Pituitary and adrenal control of pancreatic endocrine function in the duck.

Recent clinical and immunological data suggest that the classical concept of "idiopathic autoimmune diseases" is to be revised. In a normal population, autoimmunity reactions against thyroid gland, gastric mucosa and adrenals develop slowly with increasing age and are found more frequently in women than in men (at least so far as thyroid antibodies are concerned) as is lowering of the functional activity of T lymphocytes. Diabetes takes its place among a series of factors diminishing immunocyte reactivity, and thus enhancing the development of the autoimmunity process. This may perhaps be promoted in some way by genetic factors, perhaps those which also play a definite though as yet ill-defined role in determining the emergence of diabetes. For the present, diabetes mellitus itself must only rarely be considered a consequence of an autoimmune process and then only in certain insulin-dependent cases. By contrast, diabetes appears frequently to be an activator of autoimmune phenomena against tissues other than pancreas, namely thyroid gland, adrenals and gastric mucosa. Awareness of these associations should encourage physicians to seek latent humoral or cellular evidence of autoimmune phenomena in diabetics; this would favour the early recognition of clinically important abnormalities which may accompany the diabetes.