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- Title
The role of granulocyte-macrophage colony-stimulating factor in the pathogenesis of neuromyelitis optica: A white or black knight?
- Authors
Masuda, Hiroki; Uzawa, Akiyuki; Mori, Masahiro; Kuwabara, Satoshi
- Abstract
Granulocyte-macrophage colony-stimulating factor (GM-CSF) not only induces the differentiation of hematopoietic cells into granulocytes and macrophages but also exerts immunomodulatory functions. GM-CSF promotes experimental autoimmune encephalomyelitis, multiple sclerosis, and rheumatoid arthritis. Conversely, GM-CSF ameliorates some type 2 helper T cell-dominant diseases, including experimental autoimmune myasthenia gravis, experimental autoimmune thyroiditis, Crohn's disease, type 1 diabetes mellitus, autoimmune neutropenia, and juvenile systemic lupus erythematosus. However, the contribution of GM-CSF to the pathogenesis of neuromyelitis optica (NMO) has not been studied. In this article, we review GM-CSF roles in the central nervous system and report evidence that GM-CSF may positively affect the pathogenesis of NMO. We have previously reported (i) that patients with NMO expressing antinuclear antibodies (ANA-positive) have less severe disease activity and a better prognosis than ANA-negative patients and (ii) an analysis of the cytokine/chemokine profiles of 24 patients with NMO. We investigated associations between cytokine expression, ANA-positivity, and disease severity. Among the 24 patients, the six who were ANA positive had significantly elevated serum GM-CSF concentrations than the ANA-negative patients (medians: 7.0 vs 0.27 pg/mL, respectively; P = 0.001) and higher cerebrospinal fluid GM-CSF concentrations (medians: 53.7 vs 47.0 pg/mL, respectively; P = 0.068). Although no other cytokine/chemokine profiles were different based on ANA status, cerebrospinal fluid GM-CSF concentrations at relapse were negatively correlated with Kurtzke Expanded Disability Status Scale scores ( R2 = 0.26, P = 0.009). Therefore, GM-CSF may play a protective role in the pathogenesis of NMO.
- Subjects
GRANULOCYTES; NEUROMYELITIS optica; NEUROLOGIC examination; MACROPHAGE colony-stimulating factor; HEMATOPOIESIS
- Publication
Clinical & Experimental Neuroimmunology, 2015, Vol 6, p70
- ISSN
1759-1961
- Publication type
Article
- DOI
10.1111/cen3.12273