Myelin oligodendrocyte glycoprotein antibodies in pathologically proven multiple sclerosis: frequency, stability and clinicopathologic correlations.
Controversy exists regarding the pathogenic or predictive role of anti-myelin oligodendrocyte glycoprotein (MOG) antibodies in patients with multiple sclerosis (MS). Four immunopathological patterns (IP) have been recognized in early active MS lesions, suggesting heterogeneous pathogenic mechanisms. Whether MOG antibodies contribute to this pathological heterogeneity and potentially serve as biomarkers to identify specific pathological patterns is unknown. Here we report the frequencies of antibodies to human recombinant MOG (identified by Western blot and enzyme-linked immunoabsorbent assay (ELISA)) in patients with pathologically proven demyelinating disease, and investigate whether antibody status is associated with clinical course, HLA-DR2-genotype, IP or treatment response to plasmapheresis. The biopsy cohort consisted of 72 patients: 12 pattern I, 43 pattern II and 17 pattern III. No association was found between MOG antibody status and conversion to clinically definite MS, DR-2 status, IP or response to plasmapheresis. There was poor agreement between Western blot and ELISA (kappa = 0.07 for MOG IgM). Fluctuations in antibody seropositivity were seen for 3/4 patients tested serially by Western blot. This study does not support a pathologic pattern-specific role for MOG-antibodies. Variable MOG-antibody status on serial measurements, coupled with the lack of Western blot and ELISA correlations, raises concern regarding the use of MOG-antibody as an MS biomarker and underscores the need for methodological consensus.
Pittock
S J
SJ
Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
Reindl
M
M
Achenbach
S
S
Berger
T
T
Bruck
W
W
Konig
F
F
Morales
Y
Y
Lassmann
H
H
Bryant
S
S
Moore
S B
SB
Keegan
B M
BM
Lucchinetti
C F
CF
D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015153:Blotting, Western; D015331:Cohort Studies; D003711:Demyelinating Diseases / Q000235:genetics / Q000276:immunology / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D005838:Genotype; D015802:HLA-DR2 Antigen / Q000235:genetics; D006801:Humans; D009103:Multiple Sclerosis / Q000235:genetics / Q000276:immunology* / Q000473:pathology; D009185:Myelin Proteins; D018992:Myelin-Associated Glycoprotein / Q000276:immunology*; D063308:Myelin-Oligodendrocyte Glycoprotein; D010956:Plasmapheresis; D011237:Predictive Value of Tests
D001323:Autoantibodies; D015415:Biomarkers; D015802:HLA-DR2 Antigen; C571326:MOG protein, human; D009185:Myelin Proteins; D018992:Myelin-Associated Glycoprotein; D063308:Myelin-Oligodendrocyte Glycoprotein