Cargando…

Pathophysiology of myelin oligodendrocyte glycoprotein antibody disease

Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) is a spectrum of diseases, including optic neuritis, transverse myelitis, acute disseminated encephalomyelitis, and cerebral cortical encephalitis. In addition to distinct clinical, radiological, and immunological features, the infectious...

Descripción completa

Detalles Bibliográficos
Autores principales: Corbali, Osman, Chitnis, Tanuja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10011114/
https://www.ncbi.nlm.nih.gov/pubmed/36925938
http://dx.doi.org/10.3389/fneur.2023.1137998
_version_ 1784906315998429184
author Corbali, Osman
Chitnis, Tanuja
author_facet Corbali, Osman
Chitnis, Tanuja
author_sort Corbali, Osman
collection PubMed
description Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) is a spectrum of diseases, including optic neuritis, transverse myelitis, acute disseminated encephalomyelitis, and cerebral cortical encephalitis. In addition to distinct clinical, radiological, and immunological features, the infectious prodrome is more commonly reported in MOGAD (37–70%) than NMOSD (15–35%). Interestingly, pediatric MOGAD is not more aggressive than adult-onset MOGAD, unlike in multiple sclerosis (MS), where annualized relapse rates are three times higher in pediatric-onset MS. MOGAD pathophysiology is driven by acute attacks during which T cells and MOG antibodies cross blood brain barrier (BBB). MOGAD lesions show a perivenous confluent pattern around the small veins, lacking the radiological central vein sign. Initial activation of T cells in the periphery is followed by reactivation in the subarachnoid/perivascular spaces by MOG-laden antigen-presenting cells and inflammatory CSF milieu, which enables T cells to infiltrate CNS parenchyma. CD4+ T cells, unlike CD8+ T cells in MS, are the dominant T cell type found in lesion histology. Granulocytes, macrophages/microglia, and activated complement are also found in the lesions, which could contribute to demyelination during acute relapses. MOG antibodies potentially contribute to pathology by opsonizing MOG, complement activation, and antibody-dependent cellular cytotoxicity. Stimulation of peripheral MOG-specific B cells through TLR stimulation or T follicular helper cells might help differentiate MOG antibody-producing plasma cells in the peripheral blood. Neuroinflammatory biomarkers (such as MBP, sNFL, GFAP, Tau) in MOGAD support that most axonal damage happens in the initial attack, whereas relapses are associated with increased myelin damage.
format Online
Article
Text
id pubmed-10011114
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-100111142023-03-15 Pathophysiology of myelin oligodendrocyte glycoprotein antibody disease Corbali, Osman Chitnis, Tanuja Front Neurol Neurology Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) is a spectrum of diseases, including optic neuritis, transverse myelitis, acute disseminated encephalomyelitis, and cerebral cortical encephalitis. In addition to distinct clinical, radiological, and immunological features, the infectious prodrome is more commonly reported in MOGAD (37–70%) than NMOSD (15–35%). Interestingly, pediatric MOGAD is not more aggressive than adult-onset MOGAD, unlike in multiple sclerosis (MS), where annualized relapse rates are three times higher in pediatric-onset MS. MOGAD pathophysiology is driven by acute attacks during which T cells and MOG antibodies cross blood brain barrier (BBB). MOGAD lesions show a perivenous confluent pattern around the small veins, lacking the radiological central vein sign. Initial activation of T cells in the periphery is followed by reactivation in the subarachnoid/perivascular spaces by MOG-laden antigen-presenting cells and inflammatory CSF milieu, which enables T cells to infiltrate CNS parenchyma. CD4+ T cells, unlike CD8+ T cells in MS, are the dominant T cell type found in lesion histology. Granulocytes, macrophages/microglia, and activated complement are also found in the lesions, which could contribute to demyelination during acute relapses. MOG antibodies potentially contribute to pathology by opsonizing MOG, complement activation, and antibody-dependent cellular cytotoxicity. Stimulation of peripheral MOG-specific B cells through TLR stimulation or T follicular helper cells might help differentiate MOG antibody-producing plasma cells in the peripheral blood. Neuroinflammatory biomarkers (such as MBP, sNFL, GFAP, Tau) in MOGAD support that most axonal damage happens in the initial attack, whereas relapses are associated with increased myelin damage. Frontiers Media S.A. 2023-02-28 /pmc/articles/PMC10011114/ /pubmed/36925938 http://dx.doi.org/10.3389/fneur.2023.1137998 Text en Copyright © 2023 Corbali and Chitnis. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Corbali, Osman
Chitnis, Tanuja
Pathophysiology of myelin oligodendrocyte glycoprotein antibody disease
title Pathophysiology of myelin oligodendrocyte glycoprotein antibody disease
title_full Pathophysiology of myelin oligodendrocyte glycoprotein antibody disease
title_fullStr Pathophysiology of myelin oligodendrocyte glycoprotein antibody disease
title_full_unstemmed Pathophysiology of myelin oligodendrocyte glycoprotein antibody disease
title_short Pathophysiology of myelin oligodendrocyte glycoprotein antibody disease
title_sort pathophysiology of myelin oligodendrocyte glycoprotein antibody disease
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10011114/
https://www.ncbi.nlm.nih.gov/pubmed/36925938
http://dx.doi.org/10.3389/fneur.2023.1137998
work_keys_str_mv AT corbaliosman pathophysiologyofmyelinoligodendrocyteglycoproteinantibodydisease
AT chitnistanuja pathophysiologyofmyelinoligodendrocyteglycoproteinantibodydisease