SIGNIFICANCE OF TUMOR-NECROSIS-FACTOR-ALPHA IN PATIENTS WITH LONG-STANDING TYPE-I DIABETES-MELLITUS

Fifteen out of the forty-five patients with long-standing diabetes mel litus type I were characterised by the presence of TNF alpha in the se ra when examined on several occasions over a period of five years. TNF alpha-producing patients had a better control of the disease and a sm aller percentage of them suffered from diabetic complications as compa red with those not producing this cytokine. TNF alpha-producing patien ts had lower levels of the proinflammatory markers -IL6 and CRP, and h igher concentrations of ACTH and cortisol than those not producing thi s cytokine. We suggest that TNF alpha released systemically in diabeti c patients stimulates the hypophysis-adrenal axis, and in that way ind irectly ameliorates autoimmune response occurring during the advanced phase of the disease.