Aquaporin 4 Antibodies in the Cerebrospinal Fluid Are Helpful in Diagnosing Chinese Patients with Neuromyelitis Optica

Long, Youming; Qiu, Wei; Liu, Zhengqi; Bao, Jinsong; Wu, Ai-Min; Wang, Yuge; Wang, Honghao; Hu, Xueqiang

doi:10.1159/000330240

Cited by 28 publications

(17 citation statements)

References 57 publications

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“…CSF white blood cells (WBC), total protein concentration (TP), glucose (Glu), chloride (CL), NMO–immunoglobulin G (IgG), and the absence/presence of oligoclonal bands (OCB) were determined by the clinical laboratories at the Third Affiliated Hospital of Sun Yat‐sen University. The method of NMO‐IgG testing in serum was as described previously (Long et al., 2012). …”

Section: Methodsmentioning

confidence: 99%

Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders

Shu

Zhang

et al. 2016

Brain and Behavior

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IntroductionPrevious studies have shown that serum uric acid (UA) modulates outcomes of neurological diseases, although little is known about cerebrospinal fluid (CSF) UA levels in neuromyelitis optica spectrum disorders (NMOSDs).MethodsCerebrospinal fluid and serum UA levels were measured in samples from 68 patients, including NMOSDs during relapse (n = 38) and controls with noninflammatory and non‐neurodegenerative diseases (CTLs, n = 30). Correlation analysis was performed between CSF UA and clinical characteristics, serum UA, and blood–brain barrier integrity in NMOSDs.ResultsCerebrospinal fluid UA levels in NMOSDs were significantly higher than in CTLs (p = .002), while serum UA differences between NMOSDs and CTLs were not statistically significant. In NMOSDs, CSF UA levels were significantly higher in patients with an impaired blood–brain barrier than in patients with an intact one (p < .001), and significantly higher in longer disease duration than in shorter disease duration patients (p = .002). CSF UA levels were also significantly higher in active patients upon MRI than in inactive patients (p < .001), and significantly higher in patients with brain lesions than without brain lesions (p = .024). CSF UA was significantly associated with the serum UA levels (r = .454, p = .002), disease duration (r = .383, p = .018), and blood–brain barrier index (r = .805, p < .001), but did not correlate with age, gender, annualized relapse rate, duration, or severity of NMOSD. Multiple regression analysis demonstrated that CSF UA was independent of the blood–brain barrier index (β = .765, p < .001) and serum UA levels (β = .01, p = .019) in NMOSDs.ConclusionsCerebrospinal fluid UA levels were elevated in NMOSD patients during relapse, and were likely modified by serum UA levels and blood–brain barrier integrity.

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Section: Methodsmentioning

confidence: 99%

Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders

Shu

Zhang

et al. 2016

Brain and Behavior

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“…The anti-aquaporin-4 (AQP4) antibody status was determined by anti-AQP4 antibody assay on an anti-AQP4-transfected cell line from a commercial BIOCHIP kit (Euroimmun) [20]. …”

Section: Methodsmentioning

confidence: 99%

<b><i>Helicobacter pylori</i></b> Infection in Neuromyelitis Optica and Multiple Sclerosis

Long¹,

Gao²,

Qiu³

et al. 2012

Neuroimmunomodulation

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Objective: To determine the Helicobacter pylori infection status in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO) spectrum. Methods:H. pylori infection was certified by indirect immunofluorescence assay. Aquaporin-4 (AQP4) antibody was detected by cell-based assay. H. pylori seroprevalence was measured in 118 patients with NMO (n = 52), high-risk NMO (hrNMO, longitudinally extensive transverse myelitis, n = 17 and recurrent optic neuritis, n = 7), MS (n = 42) and healthy controls (n = 27). Logistic regression analysis was used to determine associations between H. pylori infection and NMO and MS. Results:H. pylori antibodies were present in 119 serum samples (82.1%, 119/145), with antibody positivity in 90.4% (47/52) of the patients with NMO, 95.8% (23/24) of the patients with hrNMO, 73.8% (31/42) of the patients with MS and 59.3% (16/27) of the controls. NMO spectrum patients had greater positivity for H. pylori than MS patients (p < 0.05) and controls (p < 0.05). The frequency of H. pylori seropositivity did not significantly differ between MS patients and controls (p = 0.726). H. pylori seropositivity was significantly higher in AQP4 antibody-positive patients (54/58, 93.1%; p = 0.038) than in AQP4 antibody-negative patients (48/60, 80%). Logistic regression analysis showed that H. pylori seropositivity was significantly associated with hrNMO [odds ratio (OR) = 9.311, p = 0.005] or hrNMO + NMO (OR = 6.350, p = 0.028). Conclusion:H. pylori infection was present in most Chinese patients with NMO and hrNMO, and may be a risk factor for the NMO spectrum.

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“…Unlike MS, NMO may be a disease mediated by humoral immunity. The serum autoantibody of aquaporin-4 (AQP4-Ab) is suggested to be a specific biomarker of NMO, which can help to distinguish it from MS [4,5,6]. …”

Section: Introductionmentioning

confidence: 99%

Notable Increased Cerebrospinal Fluid Levels of Soluble Interleukin-6 Receptors in Neuromyelitis Optica

Wang

Zhong

et al. 2012

Neuroimmunomodulation

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Background: IL-6 is a proinflammatory cytokine which is involved in the maintenance of the humoral response in various autoimmune disorders. Cerebrospinal fluid (CSF) IL-6 has shown to be increased in neuromyelitis optica (NMO). The soluble form of IL-6 receptor (sIL-6R), which links to IL-6, can activate biological responses in cells. Whether or not sIL-6R is altered in NMO has not been clarified. Objective: To measure CSF IL-6 and sIL-6R in NMO and multiple sclerosis (MS) patients, and investigate whether IL-6 and sIL-6R have possible uses as sensitive biomarkers for diseases activity. Methods: CSF concentrations of IL-6 and sIL-6R were measured by an ELISA in NMO (n = 22) and MS (n = 18) patients, as well as control subjects (n = 14). Results: The concentration of IL-6 levels were higher in NMO compared to MS (p = 0.032) and the controls (p = 0.023). The levels of sIL-6R were also higher in NMO compared to MS (p = 0.002) and the controls (p < 0.001). CSF sIL-6R was associated with an Expanded Disability Status Scale score in NMO (p = 0.005) but not in MS (p = 0.891). In the MS subgroup, sIL-6R concentrations were associated with CSF white blood cells (p = 0.034). Conclusions: Our study revealed that CSF sIL-6R was increased in NMO patients, and correlated with clinical presentations.

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Aquaporin 4 Antibodies in the Cerebrospinal Fluid Are Helpful in Diagnosing Chinese Patients with Neuromyelitis Optica

Cited by 28 publications

References 57 publications

Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders

Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders

<b><i>Helicobacter pylori</i></b> Infection in Neuromyelitis Optica and Multiple Sclerosis

Notable Increased Cerebrospinal Fluid Levels of Soluble Interleukin-6 Receptors in Neuromyelitis Optica

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