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Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder

OBJECTIVE: 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). METHODS: Thirty-eight patients with MOG-IgG–associated disease and 36 with AQP4-IgG–positi...

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Autores principales: Akaishi, Tetsuya, Takahashi, Toshiyuki, Misu, Tatsuro, Kaneko, Kimihiko, Takai, Yoshiki, Nishiyama, Shuhei, Ogawa, Ryo, Fujimori, Juichi, Ishii, Tadashi, Aoki, Masashi, Fujihara, Kazuo, Nakashima, Ichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312856/
https://www.ncbi.nlm.nih.gov/pubmed/33980704
http://dx.doi.org/10.1212/WNL.0000000000012175
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author Akaishi, Tetsuya
Takahashi, Toshiyuki
Misu, Tatsuro
Kaneko, Kimihiko
Takai, Yoshiki
Nishiyama, Shuhei
Ogawa, Ryo
Fujimori, Juichi
Ishii, Tadashi
Aoki, Masashi
Fujihara, Kazuo
Nakashima, Ichiro
author_facet Akaishi, Tetsuya
Takahashi, Toshiyuki
Misu, Tatsuro
Kaneko, Kimihiko
Takai, Yoshiki
Nishiyama, Shuhei
Ogawa, Ryo
Fujimori, Juichi
Ishii, Tadashi
Aoki, Masashi
Fujihara, Kazuo
Nakashima, Ichiro
author_sort Akaishi, Tetsuya
collection PubMed
description OBJECTIVE: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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spelling pubmed-83128562021-07-27 Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder Akaishi, Tetsuya Takahashi, Toshiyuki Misu, Tatsuro Kaneko, Kimihiko Takai, Yoshiki Nishiyama, Shuhei Ogawa, Ryo Fujimori, Juichi Ishii, Tadashi Aoki, Masashi Fujihara, Kazuo Nakashima, Ichiro Neurology Research Article OBJECTIVE: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. Lippincott Williams & Wilkins 2021-07-06 /pmc/articles/PMC8312856/ /pubmed/33980704 http://dx.doi.org/10.1212/WNL.0000000000012175 Text en Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Research Article
Akaishi, Tetsuya
Takahashi, Toshiyuki
Misu, Tatsuro
Kaneko, Kimihiko
Takai, Yoshiki
Nishiyama, Shuhei
Ogawa, Ryo
Fujimori, Juichi
Ishii, Tadashi
Aoki, Masashi
Fujihara, Kazuo
Nakashima, Ichiro
Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder
title Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder
title_full Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder
title_fullStr Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder
title_full_unstemmed Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder
title_short Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder
title_sort difference in the source of anti-aqp4-igg and anti-mog-igg antibodies in csf in patients with neuromyelitis optica spectrum disorder
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312856/
https://www.ncbi.nlm.nih.gov/pubmed/33980704
http://dx.doi.org/10.1212/WNL.0000000000012175
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