, Volume 41, Issue 10, pp 1241–1248

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

  • J. C. Pickup
  • M. A. Crook
For debate

DOI: 10.1007/s001250051058

Cite this article as:
Pickup, J. & Crook, M. Diabetologia (1998) 41: 1241. doi:10.1007/s001250051058


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

Keywords Innate immune system acute-phase response cytokines interleukins 

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • J. C. Pickup
    • 1
  • M. A. Crook
    • 1
  1. 1.Department of Chemical Pathology, United Medical and Dental Schools, Guy's Hospital, London, UKGB

Personalised recommendations