Granulocyte Macrophage Colony Stimulating Factor (GM-CSF) is a cytokine that plays a crucial role in the immune system by stimulating the production and differentiation of granulocytes and macrophages from bone marrow precursors . GM-CSF is produced by various cell types, including T cells, B cells, macrophages, monocytes, mast cells, vascular endothelial cells, and fibroblasts .
GM-CSF was first described in the conditioned media of mouse lung tissue following lipopolysaccharide (LPS) injection, which triggered the proliferation of bone marrow-derived macrophages and granulocytes . It acts on mature myeloid cells as a pro-survival, activation, and differentiation factor . GM-CSF promotes the survival and activation of macrophages, neutrophils, eosinophils, and dendritic cells, and it plays a critical role in the maturation and surfactant catabolism of alveolar macrophages .
Recent studies have revealed that GM-CSF has pro-inflammatory functions and contributes to the pathogenicity of Th17 cells in the development of Th17-mediated autoimmune diseases . GM-CSF inhibition in some animal models of autoimmune diseases has shown significant beneficial effects . Therefore, several agents targeting GM-CSF are being developed and are expected to be useful for the treatment of autoimmune diseases . In clinical trials for rheumatoid arthritis patients, GM-CSF inhibition showed rapid and significant efficacy with no serious side effects .
Namilumab (AMG203) is a human immunoglobulin G1 monoclonal antibody that binds with high affinity to the GM-CSF ligand, potently neutralizing GM-CSF . Preclinical data showed that a surrogate mouse antibody of namilumab neutralized GM-CSF, suppressed inflammation, and protected cartilage in an arthritis mouse model .