Serum levels of ATG5, Parkin, and lactate were more elevated in Gd+ than in Gd- MS patients (p < 0.0001), and CSF concentrations of ATG5 and Parkin were greater in Gd+ than in Gd- MS (p < 0.0001).
ATG5 mRNA levels in CD4<sup>+</sup> T cells from MS patients were positively correlated with those of the proinflammatory cytokine tumor necrosis factor.
Expression of the essential autophagy-related protein 5 (Atg5), which supports T lymphocyte survival and proliferation, is increased in T cells isolated from blood or brain tissues from patients with relapsing-remitting MS.
As the Atg12-Atg5·Atg16 multimeric complex plays an essential role in autophagy, our results suggest that Atg16L2 may play an important role in autophagy of T cells and serve as a potential biomarker to predict clinical relapse of MS.
These results indicated that ATG5 variants are associated with NMO but not MS patients, which may provide a clue for further clarifying the autoimmune mechanisms of autophagy-related pathogenesis in NMO.