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. 2020 Aug 6;10:13274. doi: 10.1038/s41598-020-70203-x

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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The scheme shows mtDNA serve as a molecular bridge of the inflammatory loop in NMOSD by activating and attracting monocytes from peripheral blood. (A) Anti-AQP4 Ab stimulate astrocytes. (B) CCL2 is produced by the stimulated astrocytes. (C) MtDNA is released from the astrocytes damaged by anti-AQP4 Ab. (D) MtDNA activates macrophages infiltrating into the parenchyma and induces the production of CCL2. (E) CCL2 recruits the monocytes from blood vessels into lesions, generating the inflammatory loop of monocyte recruitment and activation.