MACROPHAGE-MIGRATION INHIBITORY FACTOR - A REGULATOR OF GLUCOCORTICOID ACTIVITY WITH A CRITICAL ROLE IN INFLAMMATORY DISEASE

Macrophage migration inhibitory factor (MIF) was one of the first cyto kines to be identified, In the early 1990s it was 'rediscovered' as a hormone that is secreted by the anterior pituitary gland and counter-r egulates the anti inflammatory effects of glucocorticoids, We now know that glucocorticoids stimulate the release of MIF from T cells and ma crophages; this appears to be a physiological response to override the effects of glucocorticoids at the inflammatory site, However, this re sponse can become pathological in acute respiratory distress syndrome (ARDS), in which high concentrations of MIF in the alveoli might contr ibute to ARDS pathogenesis, New insights into the structure and functi on of MIF, and the possibility of increasing the efficacy of glucocort icoids in the clinic by inhibiting MIF, are discussed in this review.