Publication: Anti-GM-CSF autoantibodies in patients with cryptococcal meningitis
Issued Date
2013-04-15
Resource Type
ISSN
15506606
00221767
00221767
Other identifier(s)
2-s2.0-84875976539
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Immunology. Vol.190, No.8 (2013), 3959-3966
Suggested Citation
Lindsey B. Rosen, Alexandra F. Freeman, Lauren M. Yang, Kamonwan Jutivorakool, Kenneth N. Olivier, Nasikarn Angkasekwinai, Yupin Suputtamongkol, John E. Bennett, Vasilios Pyrgos, Peter R. Williamson, Li Ding, Steven M. Holland, Sarah K. Browne Anti-GM-CSF autoantibodies in patients with cryptococcal meningitis. Journal of Immunology. Vol.190, No.8 (2013), 3959-3966. doi:10.4049/jimmunol.1202526 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/31932
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Title
Anti-GM-CSF autoantibodies in patients with cryptococcal meningitis
Abstract
Cryptococcal meningitis has been described in immunocompromised patients, as well as in those for whom no immune defect has been identified. GM-CSF regulates the function of phagocytes and pulmonary alveolar macrophages, critical elements in cryp-tococcal control. We performed clinical histories, immunological evaluation, and anticytokine autoantibody screening in four current patients with cryptococcal meningitis and identified and tested 103 archived plasma/cerebrospinal fluid samples from patients with cryptococcal meningitis. We assessed the ability of anti-GM-CSF autoantibody-containing plasmas to inhibit GM-CSF signaling. We recognized anti-GM-CSF autoantibodies in an otherwise healthy female with cryptococcal meningitis who later developed pulmonary alveolar proteinosis (PAP). Her diagnosis prompted screening of patients with cryptococcal meningitis for anticytokine autoantibodies. We identified seven HIV-negative patients with cryptococcal meningitis who tested positive for high-titer anti-GM-CSF autoantibodies. Two of the seven later developed evidence of PAP. Plasma from all patients prevented GM-CSF-induced STAT5 phosphorylation and MIP-1a production in normal PBMCs. This effect was limited to their IgG fraction. Anti-GM-CSF autoantibodies are associated with some cases of cryptococcal meningitis in otherwise immunocompetent patients. These cases need not have associated PAP. Copyright © 2013 by The American Association of Immunologists, Inc.