Pancreatic beta-cell damage. In search of novel pathogenetic factors.

A model for the possible pathogenesis of insulin-dependent diabetes mellitus (IDDM) is presented. It is partly based on studies of autoimmune thyroiditis and founded on the idea that inappropriate class II molecule expression in insulin-producing beta-cells of pancreatic islets could cause an organ-specific autoimmune disorder. The model is supported by results of several IDDM case studies as well as by the critical evaluation of the known effects of various lymphokines and lymphotoxins on endocrine target tissues. The possible roles of islet capillary endothelial cells and islet cell antibodies in the pathogenesis of IDDM are discussed.