Is Type II diabetes mellitus a disease of the innate immune system

摘要: Type II (non-insulin-dependent) diabetes mellitus is associated with increased blood concentrations of markers the acute-phase response, including sialic acid, α-1 acid glycoprotein, serum amyloid A, C-reactive protein and cortisol, main cytokine mediator interleukin-6. The dyslipidaemia common in (hypertriglyceridaemia low levels HDL cholesterol) also a feature natural experimental reactions. We review evidence that long-term cytokine-mediated reaction occurs part wide-ranging innate immune response. Through action cytokines on brain, liver, endothelium, adipose tissue elsewhere, this process could be major contributor to biochemical clinical features metabolic syndrome X (glucose intolerance, dyslipidaemia, insulin resistance, hypertension, central obesity, accelerated atherosclerosis) but provides mechanism for many other abnormalities seen diabetes, those clotting, reproductive system, metal ion metabolism, psychological behaviour capillary permeability. In short-term, system restores homeostasis after environmental threats; we suggest impaired glucose tolerance lifestyle stimulants, probably an innately hypersensitive produce disease instead repair. [Diabetologia (1998) 41: 1241–1248]