Selective elevation of circulating CCL2/MCP1 levels in patients with longstanding post-vaccinal macrophagic myofasciitis and ASIA

Abstract

Several medical conditions sharing similar signs and symptoms may be related to immune adjuvants. These conditions described as ASIA (Autoimmune/inflammatory Syndrome Induced by Adjuvants), include a condition characterized by macrophagic myofasciitis (MMF) assessing long-term persistence of vaccine derived-alum adjuvants into macrophages at sites of previous immunization. Despite increasing data describing clinical manifestations of ASIA have been reported, biological markers are particularly lacking for their characterization and follow up. We report an extensive cytokine screening performed in serum from 44 MMF patients compared both to sex and age matched healthy controls and to patients with various types of inflammatory neuromuscular diseases. Thirty cytokines were quantified using combination of Luminex® technology and ELISA. There was significant mean increase of serum levels of the monocytechemoattractant protein 1 (CCL2/MCP-1) in MMF patients compared to healthy subjects. MMF patients showed no elevation of other cytokines. This contrasted with inflammatory patients in whom CCL2/MCP-1 serum levels were unchanged, whereas several other inflammatory cytokines were elevated (IL1β, IL5 and CCL3/MIP1α). These results suggest that CCL2 may represent a biological marker relevant to the pathophysiology of MMF rather than a non specific inflammatory marker and that it should be checked in the other syndromes constitutive of ASIA.

Figure 1

Morin stained section from muscle biopsy with macrophagic myofasciitis showing rounded alum agglomerates within cells. (magnification x250)

Figure 2

Serum CCL2-MCP1 levels in MMF patients compared to control non-smoking and smoking healthy subjects and inflammatory patients. CCL2-MCP1 is selectively increased in MMF patients and unchanged in inflammatory patients.

Figure 3

Serum cytokine levels in MMF patients, control healthy subjects and inflammatory patients. MIP-1α, 1L-1β AND IL-5 are significantly increased in inflammatory patients but similar to healthy controls in MMF patients.