- Benedek, Gil;
- Meza-Romero, Roberto;
- Jordan, Kelley;
- Zhang, Ying;
- Nguyen, Ha;
- Kent, Gail;
- Li, Jia;
- Siu, Edwin;
- Frazer, Jenny;
- Piecychna, Marta;
- Du, Xin;
- Sreih, Antoine;
- Leng, Lin;
- Wiedrick, Jack;
- Caillier, Stacy J;
- Offner, Halina;
- Oksenberg, Jorge R;
- Yadav, Vijayshree;
- Bourdette, Dennis;
- Bucala, Richard;
- Vandenbark, Arthur A
Little is known about mechanisms that drive the development of progressive multiple sclerosis (MS), although inflammatory factors, such as macrophage migration inhibitory factor (MIF), its homolog D-dopachrome tautomerase (D-DT), and their common receptor CD74 may contribute to disease worsening. Our findings demonstrate elevated MIF and D-DT levels in males with progressive disease compared with relapsing-remitting males (RRMS) and female MS subjects, with increased levels of CD74 in females vs. males with high MS disease severity. Furthermore, increased MIF and D-DT levels in males with progressive disease were significantly correlated with the presence of two high-expression promoter polymorphisms located in the MIF gene, a -794CATT5-8 microsatellite repeat and a -173 G/C SNP. Conversely, mice lacking MIF or D-DT developed less-severe signs of experimental autoimmune encephalomyelitis, a murine model of MS, thus implicating both homologs as copathogenic contributors. These findings indicate that genetically controlled high MIF expression (and D-DT) promotes MS progression in males, suggesting that these two factors are sex-specific disease modifiers and raising the possibility that aggressive anti-MIF treatment of clinically isolated syndrome or RRMS males with a high-expresser genotype might slow or prevent the onset of progressive MS. Additionally, selective targeting of MIF:CD74 signaling might provide an effective, trackable therapeutic approach for MS subjects of both sexes.