Longitudinal analysis of myelin oligodendrocyte glycoprotein antibodies in CNS inflammatory diseases

J Neurol Neurosurg Psychiatry. 2017 Oct;88(10):811-817. doi: 10.1136/jnnp-2017-315998. Epub 2017 Jul 6.

Abstract

Background: We evaluated the seroprevalence of myelin oligodendrocyte glycoprotein immunoglobulin G1 (MOG-IgG) and associated clinical features of patients from a large adult-dominant unselected cohort with mainly relapsing central nervous system (CNS) inflammatory diseases. We also investigate the clinical relevance of MOG-IgG through a longitudinal analysis of serological status over a 2-year follow-up period.

Methods: Serum samples from 505 patients with CNS inflammatory diseases at the National Cancer Center were analysed using cell-based assays for MOG-IgG and aquaporin-4 immunoglobulin G (AQP4-IgG). MOG-IgG serostatus was longitudinally assessed in seropositive patients with available serum samples and at least 2 years follow-up.

Results: Twenty-two of 505 (4.4%) patients with CNS inflammatory diseases were positive for MOG-IgG. Patients with MOG-IgG had neuromyelitis optica spectrum disorder (NMOSD, n=10), idiopathic AQP4-IgG-negative myelitis (n=4), idiopathic AQP4-IgG-negative optic neuritis (n=4), other demyelinating syndromes (n=3) and multiple sclerosis (n=1). No relapses were seen in patients when they became MOG-IgG seronegative, whereas a persistent positive serological status was observed in patients with clinical relapses despite immunotherapy.

Conclusions: In a large adult-predominant unselected cohort of mainly relapsing CNS inflammatory diseases, we confirmed that NMOSD phenotype was most commonly observed in patients with MOG-IgG. A longitudinal analysis with 2-year follow-up suggested that persistence of MOG-IgG is associated with relapses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aquaporin 4 / immunology
  • Autoantibodies / immunology
  • Demyelinating Autoimmune Diseases, CNS* / blood
  • Humans
  • Immunoglobulin G / blood
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Myelin-Oligodendrocyte Glycoprotein / immunology*
  • Seroepidemiologic Studies*

Substances

  • Aquaporin 4
  • Autoantibodies
  • Immunoglobulin G
  • Myelin-Oligodendrocyte Glycoprotein