title: [Prognostic value of aquaporin-4 antibody in patients of inflammatory demyelinating diseases in central nervous system].
abstract: OBJECTIVE
  To determine the prognostic value of AQP4 antibody in the cohort of Chinese patients with neuromyelitis optical (NMO), HR-NMO (high-risk NMO)and classic multiple sclerosis (MS).
  
  
  METHODS
  Sera of patients with NMO, HR-NMO and MS were all investigated for the presence of AQP4 antibody by indirect immunofluorescence in human AQP4-transfected cells. The diagnostic and prognostic values of anti-AQP4 antibody were evaluated in 352 patients with NMO (n=106), HR-NMO (n=84) including optico-spinal MS (OSMS), longitudinally extensive transverse myelitis (LETM), recurrent optic neuritis (RON) and optic neuritis (ON) or transverse myelitis (TM) with other autoimmune disease and classic MS (n=162). All patients were followed up at outpatient clinics or by telephone.
  
  
  RESULTS
  In our study, the anti-AQP4 antibody's seropositivity in all demyelinating cases (n=352) was 31.3%. And 72 (65.5%) seropositive patients presented with severe ON, 82 (74.5%) with TM, 60 (54.4%) with spinal-cord lesion more than 3 segments, 16 (14.5%) had relapses of ON and 38 (34.5%) relapses of TM during a follow-up period of 24 months. Significant differences existed between anti-AQP4 antibody seropositivity and seronegative in terms of concurrent severe ON, TM, spinal-cord lesion more than 3 segments and relapses of ON and TM (P<0.05). Also, in NMO patient seropositive for anti-AQP4 antibody (n=78), 28 (35.9%) developed relapses of TM. However, in HR-NMO patient with seropositivity (n=28), 4 (14.3%) developed relapses of ON and 10 (35.7%) relapses of TM. The relapse of ON or TM occurred in 57/110 seropositive patients versus 17/242 seronegative ones (P<0.05).
  
  
  CONCLUSIONS
  As compared with anti-AQP4 antibody-negative ones, anti-AQP4 antibody-positive patients show significantly higher frequencies of severe ON, TM, longitudinal spinal-cord segments and they are more predisposed to ON or TM relapse. And seropositive NMO and HR-NMO patients are more likely to develop relapses of ON or TM. Anti-AQP4 antibody may play some roles in the diagnosis and prognostic predication of demyelinating diseases in central nervous system.
authors: Department of Neurology, Chinese PLA General Hospital, Beijing 100853, China.
authors: Yang
authors: Y
authors: Yang
authors: Wei-ping
authors: WP
authors: Wu
authors: De-hui
authors: DH
authors: Huang
authors: Lei
authors: L
authors: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D051401:Aquaporin 4 / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood*; D002648:Child; D020278:Demyelinating Autoimmune Diseases, CNS / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood / Q000175:diagnosis; D009188:Myelitis, Transverse / Q000175:diagnosis; D009471:Neuromyelitis Optica / Q000097:blood / Q000175:diagnosis; D009902:Optic Neuritis / Q000097:blood / Q000175:diagnosis*; D011379:Prognosis; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies