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Lee E, Miller C, Ataya A, Wang T. Opportunistic Infection Associated with Elevated GM-CSF Autoantibodies: A Case Series and Review of the Literature. Open Forum Infect Dis 2022; 9:ofac146. [PMID: 35531378 PMCID: PMC9070348 DOI: 10.1093/ofid/ofac146] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/17/2022] [Indexed: 11/22/2022] Open
Abstract
Granulocyte-macrophage colony-stimulating factor (GM-CSF) is known to play a key role in enhancing multiple immune functions that affect response to infectious pathogens including antigen presentation, complement- and antibody-mediated phagocytosis, microbicidal activity, and neutrophil chemotaxis. Reduced GM-CSF activity and immune response provides a mechanism for increased infection risk associated with autoimmune pulmonary alveolar proteinosis (aPAP) and other disorders involving the presence of GM-CSF autoantibodies. We present a case series of five patients with persistent or unusual pulmonary and central nervous system opportunistic infections (Cryptococcus gattii, Flavobacterium, Nocardia) and elevated GM-CSF autoantibody levels, as well as 27 cases identified on systematic review of the literature.
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Affiliation(s)
- Elinor Lee
- UCLA Division of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Christopher Miller
- UCLA Division of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Ali Ataya
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| | - Tisha Wang
- UCLA Division of Pulmonary, Critical Care, and Sleep Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Berthoux C, Mailhe M, Vély F, Gauthier C, Mège JL, Lagier JC, Melenotte C. Granulocyte Macrophage Colony-Stimulating Factor-Specific Autoantibodies and Cerebral Nocardia With Pulmonary Alveolar Proteinosis. Open Forum Infect Dis 2020; 8:ofaa612. [PMID: 33614812 PMCID: PMC7881751 DOI: 10.1093/ofid/ofaa612] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
In this study, we report the history of a 40-year-old man with a primary cerebral abscess caused by Nocardia abscessus that led to the discovery of autoimmune pulmonary alveolar lipoproteinosis (anti-granulocyte-macrophage colony-stimulating factor [GM-CSF] autoantibodies). Anti-GM-CSF autoantibodies promote immunodeficiency and should be monitored to prevent opportunistic and disseminated infections and to diagnose asymptomatic pulmonary alveolar lipoproteinosis.
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Affiliation(s)
- Charlotte Berthoux
- Aix-Marseille Université, IRD Institut de Recherche et de Developpement, APHM Assistance publique des Hôpitaux de Marseille, MEPHI Microbes, Evolution, Phylogénie et Infection, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Morgane Mailhe
- Aix-Marseille Université, IRD Institut de Recherche et de Developpement, APHM Assistance publique des Hôpitaux de Marseille, MEPHI Microbes, Evolution, Phylogénie et Infection, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Frédéric Vély
- Assistance Publique des Hôpitaux de Marseille, Hôpitaux Conception et Timone, Service d'Immunologie, Marseille, France.,Aix-Marseille Université, CNRS, INSERM, CIML, Marseille, France
| | - Clarisse Gauthier
- Assistance Publique des Hôpitaux de Marseille, Hôpital Nord, Service de Pneumologie et Maladies Respiratoires Rares, Marseille, France
| | - Jean-Louis Mège
- Assistance Publique des Hôpitaux de Marseille, Hôpitaux Conception et Timone, Service d'Immunologie, Marseille, France
| | - Jean-Christophe Lagier
- Aix-Marseille Université, IRD Institut de Recherche et de Developpement, APHM Assistance publique des Hôpitaux de Marseille, MEPHI Microbes, Evolution, Phylogénie et Infection, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Cléa Melenotte
- Aix-Marseille Université, IRD Institut de Recherche et de Developpement, APHM Assistance publique des Hôpitaux de Marseille, MEPHI Microbes, Evolution, Phylogénie et Infection, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
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