Chapter 5 - Granulocyte-Macrophage Colony-Stimulating Factor in Central Nervous System Autoimmunity

Abstract

Multiple sclerosis (MS) is an autoimmune demyelinating disease that affects the central nervous system. Experimental autoimmune encephalomyelitis (EAE), an animal model of MS, has been highly instrumental in elucidating MS immunopathogenesis and testing potential therapies. Granulocyte-macrophage colony-stimulating factor (GM-CSF, also known as Csf2) is a cytokine with an essential role in EAE development. GM-CSF can be produced by various cell types, but the relevant cellular source of GM-CSF in EAE are autoreactive myelin-specific CD4+ T cells. The role of GM-CSF in MS is not known, but the view is that it likely plays an important role, as it does in EAE, has led to ongoing clinical trials testing the safety and therapeutic efficacy of GM-CSF blockade with antibody as MS therapy. We provide an overview of our knowledge of GM-CSF in central nervous system autoimmunity, which has been evolving since the discovery of its essential role in EAE in 2001.