Prognostic implications of aquaporin-4 antibody status in neuromyelitis optica patients.
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.
Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, 34390 Çapa, Istanbul, Turkey. akmandem@istanbul.edu.tr
Gulsen
G
Akman-Demir
Erdem
E
Tüzün
Patrick
P
Waters
Sema
S
Içöz
Murat
M
Kürtüncü
Sven
S
Jarius
Zuhal
Z
Yapıcı
Melike
M
Mutlu
Nilüfer
N
Yeşilot
Angela
A
Vincent
Mefkure
M
Eraksoy
D000293:Adolescent; D000328:Adult; D051401:Aquaporin 4 / Q000097:blood*; D001323:Autoantibodies / Q000096:biosynthesis / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D011379:Prognosis; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
D051401:Aquaporin 4; D001323:Autoantibodies; D015415:Biomarkers