title: Anti-aquaporin 4 antibody in Japanese multiple sclerosis: the presence of optic spinal multiple sclerosis without long spinal cord lesions and anti-aquaporin 4 antibody.
abstract: BACKGROUND
  Anti-aquaporin 4 (AQP4) antibodies were found in patients with neuromyelitis optica (NMO) and Japanese optic-spinal multiple sclerosis (OSMS).
  
  
  OBJECTIVE
  To review the clinical features and investigate anti-AQP4 antibodies of Japanese patients with multiple sclerosis (MS), with or without long spinal cord lesions (LCL).
  
  
  METHODS
  Anti-AQP4 antibodies were examined in the sera of 128 consecutive Japanese patients by the immunofluorescence method using AQP4 transfected cells.
  
  
  RESULTS
  The 45 LCL-MS patients included 28 with a long spinal cord lesion extending contiguously over three vertebral segments on sagittal T2 weighted images (long T2 lesion) and 17 with segmental cord atrophy extending more than three vertebral segments. We identified 25 patients with anti-AQP4 antibody with LCL and anti-AQP4 antibody. Anti-AQP4 antibody was found in 12/17 (70.6%) LCL-MS patients with segmental cord atrophy, and in 13/28 (46.4%) LCL-MS patients without segmental long cord atrophy (p = 0.135, Fisher's exact test). Seropositive MS patients with LCL had more relapses than seronegative patients (p = 0.0004, Mann-Whitney U test). 9 patients with OSMS were negative for anti-AQP4 antibody who did not show LCL.
  
  
  CONCLUSIONS
  These results suggest that an anti-AQP4 antibody is found not only in MS patients with long T2 lesions but also in patients with segmental cord atrophy extending more than three vertebral segments. It is a marker of LCL-MS showing frequent exacerbations. Japanese OSMS cases comprised those that were identical to NMO cases and those that were more closely related to classic MS.
authors: MS Centre, Utano National Hospital, Kyoto, Japan. tanaka@unh.hosp.go.jp
authors: Masami
authors: M
authors: Tanaka
authors: Keiko
authors: K
authors: Tanaka
authors: Mika
authors: M
authors: Komori
authors: Takahiko
authors: T
authors: Saida
mesh_terms: D000328:Adult; D000368:Aged; D000906:Antibodies / Q000097:blood*; D051401:Aquaporin 4 / Q000276:immunology*; D001284:Atrophy / Q000097:blood; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000097:blood* / Q000473:pathology*; D013116:Spinal Cord / Q000473:pathology*
chemical_list: C496030:AQP4 protein, human; D000906:Antibodies; D051401:Aquaporin 4
references: Brain. 2002 Nov;125(Pt 11):2460-8
references: 12390972
references: Neurology. 1983 Nov;33(11):1444-52
references: 6685237
references: Ann Neurol. 1996 Oct;40(4):569-74
references: 8871575
references: Neurology. 1958 Oct;8(10):756-63
references: 13590382
references: Lancet. 2004 Dec 11-17;364(9451):2106-12
references: 15589308
references: J Neurol Neurosurg Psychiatry. 2006 Sep;77(9):1073-5
references: 16505005
references: J Exp Med. 2005 Aug 15;202(4):473-7
references: 16087714
references: Ann Neurol. 2006 Mar;59(3):566-9
references: 16453327
references: Arch Neurol. 2006 Mar;63(3):390-6
references: 16533966
references: Neurology. 2006 May 23;66(10):1485-9
references: 16717206
references: Neurology. 2005 Feb 22;64(4):621-30
references: 15728282