Macrophage migration inhibitory factor in the cerebrospinal fluid of patients with conventional and optic-spinal forms of multiple sclerosis and neuro-Behcet's disease

Macrophage migration inhibitory factor (MIF) is becoming increasingly recog nized as an important regulator of immune and inflammatory responses. It is released by activated T lymphocytes and macrophages and up-regulates the p roinflammatory activity of these cells. MIF is required for antigen- and mi togen-driven T cell activation, and stimulates macrophages to release cytok ines and nitric oxide. On the basis of the recent suggestion that pharmacol ogical modulation of MIF production and neutralization of its activity may have important implications for treatment of a variety of autoimmune or inf lammatory conditions, we determined the level of MIF in the cerebrospinal f luid (CSF) of patients with conventional-form multiple sclerosis (C-MS) and optic-spinal form multiple sclerosis (OpS-MS), and neuro-Behcet's disease (NBD). As control, the CSF of patients with non-inflammatory neurological d iseases (NIND) was used. The concentration of MIF in CSF samples was signif icantly elevated in relapsed cases of C-MS (4.13+/-1.07 ng/ml) (mean+/-S.D. ) compared with control samples (2.38+/-0.60 ng/ml) (P < 0.0001), whereas M IF in the CSF of C-MS patients in remission was not elevated (2.65+/-0.67 n g/ml). The concentration of MIF in the CSF of OpS-MS patients in relapse (5 .53+/-1.74 ng/ml) was higher than that of patients with C-MS in relapse (P < 0.05). In NBD patients, the concentration of MIF in CSF was significantly elevated (7.47+/-5.61 ng/ml) compared with control samples (P < 0.01) and correlated well with cell count in these samples (r = 0.910, P < 0.005). Th ese results suggest that MIF may play a pivotal role in immune-mediated dis eases of the central nervous system, and that MIF may be useful in the stud y of differences between C-MS and OpS-MS. (C) 2000 Published by Elsevier Sc ience B.V.