Abstract
Multiple sclerosis (MS) is one of the most common neurological disorders in young adults. The etiology of MS is not known but it is widely accepted that it is autoimmune in nature. Disease onset is believed to be initiated by the activation of CD4+ T cells that target autoantigens of the central nervous system (CNS) and their infiltration into the CNS, followed by the expansion of local and infiltrated peripheral effector myeloid cells that create an inflammatory milieu within the CNS, which ultimately lead to tissue damage and demyelination. Clinical studies have shown that progression of MS correlates with the abnormal expression of certain cytokines. The use of experimental autoimmune encephalomyelitis (EAE) model further delineates the role of these cytokines in neuroinflammation and the therapeutic potential of manipulating their biological activity in vivo. In this review, we will first present an overview on cytokines that may contribute to the pathogenesis of MS or EAE, and provide successful examples and roadblock of translating data obtained from EAE to MS. We will then focus in depth on recent findings that demonstrate the pathological role of granulocyte-macrophage colony-stimulating factor (GM-CSF) in MS and EAE, and briefly discuss the potential of targeting effector myeloid cells as a treatment strategy for MS.
Highlights
Multiple sclerosis (MS) is one of the most common neurological diseases in young adults, with initial clinical signs often observed between 20 and 45 years of age [1]
This was shown by studies demonstrating that IL-23 induces the production of granulocyte-macrophage colony-stimulating factor (GM-cerebrospinal fluid (CSF)) in IL-17 cells, and GM-CSF is the main pathogenic factor of EAE [120,122]
Targeting GM-CSF or its downstream signaling may have potential in treating progressive MS. Both clinical data and EAE model have provided strong evidence that targeting GM-CSF or GM-CSFR is a promising strategy for treating MS, and research in this area is underway
Summary
Multiple sclerosis (MS) is one of the most common neurological diseases in young adults, with initial clinical signs often observed between 20 and 45 years of age [1]. It is more prevalent in females than in males, with incidence ratio of about 3:1 [2]. Characteristics of MS pathology include plaque formation in the central nervous system (CNS) due to inflammation and demyelination, which result in clinical manifestations such as vision impairment, cognitive problems, loss of muscle coordination, weakness and fatigue, numbness, depression, bowel changes, and bladder dysfunction, depending on which area(s) of the CNS is affected [1,6,7]
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