Significance of tumor necrosis factor α in patients with long-standing type-I diabetes mellitus

Fifteen out of the forty-five patients with long-standing diabetes mellitus type I were characterised by the presence of TNF alpha in the sera when examined on several occasions over a period of five years. TNF alpha-producing patients had a better control of the disease and a smaller percentage of them suffered from diabetic complications as compared with those not producing this cytokine. TNF alpha-producing patients had lower levels of the proinflammatory markers -IL6 and CRP, and higher concentrations of ACTH and cortisol than those not producing this cytokine. We suggest that TNF alpha released systemically in diabetic patients stimulates the hypophysis-adrenal axis, and in that way indirectly ameliorates autoimmune response occurring during the advanced phase of the disease.