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Ann Indian Acad Neurol. 2016 Oct-Dec;19(4):505-509.

Serological markers associated with neuromyelitis optica spectrum disorders in South India.

Author information

1
Department of Neurology, KS Hegde Medical College, Nitte University, Mangalore, Karnataka, India.
2
Department of Neurology and Multiple Sclerosis Therapeutics, Tohoku University, Graduate School of Medicine, Sendai, Miyagi, Japan; Department of Neurology, Brain Institute, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
3
Department of Neurology, Yonezawa National Hospital, Yonezawa, Yamagata, Japan.
4
Department of Neurology and Multiple Sclerosis Therapeutics, Tohoku University, Graduate School of Medicine, Sendai, Miyagi, Japan.

Abstract

BACKGROUND:

Neuromyelitis optica spectrum disorders (NMOSDs) represent 20% of all demyelinating disorders in South India. No studies have determined the seroprevalence to both antibodies against aquaporin-4* and antimyelin oligodendrocyte glycoprotein antibody (anti-MOG+) in this population.

OBJECTIVE:

To identify and characterize seropositive patients for anti-aquaporin-4 antibody (anti-AQP4+) and anti-MOG+ in South India.

MATERIALS AND METHODS:

We included 125 consecutive patients (15 children) who were serologically characterized using live transfected cells to human M23-AQP4 or full-length MOG.

RESULTS:

Among a total of 125 patients, 30.4% of patients were anti-AQP4+, 20% were anti-MOG+, and 49.6% were seronegative. No patient was positive for both. Anti-MOG+ patients represented 28.7% (25/87) of seronegative NMOSD. In comparison to anti-AQP4+ patients, anti-MOG+ patients were commonly male, had less frequent attacks and milder disability on expanded disability status score scale. Seronegative patients were also predominantly male, 36% (9/25) had monophasic longitudinally extensive transverse myelitis and disability was comparable with anti-AQP4+ patients. Lumbar cord involvement was common in anti-MOG+ and seronegatives, whereas anti-AQP4+ patients had more cervical lesions.

CONCLUSION:

Anti-AQP4+/anti-MOG + patients accounted for nearly half of the patients suspected of having NMOSD in South India, indicating that antibody testing may be useful on the management of subgroups with different prognosis.

KEYWORDS:

Antibody; India; aquaporin-4; myelin oligodendrocyte glycoprotein; neuromyelitis optica

Conflict of interest statement

Authors Lekha Pandit, Sharik Mustafa, Anitha D’Cunha, Chaithra Malli, Akshatha Sudhir, and Toshiyuki Takahashi have no conflict of interest to disclose. Dr. Sato has received a scholarship from the Ministry of Education, Culture, Sports, Science, and Technology of Japan, grant-in-aid for scientific research from the Japan Society for the Promotion of Science (KAKENHI 15K19472), research support from CAPES/Brasil (CSF-PAJT - 88887.091277/2014-00), and speaker honoraria from Novartis. Dr. Fujihara serves on scientific advisory boards for Bayer Schering Pharma, Biogen Idec, Mitsubishi Tanabe Pharma Corporation, Novartis Pharma, Chugai Pharmaceutical, Ono Pharmaceutical, Nihon Pharmaceutical, Merck Serono, Alexion Pharmaceuticals, Medimmune, and Medical Review; has received funding for travel and speaker honoraria from Bayer Schering Pharma, Biogen Idec, Eisai Inc., Mitsubishi Tanabe Pharma Corporation, Novartis Pharma, Astellas Pharma Inc., Takeda Pharmaceutical Company Limited, Asahi Kasei Medical Co., Daiichi Sankyo, and Nihon Pharmaceutical, serve as an editorial board member of Clinical and Experimental Neuroimmunology (2009-present) and an advisory board member of Sri Lanka Journal of Neurology has received research support from Bayer Schering Pharma, Biogen Idec Japan, Asahi Kasei Medical, The Chemo-Sero-Therapeutic Research Institute, Teva Pharmaceutical, Mitsubishi Tanabe Pharma, Teijin Pharma, Chugai Pharmaceutical, Ono Pharmaceutical, Nihon Pharmaceutical, and Genzyme Japan, is funded as the secondary investigator (#22229008, 2010–2015) by the grants-in-aid for scientific research from the Ministry of Education, Science, and Technology of Japan and as the secondary investigator by the grants-in-aid for scientific research from the Ministry of Health, Welfare, and Labor of Japan (2010-present).

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