title: Antibodies to MOG and AQP4 in adults with neuromyelitis optica and suspected limited forms of the disease.
abstract: OBJECTIVE
  We aimed to report the frequency and implications of antibodies to myelin oligodendrocyte glycoprotein (MOG-ab) in adults with demyelinating syndromes suspicious for neuromyelitis optica (NMO).
  
  
  METHODS
  Samples from 174 patients (48 NMO, 84 longitudinally extensive myelitis (LETM), 39 optic neuritis (ON), and three acute disseminated encephalomyelitis (ADEM) who presented initially with isolated LETM) were retrospectively examined for AQP4-ab and MOG-ab using cell-based assays.
  
  
  RESULTS
  MOG-ab were found in 17 (9.8%) patients, AQP4-ab in 59 (34%), and both antibodies in two (1.1%). Among the 17 patients with MOG-ab alone, seven (41%) had ON, five (29%) LETM, four (24%) NMO, and one (6%) ADEM. Compared with patients with AQP4-ab, those with MOG-ab were significantly younger (median: 27 vs. 40.5 years), without female predominance (53% vs. 90%), and the clinical course was more frequently monophasic (41% vs. 7%) with a benign outcome (median Expanded Disability Status Scale: 1.5 vs. 4.0). In eight patients with paired serum-cerebrospinal fluid (CSF) samples, five had MOG-ab in both samples and three only in serum. Antibody titres did not differ among clinical phenotypes or disease course. MOG-ab remained detectable in 12/14 patients (median follow-up: 23 months) without correlation between titres' evolution and outcome.
  
  
  CONCLUSIONS
  MOG-ab identify a subgroup of adult patients with NMO, LETM and ON that have better outcome than those associated with AQP4-ab. MOG-ab are more frequently detected in serum than CSF and the follow-up of titres does not correlate with outcome.
authors.affiliation: Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain/Institute of Neurology, Medical University of Vienna, Austria.
authors.forename: Romana
authors.initials: R
authors.lastname: Höftberger
authors.affiliation: Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Sepulveda
authors.affiliation: Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Thaís
authors.initials: T
authors.lastname: Armangue
authors.affiliation: Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Blanco
authors.affiliation: Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain/Department of Pediatrics I, Division of Pediatric Neurology, Innsbruck Medical University, Innsbruck, Austria/Pediatric Neurology, Witten/Herdecke University, Children's Hospital Datteln, Germany.
authors.forename: Kevin
authors.initials: K
authors.lastname: Rostásy
authors.affiliation: Servicio de Neurología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Alvaro Cobo
authors.initials: AC
authors.lastname: Calvo
authors.affiliation: Hospital Universitario Donostia, San Sebastián, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Olascoaga
authors.affiliation: Hospital Universitari Dr. Josep Trueta, IDIBGI, Girona, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Ramió-Torrentà
authors.affiliation: Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Reindl
authors.affiliation: Departament of Neurology, University Hospital "12 de Octubre", Centro de Investigación Biomédica en red sobre Enfermedades Neurodegenerativas (CIBERNED), Departamento de Medicina, Complutense University, Madrid, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: Benito-León
authors.affiliation: Hospital Universitari La Fe de Valencia, Valencia, Spain.
authors.forename: Bonaventura
authors.initials: B
authors.lastname: Casanova
authors.affiliation: Servei de Neurologia-Neuroimunologia, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Georgina
authors.initials: G
authors.lastname: Arrambide
authors.affiliation: Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Lidia
authors.initials: L
authors.lastname: Sabater
authors.affiliation: Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Graus
authors.affiliation: Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain/Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Dalmau
authors.affiliation: Center of Neuroimmunology, Service of Neurology, Hospital Clínic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Saiz
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D051401:Aquaporin 4 / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology*; D001324:Autoantigens / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063308:Myelin-Oligodendrocyte Glycoprotein / Q000276:immunology*; D009471:Neuromyelitis Optica / Q000097:blood / Q000134:cerebrospinal fluid / Q000276:immunology*; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; D001324:Autoantigens; C571326:MOG protein, human; D063308:Myelin-Oligodendrocyte Glycoprotein
keywords: Neuromyelitis optica; antibodies to myelin oligodendrocyte glycoprotein; aquaporin-4 antibody; longitudinally extensive myelitis; optic neuritis