Insulitis

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Histological picture of insulitis in a pancreas section of a transgenic NOD mouse ( hematoxylin-eosin staining ; black bar: 20 µm)

In medicine, insulitis is an inflammatory infiltration of cells of the immune system into the islets of Langerhans in the pancreas . CD4-positive T lymphocytes are predominantly involved in insulitis ; antigen-presenting cells such as macrophages and dendritic cells and, to a lesser extent, B lymphocytes and CD8-positive T cells also play a role. The pro-inflammatory cytokines relevant for insulitis include in particular IL-1β , TNF-α and IFN-γ .

The occurrence of insulitis has been documented by pathological - histological examinations both in patients with newly manifested diabetes mellitus in childhood (type 1 diabetes) and in corresponding animal models of this disease such as the BB rat and the NOD mouse . It is therefore most likely a process with a central causal role in the death of the insulin-producing beta cells in the islets of Langerhans, which leads to type 1 diabetes. The exact processes that contribute to the development of this form of diabetes, however, as well as the events that trigger insulitis, have not yet been clarified in detail. Virus infections and other environmental factors are discussed as possible causes of insulitis .

The description of a insulitis in pancreatic tissue of patients who shortly after the manifestation had died of diabetes in childhood, by Philip Medford LeCompte and Willy Gepts wore next to the later discovery of autoantibodies against beta cell-specific antigens and proof of association of genes in the major histocompatibility complex on the Chromosome 6 with type 1 diabetes makes a decisive contribution to the fact that this is considered an autoimmune disease that can be traced back to a misdirected immune response against the body's own tissue . Since insulitis is seen as the preliminary stage of type 1 diabetes, a weakening or other modulation of the underlying inflammatory processes through immunotherapeutic measures is a possible approach to preventing the disease.

literature

  • Roland Tisch, Hugh McDevitt: Insulin-Dependent Diabetes Mellitus. In: Cell. 85/1996. Cell Press, ISSN  0092-8674 , pp. 291-297.
  • Edwin AM Gale: The Discovery of Type 1 Diabetes. In: Diabetes. 50/2001. American Diabetes Association , ISSN  0012-1797 , pp. 217-226.
  • Décio L. Eizirik, Maikel L. Colli, Fernanda Ortis: The Role of Inflammation in Insulitis and β-Cell Loss in Type 1 Diabetes. In: Nature Reviews Endocrinology . 5 (4) / 2009. Nature Publishing Group, ISSN  1759-5029 , pp. 219-226.
  • Daria La Torre, Åke Lernmark: Immunology of β-Cell Destruction. In: Shahidul Islam: The Islets of Langerhans. Series: Advances in Experimental Medicine and Biology. Volume 654. Springer, Dordrecht / London 2010, ISBN 978-90-481-3270-6 , pp. 537-583.
  • Bernd Baumann, Heba H. Salem, Bernhard O. Boehm: Anti-Inflammatory Therapy in Type 1 Diabetes. In: Current Diabetes Reports. 12 (5) / 2012. Springer, ISSN  1534-4827 , pp. 499-509.