Epidemiology of aquaporin-4 autoimmunity and neuromyelitis optica spectrum.
Epidemiology of aquaporin-4 autoimmunity and neuromyelitis optica spectrum.
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DOI：
10.1002/ana.24617
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发表时间：
2016-05
影响因子：
11.2
通讯作者：
Pittock SJ
中科院分区：
文献类型：
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作者：
Flanagan EP;Cabre P;Weinshenker BG;Sauver JS;Jacobson DJ;Majed M;Lennon VA;Lucchinetti CF;McKeon A;Matiello M;Kale N;Wingerchuk DM;Mandrekar J;Sagen JA;Fryer JP;Robinson AB;Pittock SJ
视神经脊髓炎及其谱系疾病 (NMOSD) 是一种具有特定生物标志物 aquaporin-4-IgG 的炎症性脱髓鞘疾病 (IDD)。先前的 NMO/NMOSD 流行病学研究因缺乏水通道蛋白 4-IgG 血清流行率评估、缺乏基于美国人群的研究以及黑人代表性不足而受到限制。为了克服这些限制，我们试图比较两个不同种族人群的 NMO/NMOSD 血清流行病学。我们对美国奥姆斯特德县（82% 白人[高加索人]）和马提尼克岛（90% 黑人）的 IDD 诊断患者中的 NMO/NMOSD 和水通道蛋白-4-IgG 血清发生率和血清流行率（在 80-84% IDD 中收集血清）的发病率（2003-2011 年）和患病率（2011 年 12 月 31 日）进行了一项基于人群的比较研究[非洲裔加勒比]）。 Aquaporin-4-IgG 通过 M1 同工型荧光激活细胞分选测定进行测量。马提尼克岛经年龄和性别调整后的发病率（7.3 vs 0.7/1,000,000 人年 [p<0.01]）和患病率（10 vs 3.9/100,000[p=0.01]）超过了奥姆斯特德县。马提尼克岛的 AQP4-IgG 年龄和性别调整血清发生率（6.5 vs 0.7/1,000,000 人年 [p<0.01]）和血清阳性率（7.9 vs 3.3/100,000[p=0.04]）也高于奥姆斯特德县。马提尼克县和奥姆斯特德县的种族特定患病率相似：黑人分别为 11.5 和 13/100,000，白人分别为 6.1 和 4.0/100,000。马提尼克岛的 NMO/NMOSD 代表 IDD 的比例高于奥姆斯特德县（16% vs 1.4%；p<0.01）。两个人群的发病年龄（中位年龄 35-37 岁）和女性：男性分布（8-9:1）相似； 60% 的流行病例要么一只眼睛失明，要么依赖步态辅助设备，或者两者兼而有之。这项研究报告了 NMO/NMOSD 在所有人群中的患病率最高（马提尼克岛为 10/100,000），估计其影响美国 16,000-17,000 人（高于之前的预测），并证明其对黑人的影响尤为严重。
Neuromyelitis optica and its spectrum disorders (NMOSD) are inflammatory demyelinating diseases (IDD) with a specific biomarker, aquaporin-4-IgG. Prior NMO/NMOSD epidemiological studies are limited by lack of aquaporin-4-IgG seroprevalence assessment, absence of population-based USA studies and under-representation of blacks. To overcome these limitations, we sought to compare NMO/NMOSD seroepidemiology across two ethnically divergent populations. We performed a population-based comparative study of the incidence (2003–2011) and prevalence (on December 31, 2011) of NMO/NMOSD and aquaporin-4-IgG seroincidence and seroprevalence (sera collected in 80–84% of IDD) among patients with IDD diagnosis in Olmsted County, USA (82% white [Caucasian]) and Martinique (90% black [Afro-Caribbean]). Aquaporin-4-IgG was measured by M1-isoform-fluorescent-activated-cell-sorting assays. The age and sex adjusted incidence (7.3 vs 0.7/1,000,000 person-years [p<0.01]) and prevalence (10 vs 3.9/100,000[p=0.01]) in Martinique exceeded that in Olmsted County. The AQP4-IgG age and sex-adjusted seroincidence (6.5 vs 0.7/1,000,000 person-years [p<0.01]) and seroprevalence (7.9 vs 3.3/100,000[p=0.04]) were also higher in Martinique than Olmsted County. The ethnicity-specific prevalence was similar in Martinique and Olmsted County: 11.5 and 13/100,000 in blacks, and 6.1 and 4.0/100,000 in whites, respectively. NMO/NMOSD represented a higher proportion of IDD in Martinique than Olmsted County (16% vs 1.4%; p<0.01). The onset age (median, 35–37 years) and female:male distribution (8–9:1) were similar across both populations; 60% of prevalent cases were either blind in one eye, dependent on a gait aid or both. This study reports the highest prevalence of NMO/NMOSD in any population (10/100,000 in Martinique), estimates it affects 16,000–17,000 in the USA (higher than previous predictions) and demonstrates it disproportionately affects blacks.