Antiacquaporin 4 antibodies detection by different techniques in neuromyelitis optica patients
Antiacquaporin 4 antibodies detection by different techniques in neuromyelitis optica patients
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DOI：
10.1177/1352458509106851
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发表时间：
2009-10-01
影响因子：
5.8
通讯作者：
Martino, G.
中科院分区：
文献类型：
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作者：
Fazio, R.;Malosio, M. L.;Martino, G.
背景：针对水通道蛋白-4 （AQP4）的抗体被认为是诊断视神经脊髓炎（NMO）的标志物。AQP4是一种特别表达于血管周围星形细胞足细胞上的水通道。然而，对血清阳性率和最佳检测方法尚未达成共识。目的：探讨不同检测方法检测aqp4抗体的性能。方法：建立5种不同的检测方法。其中2例能通过免疫荧光（NMO-IgG）检测脑组织血管周围IgG的反应性。另外三种检测抗aqp4抗体的方法是：对表达aqp4的细胞进行免疫荧光和流式细胞术，以及放射免疫沉淀法。我们通过对33名NMO患者、13名NMO高危患者（hrNMO）、6名急性部分横断面脊髓炎（APTM）患者、20名多发性硬化症（MS）患者和67名年龄和性别匹配的健康对照者的血清进行分析，评估了这些检测方法的敏感性和特异性。结果：我们发现血清NMO- igg和抗aqp4反应性几乎只存在于NMO和hrNMO患者中。血清阳性率和敏感性从30%到47%不等，取决于测定方法。特异性从95%到100%不等。比较五种测定方法的结果，我们注意到在一些样品中缺乏一致性。结论：检测NMO- igg或抗aqp4抗体可能是协助神经科医生鉴别NMO、hrNMO、APTM或ms患者的一种有价值的工具。目前缺乏检测抗aqp4抗体的金标准，这意味着有必要对这些抗体的检测进行标准化。
Background: Antibodies against aquaporin-4 (AQP4), a water channel particularly expressed on perivascular astrocytic podocytes, are proposed as a marker for the diagnosis of neuromyelitis optica (NMO). However, a consensus on seroprevalence and optimal detection method has not yet been reached.Objectives: To investigate the performance of different assays to detect anti-AQP4 antibodies.Methods: We set up five different assays. Two of them were capable to detect perivascular IgG reactivity on brain tissue by immunofluorescence (NMO-IgG). Other three assays have been set to detect anti-AQP4 antibodies: immunofluorescence and flow cytometry on AQP4-expressing cells, and a radioimmunoprecipitation assay. We assessed sensitivity and specificity of these assays by interrogating sera of 33 NMO patients, 13 patients at high risk to develop NMO (hrNMO), 6 patients affected by acute partial transverse myelitis (APTM), 20 patients with multiple sclerosis (MS), and 67 age- and sex-matched healthy controls.Results: We found that the presence of serum NMO-IgG and anti-AQP4 reactivity is almost exclusively restricted to patients with NMO and hrNMO. Seroprevalence and sensitivity ranged from 30 to 47%, depending on the assay. Specificity ranged from 95 to 100%. Comparing results obtained in the five assays, we noticed lack of concordance in some samples.Conclusions: Detection of NMO-IgG or anti-AQP4 antibodies may represent a valuable tool to assist neurologists in the differential diagnosis between patients with NMO, hrNMO, APTM, or MS. The current lack of a gold standard to detect anti-AQP4 antibodies implies the necessity to standardize the detection of these antibodies.