Antiacquaporin 4 antibodies detection by different techniques in neuromyelitis optica patients

Fazio, Raffaella; Malosio, Maria Luisa; Lampasona, Vito; Feo, Donatella De; Privitera, Daniela; Marnetto, Fabiana; Centonze, Diego; Ghezzi, Angelo; Comı, Gıancarlo; Furlan, Roberto; Martino, Gianvito

doi:10.1177/1352458509106851

Cited by 67 publications

(56 citation statements)

References 29 publications

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“…The presence of oligoclonal bands (OCB) of immunoglobulin G (IgG) restricted to the CSF is detected in only 15-30% of the patients [1]. The detection of AQP4-IgG is considered a serum biomarker [7,8] contributing to the diagnosis of NMO and to broaden its clinical spectrum. However, the AQP4-IgG seropositive rate depends on the assay type used [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…The detection of AQP4-IgG is considered a serum biomarker [7,8] contributing to the diagnosis of NMO and to broaden its clinical spectrum. However, the AQP4-IgG seropositive rate depends on the assay type used [8][9][10][11]. The cellbased assay, currently the gold standard, has 100% specificity and between 68% (commercial CBA) and 73% (Oxford CBA) sensitivity in contrast with the commercial ELISA assay that has 97.7% specificity and 70% sensitivity [11].…”

Section: Introductionmentioning

confidence: 99%

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Neuromyelitis optica in Portugal (NEMIPORT) – A multicentre study

Domingos

Isidoro

Figueiredo

et al. 2015

Clinical Neurology and Neurosurgery

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Results: Sixty-seven patients fulfilled the inclusion criteria. They were mainly Caucasian, 55 female. Median age at onset was 32.0 years and mean follow-up 7.4 ± 6.0 years. Twenty-one patients were definite NMO and optic neuritis (ON) the most frequent initial presentation. Forty-six were classified as NMO spectrum disorders. The main subtypes were recurrent ON and single longitudinally extensive transverse myelitis. Twenty-four patients had positive AQP4-IgG. Twenty-three had other circulating autoantibodies. Fifteen out of 67 patients had concomitant autoimmune disease. There was a significant correlation between the presence of autoimmune disease and the positivity for AQP4-IgG. Five patients died, all definite NMO. Conclusion: This is the first study about this rare disease in Portugal. Demographic features were similar to other studies. The existence of concomitant autoimmune disease was significantly associated with seropositivity for AQP4-IgG.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neuromyelitis optica in Portugal (NEMIPORT) – A multicentre study

Domingos

Isidoro

Figueiredo

et al. 2015

Clinical Neurology and Neurosurgery

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“…This has been confirmed in many studies, and the presence of such antibodies is now among the diagnostic criteria for NMO 5,6 .…”

Section: Discussionmentioning

confidence: 59%

“…A specific IgG autoantibody, NMO-IgG, selectively targeting aquaporin 4 (AQP4), which accumulates in the central nervous system (CNS) microvessels, pia, subpia, and Virchow-Robin space, has been confirmed by indirect immunofluorescence with a composite substrate of mouse tissue 3,4 . According to this antibody, the new diagnostic criteria for NMO proposed by Wingerchuk et al facilitate its distinction from multiple sclerosis (MS) 5,6 . In subsequent studies, analysis of pathological brain lesions in NMO patients revealed a pattern of vasculocentric immune complex deposition and AQP4 loss ORIGINAL ARTICLE identical to that seen in NMO lesions, suggesting that AQP4 antibodies are related to NMO pathology 7,8 .…”

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confidence: 99%

Serum-Positive and -Negative AQP4 Antibody NMO in Chinese Patients

Long

Liu

2012

Can. J. Neurol. Sci.

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232Neuromyelitis optica (NMO) is a severe idiopathic immunomediated inflammatory demyelinating and necrotizing disease that is characterized by transverse myelopathy and optic neuropathy. The exact etiology and mechanisms of NMO remain unknown. Serological and clinical evidence of B cell autoimmunity has been observed in a high proportion of patients, 1 suggesting a prominent role for humoral mechanisms in the pathogenesis of NMO. Neuromyelitis optica lesions show a marked deposition of immunoglobulins and complement in a characteristic perivascular rosette pattern along the outer rim of thickened vessel walls 2 . A specific IgG autoantibody, NMO-IgG, selectively targeting aquaporin 4 (AQP4), which accumulates in the central nervous system (CNS) microvessels, pia, subpia, and Virchow-Robin space, has been confirmed by indirect immunofluorescence with a composite substrate of mouse tissue 3,4 . According to this antibody, the new diagnostic criteria for NMO proposed by Wingerchuk et al facilitate its distinction from multiple sclerosis (MS) 5,6 . In subsequent studies, analysis of pathological brain lesions in NMO patients revealed a pattern of vasculocentric immune complex deposition and AQP4 loss ABSTRACT: Objective: To compare the clinical features of our sero-negative and sero-positive neuromyelitis optica (NMO) patients. Methods: Thirty-nine patients with NMO were recruited and analyzed retrospectively. Serum aquaporin 4 (AQP4) antibody status was determined by a cell-based assay. For the sero-negative patients, cerebrospinal fluid (CSF) and serum samples were re-tested using the cell-based assay and an indirect immunofluorescence assay. Results: By the cell-based assay, 30 patients (76.92%, 30/39), were positive for AQP4 antibodies in serum and 37 patients (94.9%, 37/39), had a CSF-positive antibody status. Seven NMO patients (17.9%, 7/39) were sero-negative by the cell-based assay but demonstrated positive CSF results. By indirect immunofluorescence, the remaining two patients, who had no AQP4 antibodies in serum or CSF by the cell-based assay, were positive for IgG antibodies in serum, which selectively targeted the central nervous system microvessels, pia, subpia, Virchow-Robin space, kidney, and stomach. There were no significant differences between the sero-positive and sero-negative NMO groups among their demographic and clinical data. Conclusions: Repeating the test using a different assay or CSF is helpful to clarify whether sero-negative NMO patients do in fact carry AQP4 antibodies. ORIGINAL ARTICLEidentical to that seen in NMO lesions, suggesting that AQP4 antibodies are related to NMO pathology 7,8 .Although more than 15 different immunoassays for the detection of AQP4 antibodies in patients with NMO have been developed, only a proportion of patients (33-91% among Western NMO cases and 41.7-91% among Japanese opticospinal MS (OSMS) are positive for AQP4 antibodies in serum 3,9,10 . In other words, the number of sero-negative NMO patients is not negligible.https://www.cambridge.org/core/terms. h...

