A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis

Lennon, Vanda A.; Wingerchuk, Dean M.; Kryzer, Thomas J.; Pittock, Sean J.; Lucchinetti, Claudia F.; Fujihara, Kazuo; Nakashima, Ichiro; Weinshenker, Brian G.

doi:10.1016/s0140-6736(04)17551-x

Cited by 2,912 publications

(2,305 citation statements)

References 18 publications

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“…Four patients had evidence of increased CSF OCBs: 1 patient with SS/NMOSD (4 bands), 1 with NMO alone (2 bands), and the 2 with MS (13 and 15 bands). Finally, testing for serum NMO-IgG is recommended in all cases of suspected NMO/NMOSD, given its high specificity for disease and therefore the ability to differentiate from MS as well as CTD without high-risk features (LM or recurrent ON) (1,37,38). The recognition of these features in subjects with CTD and inflammatory myelitis is crucial, as patients with concurrent NMO have a high risk of disease relapse, as do some patients with NMO-IgG positivity (5,6).…”

Section: Discussionmentioning

confidence: 99%

“…Serum NMO-IgG antibody testing was performed by Mayo Medical Laboratories at the Mayo Clinic (Rochester, Minnesota). All of the samples were tested using an indirect immunofluorescence assay as previously described (1). Statistical comparisons were calculated using Fisher's exact testing; all analyses were performed using SAS, version 9.2.…”

Section: Methodsmentioning

confidence: 99%

“…The clinical syndrome was first described by Devic and Gault in 1894, and was considered a variant of multiple sclerosis (MS). A resurgence of interest has followed the recent identification of a disease-specific autoantibody, NMO-IgG, and its target antigen, the aquaporin 4 (AQP-4) receptor (1). NMO is classically defined by the presence of both optic neuritis (ON) and longitudinal myelitis (LM), with contiguous spinal cord involvement spanning 3 or more vertebrae.…”

Section: Introductionmentioning

confidence: 99%

“…Formal diagnosis requires the presence of transverse myelitis (TM), ON, and 2 of 3 supporting criteria (Figure 1), one of which is the serum NMO-IgG antibody. The sensitivity of this assay ranges from 60 -70%, with a specificity of Ͼ90% (1,4).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

Kolfenbach

Horner

Ferucci

et al. 2011

Arthritis Care & Research

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

Kolfenbach

Horner

Ferucci

et al. 2011

Arthritis Care & Research

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“…In 75% of NMOSD patients, autoreactive B cells produce antibodies against the aquaporin‐4 (AQP4) water channel (AQP4‐IgG) 2, 3. In the central nervous system (CNS), AQP4 is highly expressed on astrocyte end‐feet, and AQP4‐IgG has been shown to initiate an inflammatory cascade that ultimately leads to demyelination and neuronal injury 1, 4, 5.…”

Section: Introductionmentioning

confidence: 99%

CNS Aquaporin‐4‐specific B cells connect with multiple B‐cell compartments in neuromyelitis optica spectrum disorder

Kowarik

Astling

Gasperi

et al. 2017

Ann Clin Transl Neurol

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ObjectivesNeuromyelitis optica spectrum disorder (NMOSD) is a severe inflammatory disorder of the central nervous system (CNS) targeted against aquaporin‐4 (AQP4). The origin and trafficking of AQP4‐specific B cells in NMOSD remains unknown.MethodsPeripheral (n = 7) and splenic B cells (n = 1) recovered from seven NMOSD patients were sorted into plasmablasts, naïve, memory, and CD27‐IgD‐ double negative (DN) B cells, and variable heavy chain (VH) transcriptome sequences were generated by deep sequencing. Peripheral blood (PB) VH repertoires were compared to the same patient's single‐cell cerebrospinal fluid (CSF) plasmablast (PB) VH transcriptome, CSF immunoglobulin (Ig) proteome, and serum Ig proteome. Recombinant antibodies were generated from paired CSF heavy‐ and light chains and tested for AQP4 reactivity.ResultsApproximately 9% of the CSF VH sequences aligned with PB memory B cells, DN B cells, and plasmablast VH sequences. AQP4‐specific VH sequences were observed in each peripheral B‐cell compartment. Lineage analysis of clonally related VH sequences indicates that CSF AQP4‐specific B cells are closely related to an expanded population of DN B cells that may undergo antigen‐specific B‐cell maturation within the CNS. CSF and serum Ig proteomes overlapped with the VH sequences from each B‐cell compartment; the majority of matches occurring between the PB VH sequences and serum Ig proteome.InterpretationDuring an acute NMOSD relapse, a dynamic exchange of B cells occurs between the periphery and CNS with AQP4‐specific CSF B cells emerging from postgerminal center memory B cells and plasmablasts. Expansion of the PB DN B‐cell compartment may be a potential biomarker of NMOSD activity.

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Neuromyelitis Optica IgG Status in Acute Partial Transverse Myelitis

Scott

Kassab

Pittock³

2006

Arch Neurol

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Background: Neuromyelitis optica (NMO) IgG is a specific marker for NMO. Furthermore, a high proportion of patients with longitudinally extensive transverse myelitis (characterized by spinal cord lesions extending 3 vertebral segments or more on magnetic resonance imaging) are seropositive for NMO-IgG and are considered to have a limited form of NMO. The NMO-IgG status in mild cases of acute partial transverse myelitis asociated with minimal magnetic resonance imaging abnormalities (spinal cord lesions Ͻ2 vertebral segments on magnetic resonance imaging) is unknown. Objective: To investigate the NMO-IgG status of patients with acute partial transverse myelitis and a normal cerebral magnetic resonance image.

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A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis

Cited by 2,912 publications

References 18 publications

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

Neuromyelitis optica spectrum disorder in patients with connective tissue disease and myelitis

CNS Aquaporin‐4‐specific B cells connect with multiple B‐cell compartments in neuromyelitis optica spectrum disorder

Neuromyelitis Optica IgG Status in Acute Partial Transverse Myelitis

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