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Antibodies to MOG in adults with inflammatory demyelinating disease of the CNS.

Kim SM, Woodhall MR, Kim JS, Kim SJ, Park KS, Vincent A, Lee KW, Waters P - Neurol Neuroimmunol Neuroinflamm (2015)

Bottom Line: Moreover, MOG-Ab patients did not meet the diagnostic criteria for definite neuromyelitis optica (NMO) and had less spinal cord involvement than the AQP4-Ab group.Four patients (23.5%) had poor visual outcomes (<0.2) or paraplegia.The radiologic as well as clinical manifestations of MOG-Ab patients can be useful in their differential diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology (S.-M.K., J.-S.K., K.S.P., K.-W.L.) and Ophthalmology (S.-J.K.), Seoul National University College of Medicine, Seoul, Republic of Korea; Nuffield Department of Clinical Neurosciences (M.R.W., A.V., P.W.), John Radcliffe Hospital, Oxford, United Kingdom; and Department of Neurology (K.S.P.), Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea.

ABSTRACT

Objective: To evaluate the clinical relevance of myelin oligodendrocyte glycoprotein antibody (MOG-Ab) in a cohort of adults with inflammatory demyelinating disease (IDD) of the CNS.

Methods: Live cell-based assays for MOG-Ab (IgG1 subset) and antibody to aquaporin-4 (AQP4-Ab) were performed in a cohort of 270 adult patients with IDD and 72 controls. Patients were first grouped by positive antibody result as MOG-Ab or AQP4-Ab, and the remainder were grouped by published diagnostic criteria.

Results: Seventeen patients with IDD (6.3%) had MOG-Abs and 49 patients (18.1%) had AQP4-Abs; none had both antibodies. The MOG-Ab patients predominantly manifested with isolated symptoms of optic neuritis (83%). One-third of these patients experienced relapses, which involved only the optic nerve, and all relapsed within 1 year of disease onset. At onset, MRI in the MOG-Ab group uniquely demonstrated perineural enhancement, extending to the soft tissues around the optic nerves (33%). Although about 30% of MOG-Ab patients had brain MRI lesions, they had fewer periventricular lesions than the 26 patients with relapsing-remitting multiple sclerosis (MS); none of these lesions were ovoid or perpendicular to the ventricle. Moreover, MOG-Ab patients did not meet the diagnostic criteria for definite neuromyelitis optica (NMO) and had less spinal cord involvement than the AQP4-Ab group. Four patients (23.5%) had poor visual outcomes (<0.2) or paraplegia.

Conclusions: MOG-Abs may be a disease-specific biomarker in adult patients with IDD who have a disease distinct from NMO or MS. The radiologic as well as clinical manifestations of MOG-Ab patients can be useful in their differential diagnosis.

No MeSH data available.


Related in: MedlinePlus

Percent positivity by clinical featureOverall, 6.3% of patients with inflammatory demyelinating disease were myelin oligodendrocyte glycoprotein antibody (MOG-Ab) positive (black) and 18.1% were aquaporin-4 antibody (AQP4-Ab) positive (blue). The majority of MOG patients had optic neuritis (ON), whereas the majority of AQP4 patients had either neuromyelitis optica (NMO) or acute transverse myelitis (ATM). Just over 50% of patients with recurrent or bilateral ON were antibody-positive. ADEM = acute disseminated encephalomyelitis.
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Figure 1: Percent positivity by clinical featureOverall, 6.3% of patients with inflammatory demyelinating disease were myelin oligodendrocyte glycoprotein antibody (MOG-Ab) positive (black) and 18.1% were aquaporin-4 antibody (AQP4-Ab) positive (blue). The majority of MOG patients had optic neuritis (ON), whereas the majority of AQP4 patients had either neuromyelitis optica (NMO) or acute transverse myelitis (ATM). Just over 50% of patients with recurrent or bilateral ON were antibody-positive. ADEM = acute disseminated encephalomyelitis.

Mentions: MOG-Abs were most frequent in patients with recurrent or bilateral ON (10/30; 33.3%) or those with a single ON attack (4/27; 14.8%), whereas only 1/125 patients with ATM (0.8%), 1/7 with ADEM (14.3%), and none with definite NMO (n = 23) had MOG-Abs. AQP4-Ab positivity was found in patients with definite NMO (20/23; 87.0%) but also in patients with recurrent or bilateral ON (5/30; 16.7%), ADEM (1/7; 14.3%), or ATM (17/125; 13.6%). The assay results are summarized in figure e-1, and the proportion of each disease group with MOG- and AQP4-Abs is shown in figure 1.


