells of the pancreatic islets. Several hypotheses link genetic susceptibility for diabetes to immunologic mechanisms. The cytokines interferon gamma and interleukin-6 have essential roles in the progressive destruction of beta cells. Studies with experimental models may improve definition of the pathogenesis of insulin-dependent diabetes mellitus. Combining genetic studies that detect susceptibility to insulin-dependent diabetes mellitus with future therapies aimed at interrupting cytokine production or cytokine receptor expression may lead to prevention of insulin-dependent diabetes mellitus.