In other instances, autoantibodies have been shown to cause severe pathology by neutralizing the biological activity of the target cytokine, as it is the case for autoantibodies to the granulocyte–macrophage colony-stimulating factor (GM-CSF) in autoimmune pulmonary alveolar proteinosis (PAP) and autoantibodies to erythropoietin in pure red-cell aplasia5, 6. This evidence concerns the gene CSF2 and pulmonary alveolar proteinosis.