Antibodies to MOG in adults with inflammatory demyelinating disease of the CNS.

Kim SM, Woodhall MR, Kim JS, Kim SJ, Park KS, Vincent A, Lee KW, Waters P - Neurol Neuroimmunol Neuroinflamm (2015)

Percent positivity by clinical featureOverall, 6.3% of patients with inflammatory demyelinating disease were myelin oligodendrocyte glycoprotein antibody (MOG-Ab) positive (black) and 18.1% were aquaporin-4 antibody (AQP4-Ab) positive (blue). The majority of MOG patients had optic neuritis (ON), whereas the majority of AQP4 patients had either neuromyelitis optica (NMO) or acute transverse myelitis (ATM). Just over 50% of patients with recurrent or bilateral ON were antibody-positive. ADEM = acute disseminated encephalomyelitis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608758&req=5

Figure 1: Percent positivity by clinical featureOverall, 6.3% of patients with inflammatory demyelinating disease were myelin oligodendrocyte glycoprotein antibody (MOG-Ab) positive (black) and 18.1% were aquaporin-4 antibody (AQP4-Ab) positive (blue). The majority of MOG patients had optic neuritis (ON), whereas the majority of AQP4 patients had either neuromyelitis optica (NMO) or acute transverse myelitis (ATM). Just over 50% of patients with recurrent or bilateral ON were antibody-positive. ADEM = acute disseminated encephalomyelitis.
Mentions: MOG-Abs were most frequent in patients with recurrent or bilateral ON (10/30; 33.3%) or those with a single ON attack (4/27; 14.8%), whereas only 1/125 patients with ATM (0.8%), 1/7 with ADEM (14.3%), and none with definite NMO (n = 23) had MOG-Abs. AQP4-Ab positivity was found in patients with definite NMO (20/23; 87.0%) but also in patients with recurrent or bilateral ON (5/30; 16.7%), ADEM (1/7; 14.3%), or ATM (17/125; 13.6%). The assay results are summarized in figure e-1, and the proportion of each disease group with MOG- and AQP4-Abs is shown in figure 1.

Bottom Line: Moreover, MOG-Ab patients did not meet the diagnostic criteria for definite neuromyelitis optica (NMO) and had less spinal cord involvement than the AQP4-Ab group.Four patients (23.5%) had poor visual outcomes (<0.2) or paraplegia.The radiologic as well as clinical manifestations of MOG-Ab patients can be useful in their differential diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology (S.-M.K., J.-S.K., K.S.P., K.-W.L.) and Ophthalmology (S.-J.K.), Seoul National University College of Medicine, Seoul, Republic of Korea; Nuffield Department of Clinical Neurosciences (M.R.W., A.V., P.W.), John Radcliffe Hospital, Oxford, United Kingdom; and Department of Neurology (K.S.P.), Seoul National University Bundang Hospital, Gyeonggi, Republic of Korea.

ABSTRACT

Objective: To evaluate the clinical relevance of myelin oligodendrocyte glycoprotein antibody (MOG-Ab) in a cohort of adults with inflammatory demyelinating disease (IDD) of the CNS.

Methods: Live cell-based assays for MOG-Ab (IgG1 subset) and antibody to aquaporin-4 (AQP4-Ab) were performed in a cohort of 270 adult patients with IDD and 72 controls. Patients were first grouped by positive antibody result as MOG-Ab or AQP4-Ab, and the remainder were grouped by published diagnostic criteria.

Results: Seventeen patients with IDD (6.3%) had MOG-Abs and 49 patients (18.1%) had AQP4-Abs; none had both antibodies. The MOG-Ab patients predominantly manifested with isolated symptoms of optic neuritis (83%). One-third of these patients experienced relapses, which involved only the optic nerve, and all relapsed within 1 year of disease onset. At onset, MRI in the MOG-Ab group uniquely demonstrated perineural enhancement, extending to the soft tissues around the optic nerves (33%). Although about 30% of MOG-Ab patients had brain MRI lesions, they had fewer periventricular lesions than the 26 patients with relapsing-remitting multiple sclerosis (MS); none of these lesions were ovoid or perpendicular to the ventricle. Moreover, MOG-Ab patients did not meet the diagnostic criteria for definite neuromyelitis optica (NMO) and had less spinal cord involvement than the AQP4-Ab group. Four patients (23.5%) had poor visual outcomes (<0.2) or paraplegia.

Conclusions: MOG-Abs may be a disease-specific biomarker in adult patients with IDD who have a disease distinct from NMO or MS. The radiologic as well as clinical manifestations of MOG-Ab patients can be useful in their differential diagnosis.

No MeSH data available.


Related in: MedlinePlus