Autoantibody to MOG suggests two distinct clinical subtypes of NMOSD  

作　　者：Yaping Yan Yujing Li Ying Fu Li Yang Lei Su Kaibin Shi Minshu Li Qiang Liu Aimee Borazanci Yaou Liu Yong He Jeffrey L Bennett Timothy L Vollmer Fu-Dong Shi 

机构地区：[1]Departments of Neurology and Immunology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, China [2]Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix 85013, USA [3]State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University Beijing 100875, China [4]Department of Neurology, University of Colorado School of Medicine, Aurora 80045, USA

出　　处：《Science China(Life Sciences)》2016年第12期1270-1281,共12页中国科学（生命科学英文版）

基　　金：supported by National Basic Research Program of China Grant (2013CB96690);the Natural Science Foundation of China Grants (81100888, 81230028, 81371372);the National Key Clinical Specialty Construction Program of China;US National Institute of Health (R01AI083294);the American Heart Association (14GRNT18970031)

摘　　要：We characterized a unique group of patients with neuromyelitis optica spectrum disorder （NMOSD） who carded autoantibod- ies of aquaporin-4 （AQP4） and myelin-oligodendrocyte glycoprotein （MOG）. Among the 125 NMOSD patients, 10 （8.0%） were AQP4- and MOG-ab double positive, and 14 （11.2%） were MOG-ab single positive. The double-positive patients had a multiphase disease course with a high annual relapse rate （P=0.0431）, and severe residual disability （P〈0.0001）. Of the dou- ble-positive patients, 70% had MS-like brain lesions, more severe edematous, multifocal regions on spinal magnetic resonance imaging （MRI）, pronounced decreases of retinal nerve fiber layer thickness and atrophy of optic nerves. In contrast, patients with only MOG-ab had a higher ratio of monophasic disease course and mild residual disability. Spinal cord MRI illustrated multifocal cord lesions with mild edema, and brain MRIs showed more lesions around lateral ventricles. NMOSD patients carrying both autoantibodies to AQP4 and MOG existed and exhibited combined features of prototypic NMO and relaps- ing-remitting form of MS, whereas NMOSD with antibodies to MOG only exhibited an ＂intermediate＂ phenotype between NMOSD and MS. Our study suggests that antibodies against MOG might be pathogenic in NMOSD patients and that determi- nation of anti-MOG antibodies maybe instructive for management of NMOSD patients.We characterized a unique group of patients with neuromyelitis optica spectrum disorder(NMOSD) who carried autoantibodies of aquaporin-4(AQP4) and myelin-oligodendrocyte glycoprotein(MOG). Among the 125 NMOSD patients, 10(8.0%) were AQP4- and MOG-ab double positive, and 14(11.2%) were MOG-ab single positive. The double-positive patients had a multiphase disease course with a high annual relapse rate(P=0.0431), and severe residual disability(P<0.0001). Of the double-positive patients, 70% had MS-like brain lesions, more severe edematous, multifocal regions on spinal magnetic resonance imaging(MRI), pronounced decreases of retinal nerve fiber layer thickness and atrophy of optic nerves. In contrast, patients with only MOG-ab had a higher ratio of monophasic disease course and mild residual disability. Spinal cord MRI illustrated multifocal cord lesions with mild edema, and brain MRIs showed more lesions around lateral ventricles. NMOSD patients carrying both autoantibodies to AQP4 and MOG existed and exhibited combined features of prototypic NMO and relapsing-remitting form of MS, whereas NMOSD with antibodies to MOG only exhibited an "intermediate" phenotype between NMOSD and MS. Our study suggests that antibodies against MOG might be pathogenic in NMOSD patients and that determination of anti-MOG antibodies maybe instructive for management of NMOSD patients.

关 键 词：MOG antibody AQP4 antibody neuromyelitis optica spectrum disorder PHENOTYPE 

分 类 号：R744.5[医药卫生—神经病学与精神病学]