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Abstract Details

Defining the CSF Cytokine and Chemokine Profile of Patients with Autoimmune GFAP Meningoencephalomyelitis
Autoimmune Neurology
P1 - Poster Session 1 (12:00 PM-1:00 PM)
032

To describe the cytokine/chemokine profile in the cerebrospinal fluid (CSF) of patients with autoimmune GFAP meningoencephalomyelitis.
GFAP meningoencephalomyelitis is one of the most common antibody-associated diseases of the central nervous system. The intracellular nature of the antigen suggests a cytotoxic T-cell mediated process, yet the pathophysiology remains poorly understood and patients often have good recovery. Histopathological findings reveal two distinct phenotypes in humans (lymphocytic and granulomatous). Defining the CSF cytokine/chemokine signature in this disease will help elucidate disease mechanisms.
We utilized a recently validated multiplexed automated immunoassay (Ella by Biotechne) to measure 17 analytes (IL-1b, IL-2, IL-4, IL-5, IL-6, IL-8/CXCL8, IL-10, IL-12p70, IL-13, IL-17A, GM-CSF, TNF-alpha, IFN-gamma, CXCL9, CXCL10, CXCL13, BAFF) in the CSF of GFAP-IgG positive patients tested in a neural antibody clinical service laboratory over a seven-month period. Additionally, CSF of all GFAP-IgG positive patients with clinical data (2016-2024) were evaluated. Results were compared to non-inflammatory disease controls (n=42); comparisons were made with the Wilcoxon rank-sum test.
Seventy-nine patient CSFs were tested so far. IL-5, IL-6, IL-10, IL-8/CXCL8, CXCL9, CXCL10 CXCL13, IFN-gamma, TNF-alpha, GM-CSF and BAFF were significantly elevated in CSF from GFAP patients compared to non-inflammatory controls (P<0.01 for all). Analysis of clinical characteristics of patients, correlations to cytokine elevations, and a comparison to infectious and inflammatory controls are in progress.
GFAP meningoencephalomyelitis is associated with significant CSF elevations of cytokines and chemokines associated with T-cell and B-cell responses, as well as macrophage activation; neural cell inflammatory responses might also contribute to these findings. These observations comply with previously reported histopathological findings, but further studies are necessary to identify signatures predicting of outcome and underlying histopathology type.
Authors/Disclosures
Yahel Segal, MD (Mayo Clinic)
PRESENTER 		Dr. Segal has nothing to disclose.
Georgios Mangioris, MD Dr. Mangioris has nothing to disclose.
Sean J. Pittock, MD, FAAN (Mayo Clinic Dept of Neurology) Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche/Genentech. The institution of Dr. Pittock has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion/AstraZeneka. The institution of Dr. Pittock has received research support from NIH. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received publishing royalties from a publication relating to health care.
Binxia Yang (Mayo clinic) Binxia Yang has nothing to disclose.
Divyanshu Dubey, MD, FAAN (Mayo Clinic) The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys. The institution of Dr. Dubey has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB . Dr. Dubey has received research support from Department of Defense . Dr. Dubey has received research support from Department of Defense . Dr. Dubey has received research support from UCB. Dr. Dubey has received research support from David J. Tomassoni ALS Research Grant Program . Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care. Dr. Dubey has received intellectual property interests from a discovery or technology relating to health care.
Eoin P. Flanagan, MBBCh, FAAN (Mayo Clinic) The institution of Dr. Flanagan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Flanagan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pharmacy times. The institution of Dr. Flanagan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UCB. The institution of Dr. Flanagan has received research support from UCB. The institution of Dr. Flanagan has received research support from Roche. The institution of Dr. Flanagan has received research support from UCB. The institution of Dr. Flanagan has received research support from Merck. The institution of Dr. Flanagan has received research support from Roche. Dr. Flanagan has received publishing royalties from a publication relating to health care. Dr. Flanagan has received publishing royalties from a publication relating to health care. Dr. Flanagan has a non-compensated relationship as a Member of medical Advisory Board with The MOG Project that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial board member with Journal of The Neurologic Sciences that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial board member with Neuroimmunology Reports that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial Board Member with Neurology, Neuroimmunology Neuroinflammation (N2) Journal that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial Board Member with Neurology that is relevant to AAN interests or activities.
John R. Mills, MD, PhD (Mayo Clinic) The institution of Dr. Mills has received research support from Werfen Diagnostics. Dr. Mills has received intellectual property interests from a discovery or technology relating to health care.
Michel Toledano, MD (Mayo Clinic) Dr. Toledano has nothing to disclose.
Ivana Vodopivec, MD (Novartis Pharma AG) Dr. Vodopivec has received personal compensation for serving as an employee of Roche. An immediate family member of Dr. Vodopivec has received personal compensation for serving as an employee of Novartis. Dr. Vodopivec has stock in Roche.
Andrew McKeon, MD (Mayo Clinic) The institution of Dr. McKeon has received research support from National Institutes of Health. Dr. McKeon has received intellectual property interests from a discovery or technology relating to health care. Dr. McKeon has received intellectual property interests from a discovery or technology relating to health care. Dr. McKeon has received publishing royalties from a publication relating to health care.
Anastasia Zekeridou, MD, PhD, FAAN (Neuroimmunology Laboratory, Mayo Clinic) The institution of Dr. Zekeridou has received research support from Roche/Genentech. Dr. Zekeridou has received intellectual property interests from a discovery or technology relating to health care. Dr. Zekeridou has received intellectual property interests from a discovery or technology relating to health care. Dr. Zekeridou has received intellectual property interests from a discovery or technology relating to health care. Dr. Zekeridou has received intellectual property interests from a discovery or technology relating to health care.