Myelin Oligodendrocyte Glycoprotein-Immunoglobulin G in the CSF
Myelin Oligodendrocyte Glycoprotein-Immunoglobulin G in the CSF
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脑脊液中髓磷脂少突胶质细胞糖蛋白-免疫球蛋白 G
DOI：
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Sung
中科院分区：
文献类型：
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作者：
Y. Kwon;Boram Kim;Jun;Heejung Mo;Kyomin Choi;Seong;Jee;T. Nam;E. Sohn;S. Heo;S. Kim;Key;S. Yoon;Jeeyoung Oh;S. Baek;B. Kim;K. Park;J. Sung;Jae Ho Jung;Seong;Sung;P. Waters;Sung
背景与目的探讨脑脊液髓鞘少突胶质细胞糖蛋白-免疫球蛋白G(MOG-Ig G)检测在大型多中心队列中的临床意义。方法在这项多中心队列研究中，包括来自11家转诊医院的474名疑似炎性脱髓鞘疾病(IDD)患者的配对血清-脑脊液样本。经血清筛选后，将患者分为髓鞘少突胶质细胞糖蛋白抗体阳性相关疾病(MOGAD，31例)、水通道蛋白-4-抗体阳性视神经脊髓炎谱系障碍(AQP4-Ig G+NMOSD，60例)、其他IDDS(217例)、多发性硬化(MS，45例)和非IDDS(121例)。然后我们筛查脑脊液中的MOG-IgG，并比较脑脊液中唯一阳性的患者和血清阳性的MOGAD患者的临床和血清学特征。结果MOGAD阳性19例(61.3%)，其他IDDS(脑脊液MOG+IDD)9例(4.1%)，MS 4例(8.9%)，但无AQP4-Ig G+NMOSD和非IDDS患者脑脊液MOG-Ig G阳性。具有非MS表型的脑脊液MOG-Ig G独有阳性患者的临床、病理和预后特征与血清阳性MOGAD患者相似。12例患者从发病时就观察到鞘内MOG-Ig G合成，其中4例血清阳性，8例脑脊液特异性阳性，均累及大脑或脊髓。脑脊液MOG-Ig G滴度和校正的脑脊液/血清MOG-Ig G指数与伤残、脑脊液细胞增多症和脑脊液蛋白水平相关，而与血清MOG-Ig G滴度无关。[讨论]除MS外，IDD患者也可检出脑脊液中的MOG-Ig G，提示脑脊液中MOG-Ig G阳性有助于MOGAD的诊断。MOGAD患者中枢神经系统中MOG-Ig G的合成可从发病时检测到，并与疾病的严重程度相关。证据分类本研究提供了第二类证据，表明在没有MS表型的情况下，脑脊液MOG-IgG的存在可以改善MOGAD的诊断，并且鞘内合成MOG-IgG与残疾增加相关。
Background and Objective To investigate the clinical relevance of CSF myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG) testing in a large multicenter cohort. Methods In this multicenter cohort study, paired serum-CSF samples from 474 patients with suspected inflammatory demyelinating disease (IDD) from 11 referral hospitals were included. After serum screening, patients were grouped into seropositive myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD, 31), aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder (AQP4-IgG + NMOSD, 60), other IDDs (217), multiple sclerosis (MS, 45), and non-IDDs (121). We then screened CSF for MOG-IgG and compared the clinical and serologic characteristics of patients uniquely positive for MOG-IgG in the CSF to seropositive patients with MOGAD. Results Nineteen patients with seropositive MOGAD (61.3%), 9 with other IDDs (CSF MOG + IDD, 4.1%), 4 with MS (8.9%), but none with AQP4-IgG + NMOSD nor with non-IDDs tested positive in the CSF for MOG-IgG. The clinical, pathologic, and prognostic features of patients uniquely positive for CSF MOG-IgG, with a non-MS phenotype, were comparable with those of seropositive MOGAD. Intrathecal MOG-IgG synthesis, observed from the onset of disease, was shown in 12 patients: 4 of 28 who were seropositive and 8 who were uniquely CSF positive, all of whom had involvement of either brain or spinal cord. Both CSF MOG-IgG titer and corrected CSF/serum MOG-IgG index, but not serum MOG-IgG titer, were associated with disability, CSF pleocytosis, and level of CSF proteins. Discussion CSF MOG-IgG is found in IDD other than MS and also in MS. In IDD other than MS, the CSF MOG-IgG positivity can support the diagnosis of MOGAD. The synthesis of MOG-IgG in the CNS of patients with MOGAD can be detected from the onset of the disease and is associated with the severity of the disease. Classification of Evidence This study provides Class II evidence that the presence of CSF MOG-IgG can improve the diagnosis of MOGAD in the absence of an MS phenotype, and intrathecal synthesis of MOG-IgG was associated with increased disability.
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.