TNF and type 1 diabetes mellitus: Other mechanisms that have been proposed to contribute to T1D pathogenesis include the activation of autoreactive T cells via bystander activation or epitope spreading during inflammation (9), as well as the infiltration of the pancreas by other pro-inflammatory immune cells, which produce cytokines such as interferons or tumor necrosis factor (TNF), that could contribute to beta cell destruction(10) (Table 1).