Features of anti-aquaporin 4 antibody-seropositive Chinese patients with neuromyelitis optica spectrum optic neuritis

Abstract

The detection of anti-aquaporin-4 autoantibody (AQP-4 Ab) is crucial to detect patients who will develop neuromyelitis optica (NMO); however, there are few studies on the AQP-4 Ab serostatus of patients with neuromyelitis optica spectrum ON. We analyzed the clinical and paraclinical features of neuromyelitis optica spectrum ON patients in China according to the patients' AQP4-Ab serostatus. 125 patients with recurrent and bilateral ON with simultaneous attacks were divided into AQP-4 Ab-seropositive and -seronegative groups. Demographic, clinical, serum autoantibody data, connective tissue disorders (CTDs), visual performance were compared. A Visual Acuity (VA) of less than 0.1 during acute ON attacks occurred more frequently in the seropositive group (p = 0.023); however, there was not a significant difference between groups on VA recovery after the first attack. The seropositive group experienced the worst outcome during the last attack (p = 0.017). Other co-existing autoimmunity antibodies (p < 0.001) and CTDs (p < 0.001) were more prevalent in seropositive patients. There were no significant differences on VA recovery and RNFLT combined with other autoantibodies or CTDs. The two groups did not differ significantly with regard to time to relapse, annualized relapse rates, time of diagnosis NMO, or RNFL. There were no significant differences on VA recovery and RNFLT combined with other autoantibodies or CTDs. RNFLT was thinner in NMO seropositive patients. Although AQP-4 Ab expression predicted poor visual outcome, positive patients were usually associated with mild symptoms at first onset. Anti-SSA/SSB antibody or Sjögren syndrome may be associated with AQP-4 Ab in neuromyelitis optica spectrum ON.

Clinical Characteristics, Treatment Outcomes and Predictive Factors in Optic Neuritis

“…Nevertheless, we found 17.2% in the idiopathic group which is higher than the NMOSD group and the MS group. The present study showed the majority of optic neuritis patients associated with demyelinating disease had normal disc appearance (89.6% in NMOSD, 78.3% in MS), which is quite different compared to other studies [ 2 , 24 , 41 ]. The final report by ONTT group about MS risks after optic neuritis concluded that patients without MRI brain lesion at the beginning of isolated optic neuritis attack did not develop MS when baseline exam showed severe optic disc swelling, disc or peripapillary hemorrhages, retinal or macular exudates and absence of pain.…”

“…In optic neuritis patients, AQP4-IgG was found in 0-11.4% patients in western countries and 9 – 35.2% in Asian countries [ 9 - 16 , 22 , 23 ]. This rate increased to 20-69.2% in recurrent optic neuritis [ 10 , 13 , 24 ]. We found 57.4% of the patients having at least one recurrent attack.…”

Distinct clinical characteristics of atypical optic neuritis with seronegative aquaporin-4 antibody among Chinese patients

“…Serum AQP4 antibody examination was performed by a live cell-staining immunofluorescence technique using transiently transfected AQP4-expressing cells, as described previously by our group 15. Sera were screened for antinuclear antibody (ANA), anti-Sigren syndrome A and anti-Sigren syndromeB (SSA and SSB), major histocompatibility complex-B27, rheumatoid factor, anticardiolipin antibodies (ACLs and b2-GPI), and antineutrophil cytoplasmic antibodies (ANCA) in the Examination Center for Biomedical Research of PLAGH.…”

Thickness of macular inner retinal layers and peripapillary retinal nerve fibre layer in neuromyelitis optica spectrum optic neuritis and isolated optic neuritis with one episode

“…Serum and CSF were collected from all patients for NMO-IgG testing. The presence of NMO-IgG was analysed by both commercial enzyme-linked immunosorbent assays (ELISA) kits and extracellular live cell-staining immunofluorescence technique using transiently transfected AQP4-expressing cells, as described in our previous reports (Li et al 2014(Li et al , 2015. All patients underwent a comprehensive ophthalmic examination and standardized treatments.…”