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Mult Scler. 2015 Jun;21(7):866-874. doi: 10.1177/1352458514555785. Epub 2014 Oct 24.

Antibodies to MOG and AQP4 in adults with neuromyelitis optica and suspected limited forms of the disease.

Author information

1
Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain/Institute of Neurology, Medical University of Vienna, Austria.
2
Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
3
Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain/Department of Pediatrics I, Division of Pediatric Neurology, Innsbruck Medical University, Innsbruck, Austria/Pediatric Neurology, Witten/Herdecke University, Children's Hospital Datteln, Germany.
4
Servicio de Neurología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
5
Hospital Universitario Donostia, San Sebastián, Spain.
6
Hospital Universitari Dr. Josep Trueta, IDIBGI, Girona, Spain.
7
Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
8
Departament of Neurology, University Hospital "12 de Octubre", Centro de Investigación Biomédica en red sobre Enfermedades Neurodegenerativas (CIBERNED), Departamento de Medicina, Complutense University, Madrid, Spain.
9
Hospital Universitari La Fe de Valencia, Valencia, Spain.
10
Servei de Neurologia-Neuroimunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
11
Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain/Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
#
Contributed equally

Abstract

OBJECTIVE:

We aimed to report the frequency and implications of antibodies to myelin oligodendrocyte glycoprotein (MOG-ab) in adults with demyelinating syndromes suspicious for neuromyelitis optica (NMO).

METHODS:

Samples from 174 patients (48 NMO, 84 longitudinally extensive myelitis (LETM), 39 optic neuritis (ON), and three acute disseminated encephalomyelitis (ADEM) who presented initially with isolated LETM) were retrospectively examined for AQP4-ab and MOG-ab using cell-based assays.

RESULTS:

MOG-ab were found in 17 (9.8%) patients, AQP4-ab in 59 (34%), and both antibodies in two (1.1%). Among the 17 patients with MOG-ab alone, seven (41%) had ON, five (29%) LETM, four (24%) NMO, and one (6%) ADEM. Compared with patients with AQP4-ab, those with MOG-ab were significantly younger (median: 27 vs. 40.5 years), without female predominance (53% vs. 90%), and the clinical course was more frequently monophasic (41% vs. 7%) with a benign outcome (median Expanded Disability Status Scale: 1.5 vs. 4.0). In eight patients with paired serum-cerebrospinal fluid (CSF) samples, five had MOG-ab in both samples and three only in serum. Antibody titres did not differ among clinical phenotypes or disease course. MOG-ab remained detectable in 12/14 patients (median follow-up: 23 months) without correlation between titres' evolution and outcome.

CONCLUSION:

MOG-ab identify a subgroup of adult patients with NMO, LETM and ON that have better outcome than those associated with AQP4-ab. MOG-ab are more frequently detected in serum than CSF and the follow-up of titres does not correlate with outcome.

KEYWORDS:

Neuromyelitis optica; antibodies to myelin oligodendrocyte glycoprotein; aquaporin-4 antibody; longitudinally extensive myelitis; optic neuritis

PMID:
25344373
PMCID:
PMC4824843
DOI:
10.1177/1352458514555785
[Indexed for MEDLINE]
Free PMC Article

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