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“…In the diagnosis section NMO-DBr takes into account the sensitivity variability of the AQP4 antibody assays [31][32][33][34][35][36] and the typical lesions which have been described on brain MRI 10,[12][13][14][15]24 . In addition to choices within the widely accepted NMO spectrum disorders 2,6 the system includes patients with formes frustres of NMO, typical lesions of NMO on brain MRI and AQP4-antibody seronegativity; and those who have brainstem syndrome, hypothalamic syndrome, or symptoms of encephalopathy in association typical lesions of NMO on brain MRI or AQP4-antibody seropositivity.…”

Section: Resultsmentioning

confidence: 99%

NMO-DBr: the Brazilian Neuromyelitis Optica Database System

Lana-Peixoto¹,

Talim²,

Faria-Campos

et al. 2011

Arq. Neuro-Psiquiatr.

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Objective: To present the Brazilian Neuromyelitis Optica Database System (NMO-DBr), a database system which collects, stores, retrieves, and analyzes information from patients with NMO and NMO-related disorders. Method: NMO-DBr uses Flux, a LIMS (Laboratory Information Management Systems) for data management. We used information from medical records of patients with NMO spectrum disorders, and NMO variants, the latter defined by the presence of neurological symptoms associated with typical lesions on brain magnetic resonance imaging (MRI) or aquaporin-4 antibody seropositivity. Results: NMO-DBr contains data related to patient's identification, symptoms, associated conditions, index events, recurrences, family history, visual and spinal cord evaluation, disability, cerebrospinal fluid and blood tests, MRI, optic coherence tomography, diagnosis and treatment. It guarantees confidentiality, performs cross-checking and statistical analysis. Conclusion: NMO-DBr is a tool which guides professionals to take the history, record and analyze information making medical practice more consistent and improving research in the area. Key words: NMO-DBr, Brazilian Neuromyelitis Optica Database System, neuromyelitis optica, NMO variants, database.NMO-DBr: o banco de dados brasileiro em neuromielite óptica RESUMO Objetivo: Apresentar o Brazilian Neuromyelitis Optica Database System (NMO-DBr), um sistema de banco de dados que coleta, arquiva, recupera e analisa informações de pacientes com neuromielite óptica (NMO) e doenças relacionadas. Método: NMO-DBr usa o sistema Flux, um LIMS (Laboratory Information Management Systems) para gerenciamento de informações. As informações foram colhidas dos prontuários de pacientes com espectro de NMO e variantes de NMO, estas últimas definidas por quadro neurológico associado a lesões encefálicas típicas à imagem pela ressonância magnética (IRM) ou à soropositividade do anticorpo anti-aquaporina-4. Resultados: NMO-DBr contém dados relativos a identificação, sintomas, condições associadas, eventos índices, recorrências, história familiar, avaliação visual e da medula, incapacidade, exames do líquor e de sangue, IRM, tomografia de coerência óptica (OCT), diagnóstico e tratamento. O sistema assegura confidencialidade, cruza dados e faz análises estatísticas. Conclusão: NMO-DBr é uma ferramenta que possibilita a prática médica mais consistente e promove a pesquisa na área. Palavras-chave: NMO-DBr, Brazilian Neuromyelitis Optica Database System, neuromielite óptica, variante de NMO, banco de dados.

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Antiacquaporin 4 antibodies detection by different techniques in neuromyelitis optica patients

Cited by 67 publications

References 29 publications

Neuromyelitis optica in Portugal (NEMIPORT) – A multicentre study

Neuromyelitis optica in Portugal (NEMIPORT) – A multicentre study

Serum-Positive and -Negative AQP4 Antibody NMO in Chinese Patients

NMO-DBr: the Brazilian Neuromyelitis Optica Database System

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