CCL2 and Autoimmunity: Although angiogenic activation (VEGF-A) and chest abnormalities were found in the male survivors with viral shedding in the semen, viral shedding did not explain many of the PASE symptoms and physical examination findings associated with the elevated macrophage markers (MCP-1, IL-1β, and M-CSF) found in the overall survivor cohort, suggesting autoimmunity, immune dysregulation, or other biological mechanisms might be causing some clinical manifestations.6,23 These biological mechanisms probably represent only two pathways in a more complex process of PASE pathogenesis.