Cytokines and biological markers in autoimmune GFAP astrocytopathy: The potential role for pathogenesis and therapeutic implications

Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy (GFAP-A) is a corticosteroid-responsive meningoencephalomyelitis with a poorly understood pathogenesis. We examined and compared the levels of cytokines and biological markers in the cerebrospinal fluid (CSF) of patients with GFAP-A and other neurological disorders. We identified four cytokines (tumor necrosis factor alpha [TNFα], Interleukin [IL]-27, IL-6, and chemokine [C-C motif] ligand 20) and three biological markers (GFAP, S100 calcium-binding protein B, and neurofilament light chain) present at elevated levels in CSF samples during the acute phase of GFAP-A. Additionally, we identified significant correlations between CSF TNFα, IL-27, IL-6, and CSF biological markers.