The effect of local production of cytokines in the pathogenesis of insulin-dependent diabetes mellitus

Insulin-dependent diabetes mellitus (IDDM) is an autoimmune disease mediate d by self-reactive T cells that induce inflammation and destruction of panc reatic islet beta cells. A widely held belief is that T helper lymphocytes carrying a type 1 inflammatory phenotype are the major players in generatin g IDDM. However, recent evidence shows that cytokines belonging to the Th2 pathway can also induce autoimmune diabetes. The expression of cytokines di rectly within the pancreatic islets of transgenic mice helped to characteri ze the modulatory effects that Th1 or Th2 cytokines play on T cell-mediated autoimmune responses and diabetogenesis. This review describes the new inf ormation that these transgenic models have provided in understanding the ex ceedingly complex cytokine network and its role in the pathogenesis of IDDM . (C) 1999 Academic Press.