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| Item Type: | Article |
|---|---|
| Title: | MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 1: Frequency, syndrome specificity, influence of disease activity, long-term course, association with AQP4-IgG, and origin |
| Creators Name: | Jarius, S., Ruprecht, K., Kleiter, I., Borisow, N., Asgari, N., Pitarokoili, K., Pache, F., Stich, O., Beume, L.A., Hümmert, M.W., Trebst, C., Ringelstein, M., Aktas, O., Winkelmann, A., Buttmann, M., Schwarz, A., Zimmermann, H., Brandt, A.U., Franciotta, D., Capobianco, M., Kuchling, J., Haas, J., Korporal-Kuhnke, M., Lillevang, S.T., Fechner, K., Schanda, K., Paul, F., Wildemann, B. and Reindl, M. |
| Abstract: | BACKGROUND: Antibodies to myelin oligodendrocyte glycoprotein (MOG-IgG) have been suggested to play a role in a subset of patients with neuromyelitis optica and related disorders. OBJECTIVE: To assess (i) the frequency of MOG-IgG in a large and predominantly Caucasian cohort of patients with optic neuritis (ON) and/or myelitis; (ii) the frequency of MOG-IgG among AQP4-IgG-positive patients and vice versa; (iii) the origin and frequency of MOG-IgG in the cerebrospinal fluid (CSF); (iv) the presence of MOG-IgG at disease onset; and (v) the influence of disease activity and treatment status on MOG-IgG titers. METHODS: 614 serum samples from patients with ON and/or myelitis and from controls, including 92 follow-up samples from 55 subjects, and 18 CSF samples were tested for MOG-IgG using a live cell-based assay (CBA) employing full-length human MOG-transfected HEK293A cells. RESULTS: MOG-IgG was detected in 95 sera from 50 patients with ON and/or myelitis, including 22/54 (40.7 %) patients with a history of both ON and myelitis, 22/103 (21.4 %) with a history of ON but no myelitis and 6/45 (13.3 %) with a history of longitudinally extensive transverse myelitis but no ON, and in 1 control patient with encephalitis and a connective tissue disorder, all of whom were negative for AQP4-IgG. MOG-IgG was absent in 221 further controls, including 83 patients with AQP4-IgG-seropositive neuromyelitis optica spectrum disorders and 85 with multiple sclerosis (MS). MOG-IgG was found in 12/18 (67 %) CSF samples from MOG-IgG-seropositive patients; the MOG-IgG-specific antibody index was negative in all cases, indicating a predominantly peripheral origin of CSF MOG-IgG. Serum and CSF MOG-IgG belonged to the complement-activating IgG1 subclass. MOG-IgG was present already at disease onset. The antibodies remained detectable in 40/45 (89 %) follow-up samples obtained over a median period of 16.5 months (range 0-123). Serum titers were higher during attacks than during remission (p < 0.0001), highest during attacks of simultaneous myelitis and ON, lowest during acute isolated ON, and declined following treatment. CONCLUSIONS: To date, this is the largest cohort studied for IgG to human full-length MOG by means of an up-to-date CBA. MOG-IgG is present in a substantial subset of patients with ON and/or myelitis, but not in classical MS. Co-existence of MOG-IgG and AQP4-IgG is highly uncommon. CSF MOG-IgG is of extrathecal origin. Serum MOG-IgG is present already at disease onset and remains detectable in the long-term course. Serum titers depend on disease activity and treatment status. |
| Keywords: | Neuromyelitis Optica (NMO), Devic's Syndrome, Optic Neuritis, Transverse Myelitis, Longitudinally Extensive Transverse Myelitis (LETM), Neuromyelitis Optica Spectrum Disorders (NMOSD), Multiple Sclerosis, Autoantibodies, Myelin Oligodendrocyte Glycoprotein Antibodies (MOG-IgG), Neuromyelitis Optica Antibodies (NMO-IgG), Aquaporin-4 Antibodies (AQP4-IgG), Cell-Based Assays, Cerebrospinal Fluid, Antibody Index |
| Source: | Journal of Neuroinflammation |
| ISSN: | 1742-2094 |
| Publisher: | BioMed Central |
| Volume: | 13 |
| Number: | 1 |
| Page Range: | 279 |
| Date: | 26 September 2016 |
| Official Publication: | https://doi.org/10.1186/s12974-016-0717-1 |
| PubMed: | View item in PubMed |
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