In advanced chronic pancreatitis (CP), islets are preserved even in the midst of scarring. We recently showed in CP local production of interferon (IFN)c, transforming growth factor (TGF)b and death receptor ligand TRAIL (tumor necrosis factor-related apoptosis-inducing ligand), along with functional death receptor neoexpression and apoptosis in exocrine but not in endocrine cells. However, islets are strongly induced for TRAILreceptor(R)-4 lacking the functional death domain. TRAIL-R4 signaling in T cells induces NFjB, which activates antiapoptotic programs. Here, we demonstrate that in insulinoma cells CM, TGFb/IFNc/TRAIL in combination induced TRAIL-R4 surface expression. TRAIL/IFNc upregulated NFjB subunits and its target gene survivin while downmodulating IjBa mRNA. RelA transcriptional activity increased upon stimulation with IFNc and IFNc/ TRAIL. In situ, normal pancreatic epithelia had low mRNA levels of NFjB subunits. These were higher in parenchymal areas of CP with severe fibrosis and highest in islets. NFjB-regulated proteins IjBa, survivin and another apoptosis inhibitor, cIAP1, were found in corresponding sites, again at highest levels in islets surrounded by fibrosis. In conclusion, islets in CP not only evade immune attack by nonexposure of functional death receptors in the presence of TRAIL-R4 but also additionally neoexpress NFjB and its target genes, survivin and cIAP1, to protect themselves from apoptosis.