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CSF GFAP levels in double seronegative neuromyelitis optica spectrum disorder: no evidence of astrocyte damage

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Item Type:Article
Title:CSF GFAP levels in double seronegative neuromyelitis optica spectrum disorder: no evidence of astrocyte damage
Creators Name:Hyun, J.W. and Kim, Y. and Kim, K.H. and Kim, S.H. and Olesen, M.N. and Asgari, N. and Siritho, S. and Paul, F. and Kim, H.J.
Abstract:BACKGROUND: Despite rigorous confirmation with reliable assays, some individuals showing the neuromyelitis optica spectrum disorder (NMOSD) phenotype remain negative for both aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies.: OBJECTIVE: We aimed to investigate whether double seronegative NMOSD (DN-NMOSD) and NMOSD with AQP4 antibody (AQP4-NMOSD) share the same pathophysiological basis, astrocytopathy, by measurement of cerebrospinal fluid (CSF) glial fibrillary acidic protein (GFAP) levels as a marker of astrocyte damage. METHODS: Seventeen participants who (1) satisfied the 2015 diagnostic criteria for NMOSD, and (2) tested negative for AQP4 and MOG antibodies confirmed with repeated cell-based assays, and (3) had available CSF samples obtained at the point of clinical attacks, were enrolled from 4 medical centers (South Korea, Germany, Thailand, and Denmark). Thirty age-matched participants with AQP4-NMOSD, 17 participants with MOG antibody associated disease (MOGAD), and 15 participants with other neurological disorders (OND) were included as controls. The concentration of CSF GFAP was measured using enzyme-linked immunosorbent assay. RESULTS: CSF GFAP levels in the DN-NMOSD group were significantly lower than those in the AQP4-NMOSD group (median: 0.49 versus 102.9 ng/mL; p < 0.001), but similar to those in the OND (0.25 ng/mL) and MOGAD (0.39 ng/mL) control groups. The majority (90% (27/30)) of participants in the AQP4-NMOSD group showed significantly higher CSF GFAP levels than the highest level measured in the OND group, while no participant in the DN-NMOSD and MOGAD groups did. CONCLUSIONS: These results suggest that DN-NMOSD has a different underlying pathogenesis other than astrocytopathy, distinct from AQP4-NMOSD.
Keywords:Neuromyelitis Optica Spectrum Disorder, Biomarker, Glial Fibrillary Acidic Protein, Astrocyte, Aquaporin-4, Myelin Oligodendrocyte Glycoprotein
Source:Journal of Neuroinflammation
Publisher:BioMed Central
Page Range:86
Date:12 April 2022
Official Publication:https://doi.org/10.1186/s12974-022-02450-w
PubMed:View item in PubMed

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