Aquaporin-4 autoimmune syndrome and anti-aquaporin-4 antibody-negative opticospinal multiple sclerosis in Japanese.
BACKGROUND
Antibodies to aquaporin-4 (AQP4) are found in a fraction of Japanese opticospinal multiple sclerosis (OSMS) patients. However, it remains unknown whether anti-AQP4 antibody-positive and negative OSMS patients possess an identical disease.


OBJECTIVE
The objective of the current study was to clarify immunological differences between the two groups of patients.


METHODS
We studied the serum antibody titers against AQP4 in 191 patients with idiopathic central nervous system demyelinating diseases and clarified their relationships with immunological parameters.


RESULTS
Anti-AQP4 antibody positivity rate was higher in patients with OSMS (21/58, 36.2%), idiopathic recurrent myelitis (4/17, 23.5%), and recurrent optic neuritis (7/26, 26.9%), than in conventional MS (CMS) patients (6/90, 6.7%) and patients with other diseases (0/87). Anti-AQP4 antibody titer was significantly higher in patients with SS-A/B antibodies than in those without them. Anti-AQP4 antibody-negative OSMS patients showed significantly higher CD4(+)IFN-gamma(+)IL-4(-)T cell percentages and intracellular IFN-gamma/IL-4 ratios than anti-AQP4 antibody-positive patients, anti-AQP4 antibody-negative CMS patients, and healthy controls, and CD4(+)IFN-gamma(+)IL-4(-)T cell percentages were negatively correlated with anti-AQP4 antibody titers.


CONCLUSIONS
Anti-AQP4 antibody-positive patients are immunologically distinct from anti-AQP4 antibody-negative OSMS patients owing to a Th2 shift in the former group in comparison to a Th1 shift in the latter.
Matsushita
T
T
Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Isobe
N
N
Matsuoka
T
T
Shi
N
N
Kawano
Y
Y
Wu
X M
XM
Yoshiura
T
T
Nakao
Y
Y
Ishizu
T
T
Kira
J I
JI
D051401:Aquaporin 4 / Q000276:immunology*; D044466:Asian People; D001323:Autoantibodies / Q000097:blood*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007371:Interferon-gamma / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D007564:Japan; D008279:Magnetic Resonance Imaging; D020528:Multiple Sclerosis, Chronic Progressive / Q000208:ethnology / Q000276:immunology* / Q000473:pathology; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000208:ethnology / Q000276:immunology* / Q000473:pathology; D009471:Neuromyelitis Optica / Q000208:ethnology / Q000276:immunology* / Q000473:pathology; D009902:Optic Neuritis / Q000208:ethnology / Q000276:immunology* / Q000473:pathology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013116:Spinal Cord / Q000473:pathology; D013577:Syndrome
C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; C508598:IL4 protein, human; D007074:Immunoglobulin G; D015847:Interleukin-4; D007371:Interferon-gamma