Antibodies to MOG in adults with inflammatory demyelinating disease of the CNS

Abstract

Objective:To evaluate the clinical relevance of myelin oligodendrocyte glycoprotein antibody (MOG-Ab) in a cohort of adults with inflammatory demyelinating disease (IDD) of the CNS.Methods:Live cell-based assays for MOG-Ab (IgG1 subset) and antibody to aquaporin-4 (AQP4-Ab) were performed in a cohort of 270 adult patients with IDD and 72 controls. Patients were first grouped by positive antibody result as MOG-Ab or AQP4-Ab, and the remainder were grouped by published diagnostic criteria.Results:Seventeen patients with IDD (6.3%) had MOG-Abs and 49 patients (18.1%) had AQP4-Abs; none had both antibodies. The MOG-Ab patients predominantly manifested with isolated symptoms of optic neuritis (83%). One-third of these patients experienced relapses, which involved only the optic nerve, and all relapsed within 1 year of disease onset. At onset, MRI in the MOG-Ab group uniquely demonstrated perineural enhancement, extending to the soft tissues around the optic nerves (33%). Although about 30% of MOG-Ab patients had brain MRI lesions, they had fewer periventricular lesions than the 26 patients with relapsing-remitting multiple sclerosis (MS); none of these lesions were ovoid or perpendicular to the ventricle. Moreover, MOG-Ab patients did not meet the diagnostic criteria for definite neuromyelitis optica (NMO) and had less spinal cord involvement than the AQP4-Ab group. Four patients (23.5%) had poor visual outcomes (<0.2) or paraplegia.Conclusions:MOG-Abs may be a disease-specific biomarker in adult patients with IDD who have a disease distinct from NMO or MS. The radiologic as well as clinical manifestations of MOG-Ab patients can be useful in their differential diagnosis.

Longitudinal analysis of myelin oligodendrocyte glycoprotein antibodies in CNS inflammatory diseases

“…In this cohort, MOG-IgG was detected in 4.4% (22/505) of patients and in 4.1% (10/243) of patients with NMOSD who fulfilled the IPND criteria. Seroprevalence of MOG-IgG was comparable with that of one previous study based on an unselected cohort with CNS inflammatory diseases (17/270, 6.3%),25 but was slightly lower than those of previous studies based on the selected NMOSD cohorts, which varied from 5.6% to 38% 7–13. However, the prevalence of NMOSD in patients with MOG-IgG could not be directly compared because the previous study was performed before introduction of the IPND criteria.…”

Multiple Autoantibodies and Neuromyelitis Optica Spectrum Disorders

“…Another explanation is that NMOSD, either as an initial presenting feature or as a complication of other autoimmune disorders, has gone unrecognized because AQP4-Ab has not been measured in patients with autoimmune disorders and suspected NMOSD. The third explanation is the limitation of testing myelin oligodendrocyte glycoprotein antibody, which is considered to contribute to NMOSD, and is related to inflammatory demyelinating disease of the central nervous system [25,26,27]. The investigation of myelin oligodendrocyte glycoprotein antibody could be an interesting avenue for further NMOSD research.…”

Diffusion tensor imaging for multilevel assessment of the visual pathway: possibilities for personalized outcome prediction in autoimmune disorders of the central nervous system

“…The discovery and investigation of aquaporin-4 (AQP4)-antibodies [21,[31][32][33][34][35] have revolutionized NMOSD diagnostics by setting the disease apart from MS [36,37] and substantially changing NMOSD treatment [38] which considerably differs from classic diseasemodifying treatment in MS [39][40][41][42][43][44][45][46][47][48]. However, especially against the background of emerging evidence on myelin oligodendrocyte glycoprotein (MOG) -antibody-positive cases related to NMOSD, the heterogeneous pathophysiology of NMOSD still needs to be fully elucidated [49][50][51][52][53][54][55][56][57][58].…”