To the Editor.
—Strong immunosuppressants have halted the autoimmune destruction of the pancreatic β cell in new-onset insulin-dependent diabetes, enabling as many as 50% of patients to be independent of insulin 1 year after diagnosis.1 However, the high incidence of side effects associated with these agents makes their long-term use untenable in a disease that can be treated safely with insulin for decades.Pentoxifylline has been in use for more than 20 years with minimal side effects and was recently discovered to have immunosuppressive properties. Pentoxifylline inhibits expression of tumor necrosis factor α (TNF-α)2 and possibly the interleukin 2 receptor.3 Both TNF-α and interleukin 2 have been strongly implicated in the destruction of the β cell in insulin-dependent diabetes,3 and TNF-α has been reported to impair insulin action.4 The relative safety of pentoxifylline prompted us to begin an unmasked (Human Studies Committee-approved trial of pentoxifylline
MacDonald MJ, Shahidi NT, Allen DB, Lustig RH, Mitchell TL, Cornwell ST. Pentoxifylline in the Treatment of Children With New-Onset Type I Diabetes Mellitus. JAMA. 1994;271(1):27-28. doi:10.1001/jama.1994.03510250043028