Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder.
Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder.
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DOI：
10.1212/wnl.0000000000012175
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发表时间：
2021-07-06
期刊：
影响因子：
9.9
通讯作者：
Nakashima I
中科院分区：
文献类型：
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作者：
Akaishi T;Takahashi T;Misu T;Kaneko K;Takai Y;Nishiyama S;Ogawa R;Fujimori J;Ishii T;Aoki M;Fujihara K;Nakashima I
阐明抗水通道蛋白4抗体（AQP 4-IgG）和抗髓鞘少突胶质细胞糖蛋白抗体（MOG-IgG）在鞘内合成来源和水平上的差异。对38例MOG-IgG相关性疾病和36例AQP 4-IgG阳性的视神经肌萎缩性疾病（NMOSD）患者进行了急性发作期血清和脑脊液抗体滴度的检测。计算CSF和血清白蛋白、总免疫球蛋白G和每种疾病特异性抗体水平之间的比值。通过计算这些抗体的抗体指数来评价每种疾病特异性抗体的鞘内产生水平。38例MOG-IgG患者中有11例仅在CSF中呈抗体阳性，而AQP 4-IgG患者无CSF限制性AQP 4-IgG。MOG-IgG阳性和AQP 4-IgG阳性病例中分别有75.0%和43.8%的患者出现血脑屏障损害，表现为白蛋白水平升高。此外，MOG-IgG的效价是AQP 4-IgG效价的>10倍（效应量r = 0.659，p < 0.0001）。在21例MOG-IgG患者中有12例证实了抗体指数升高（>4.0），而在16例AQP 4-IgG患者中仅观察到1例（φ = 0.528，p < 0.0001）。CSF MOG-IgG滴度（ρ = 0.519，p = 0.001）和MOG-IgG抗体指数（ρ = 0.472，p = 0.036）与CSF细胞计数相关，但与临床残疾无关。鞘内MOG-IgG的产生可能比AQP 4-IgG更频繁。这一发现意味着MOG-IgG相关疾病和AQP 4-IgG阳性NMOSD之间B细胞运输和抗体产生的不同性质。
To elucidate the differences in the source and in the level of intrathecal synthesis between anti–aquaporin-4 antibodies (AQP4-IgG) and anti-myelin oligodendrocyte glycoprotein antibodies (MOG-IgG). Thirty-eight patients with MOG-IgG–associated disease and 36 with AQP4-IgG–positive neuromyelitis optica spectrum disorders (NMOSD) were studied for the antibody titers in the sera and CSF simultaneously collected in the acute attacks. The quotients between CSF and serum levels of albumin, total immunoglobulin G, and each disease-specific antibody were calculated. Intrathecal production level in each disease-specific antibody was evaluated by calculating the antibody index from these quotients. Eleven of the 38 patients with MOG-IgG were positive for the antibody only in the CSF, while no patient with AQP4-IgG showed CSF-restricted AQP4-IgG. Blood-brain barrier compromise as shown by raised albumin quotients was seen in 75.0% of MOG-IgG–positive cases and 43.8% of AQP4-IgG–positive cases. Moreover, MOG-IgG quotients were >10 times higher than AQP4-IgG quotients (effect size r = 0.659, p < 0.0001). Elevated antibody index (>4.0) was confirmed in 12 of 21 with MOG-IgG, whereas it was seen only in 1 of 16 with AQP4-IgG (φ = 0.528, p < 0.0001). The CSF MOG-IgG titers (ρ = 0.519, p = 0.001) and antibody indexes for MOG-IgG (ρ = 0.472, p = 0.036) correlated with the CSF cell counts but not with clinical disability. Intrathecal production of MOG-IgG may occur more frequently than that of AQP4-IgG. This finding implies the different properties of B-cell trafficking and antibody production between MOG-IgG–associated disease and AQP4-IgG–positive NMOSD.
影响因子：
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作者：
Klawiter, Eric C.;Piccio, Laura;Lyons, Jeri-Anne;Mikesell, Robert;O'Connor, Kevin C.;Cross, Anne H.
通讯作者：
Cross, Anne H.