Prognostic implications of aquaporin-4 antibody status in neuromyelitis optica patients
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Neuromyelitis optica (NMO) is an inflammatory/demyelinating disorder predominantly affecting the optic nerves and spinal cord. Recent findings showed an underlying humoral abnormality in NMO, characterized by a serum antibody against aquaporin-4 (Aqp-4-Ab). In this study, we evaluated the Aqp-4-Ab status among Turkish patients with NMO to determine the clinical and prognostic relevance. Serum samples from 35 consecutive patients with NMO followed at a single center and diagnosed according to the 2006 revised criteria, were evaluated for Aqp-4-Ab. All samples were obtained during a relapse prior to any immunosuppressive treatment. Aqp-4-Ab was positive in 21/35 (60%) patients. Among these cases, 11 had an EDSS of 6.0 or more, whereas only two patients in the seronegative group had such severe disability (p < 0.05). Overall, seropositive cases had a mean EDSS score of 5.1 ± 2.2 compared with 3.5 ± 1.7 in seronegative cases (p < 0.01). There were trends towards female predominance in seropositive cases and a monophasic course predominance in seronegative cases. Disease duration, age at onset, number of attacks and time to definite NMO did not differ between groups. Our findings in this single-center cohort suggest that the presence of Aqp-4-Ab might have a prognostic significance indicating a more severe disease course.
KeywordsNeuromyelitis optica Multiple sclerosis NMO-IgG Anti aquaporin-4 antibodies Aquaporin-4 seropositivity Prognosis
- 8.Akman-Demir G, Eraksoy M, Tüzün E, Jarius S, Icoz S, Kurtuncu M, Waters P, Yapici Z, Mutlu M, Vincent A (2008) Devic’s neuromyelitis optica: an analysis of 47 patients and prognostic implications of NMO IgG status. Neurology 70(Suppl.1):A-267 abstractGoogle Scholar
- 11.Cabrera-Gómez JA, Bonnan M, González-Quevedo A, Saiz-Hinarejos A, Marignier R, Olindo S, Graus F, Smadja D, Merle H, Thomas L, Gómez-García A, Cabre P (2009) Neuromyelitis optica positive antibodies confer a worse course in relapsing-neuromyelitis optica in Cuba and French West Indies. Mult Scler 15:828–833PubMedCrossRefGoogle Scholar
- 17.Nakashima I, Fujihara K, Miyazawa I, Misu T, Narikawa K, Nakamura M, Watanabe S, Takahashi T, Nishiyama S, Shiga Y, Sato S, Weinshenker BG, Itoyama Y (2006) Clinical and MRI features of Japanese patients with multiple sclerosis positive for NMO-IgG. J Neurol Neurosurg Psychiatry 77:1073–1075PubMedCrossRefGoogle Scholar