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Updated: Mar 13, 2026
An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
Increased serum levels of macrophage migration inhibitory factor (MIF) in patients with microscopic polyangiitis
Hirohito Kanemitsu1, Mizuho Matsunawa1, Kuninobu Wakabayashi1
1Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
Objective:
To test the hypothesis that macrophage migration inhibitory factor (MIF) is involved in the disease activity of systemic vasculitis.
Methods:
Patients with systemic vasculitis were divided into three groups based on the size of the affected vessels. Microscopic polyangiitis (MPA) was considered as small vessel vasculitis (SVV), polyarteritis nodosa as medium-sized vessel vasculitis (MVV), and giant cell arteritis and Takayasu arteritis as large vessel vasculitis (LVV). Sera from patients with systemic vasculitis and healthy individuals were collected, and MIF levels were measured using an enzyme-linked immunosorbent assay. Disease activity of vasculitis was assessed using the Birmingham Vasculitis Activity Score (BVAS).
Results:
Serum MIF levels were significantly higher in the vasculitis patients than in healthy individuals. Among the vasculitis patients, MIF levels were significantly higher in patients in the SVV group (median; 4161.7 pg/ml) than in the other groups (MVV; 1443.2 pg/ml and LVV; 1576.7 pg/ml). In patients with MPA, a positive correlation was observed between serum MIF levels and CRP levels and disease activity (BVAS). Notably, serum MIF levels were significantly diminished after clinical improvement.
Conclusions:
Our findings suggest that MIF may have an important role in small vessel vasculopathy and serve as a useful serologic marker of MPA disease activity.
Insights
Macrophage migration inhibitory factor (MIF) is elevated in systemic vasculitis, particularly small vessel vasculitis. Higher MIF levels correlate with disease activity in microscopic polyangiitis (MPA), suggesting its role as a potential biomarker.
Area of Science:
- Immunology
- Rheumatology
- Vascular Biology
Background:
- Systemic vasculitis encompasses a group of autoimmune diseases characterized by inflammation of blood vessels.
- The role of specific inflammatory mediators, such as macrophage migration inhibitory factor (MIF), in vasculitis pathogenesis requires further elucidation.
Purpose of the Study:
- To investigate the involvement of macrophage migration inhibitory factor (MIF) in the disease activity of various types of systemic vasculitis.
- To assess MIF as a potential serologic marker for disease activity, particularly in microscopic polyangiitis (MPA).
Main Methods:
- Patients with systemic vasculitis were categorized into small (SVV), medium (MVV), and large (LVV) vessel vasculitis groups.
- Serum MIF levels were quantified using enzyme-linked immunosorbent assay (ELISA) and correlated with disease activity scores (BVAS) and C-reactive protein (CRP) levels.
- MIF levels were compared between vasculitis patients and healthy controls, and changes were monitored during clinical improvement.
Main Results:
- Serum MIF levels were significantly elevated in patients with systemic vasculitis compared to healthy individuals.
- MIF levels were highest in the small vessel vasculitis (SVV) group, specifically in patients with microscopic polyangiitis (MPA).
- A positive correlation was found between serum MIF, CRP levels, and disease activity (BVAS) in MPA patients, with MIF levels decreasing upon clinical improvement.
Conclusions:
- Macrophage migration inhibitory factor (MIF) plays a significant role in the pathophysiology of small vessel vasculopathy.
- Serum MIF levels show promise as a valuable serologic marker for assessing disease activity in microscopic polyangiitis (MPA).
