Anti-myelin Oligodendrocyte Glycoprotein Antibodies in Pediatric Patients With Optic Neuritis

Arch Neurol. 2012 Jun;69(6):752-6. doi: 10.1001/archneurol.2011.2956.

Abstract

Objective: To study the humoral immune response directed at myelin oligodendrocyte glycoprotein (MOG)in pediatric patients with isolated and recurrent optic neuritis(ON).

Design: Observational prospective case series.

Setting: Six pediatric hospitals in Germany and Austria.

Patients: Thirty-seven patients 18 years or younger with single or recurrent episodes of ON were recruited from 6 different hospitals.

Main outcome measures: Clinical features, magnetic resonance imaging findings, intrathecal IgG synthesis,and outcome were recorded. A live cell–based immunofluorescence assay was used to measure serum IgG antibodies to MOG and aquaporin 4.

Results: A single episode of ON was observed in 10 patients,and 15 experienced 2 to 12 episodes. The acute episode of ON was part of a clinically isolated syndrome in 12 patients, of whom 8 were subsequently classified as having multiple sclerosis. High-titer serum MOG-IgG antibodies (1:160) were detected in 17 patients (46%).In addition, high titers of MOG-IgG antibodies were more frequently observed in 12 of the 15 patients with recurrent episodes of ON (80%; median titer, 1:640)compared with 2 of the 10 patients with monophasic ON(20%; median titer, 0) and 3 of the 12 patients with ON as part of a clinically isolated syndrome (25%; median titer, 0).

Conclusion: High-titer MOG-IgG antibodies are predominantly detected in pediatric patients with recurrent ON, indicating that anti-MOG-specific antibodies may exert a direct role in the pathogenesis of ON in this subgroup.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aquaporin 4 / immunology
  • Austria
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Germany
  • Humans
  • Immunoglobulin G / metabolism*
  • Magnetic Resonance Imaging
  • Male
  • Myelin Proteins / immunology*
  • Myelin-Oligodendrocyte Glycoprotein
  • Oligoclonal Bands / blood
  • Optic Neuritis / immunology*
  • Optic Neuritis / metabolism*
  • Pediatrics
  • Prospective Studies
  • Statistics, Nonparametric

Substances

  • AQP4 protein, human
  • Aquaporin 4
  • Immunoglobulin G
  • MOG protein, human
  • Myelin Proteins
  • Myelin-Oligodendrocyte Glycoprotein
  • Oligoclonal Bands