title: Clinical spectrum associated with MOG autoimmunity in adults: significance of sharing rodent MOG epitopes.
abstract: The aim of this study was to report the clinical spectrum associated with antibodies to myelin oligodendrocyte glycoprotein (MOG) in adult patients, and to assess whether phenotypic variants are dependent on recognition of rodent MOG epitopes. We retrospectively analyzed the features, course and outcome of 56 patients whose samples were investigated by brain tissue immunohistochemistry and cell-based assays using human and rodent MOG. The median age at symptom onset was 37 years (range 18-70); 35 patients (63 %) were female. After a median follow-up of 43 months (range 4-554), only 14 patients (25 %) developed a neuromyelitis optica spectrum disorder (NMOSD), 27 patients (47 %) retained the initial diagnosis of isolated optic neuritis, 7 (12 %) of longitudinally extensive transverse myelitis, and 2 (4 %) of acute disseminated encephalomyelitis; 6 patients (11 %) developed atypical demyelinating syndromes (4 had relapsing episodes of short myelitis lesions which in one occurred with optic neuritis; 1 had relapsing brainstem symptoms, and 1 relapsing demyelinating encephalomyelitis). The course was frequently associated with relapses (71 %) and good outcome. Twenty-seven patients (49 %) had antibodies that recognized rodent MOG epitopes, and 9 of them (16 %) showed a myelin staining pattern in rodent tissue. Only the myelin staining pattern was linked to NMOSD (p = 0.005). In conclusion, MOG autoimmunity in adult patients associates with a clinical spectrum wider than the one expected for patients with suspected NMOSD and overall good outcome. Antibodies to rodent MOG epitopes do not associate with any phenotypic variant.
authors.affiliation: Service of Neurology, Department of Neurology, Hospital Clínic, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain.|Neuroimmunology Program, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Sepúlveda
authors.affiliation: Neuroimmunology Program, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.|Neuroimmunology Unit, Department of Child Neurology, Sant Joan de Déu Hospital, University of Barcelona, Esplugues de Llobregat, Barcelona, Spain.
authors.forename: Thaís
authors.initials: T
authors.lastname: Armangue
authors.affiliation: Neuroimmunology Program, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Martinez-Hernandez
authors.affiliation: Servei de Neurologia-Neuroimmunologia, 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: Service of Neurology, Department of Neurology, Hospital Clínic, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain.|Neuroimmunology Program, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Sola-Valls
authors.affiliation: Neuroimmunology Program, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Lidia
authors.initials: L
authors.lastname: Sabater
authors.affiliation: Neurology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: Nieves
authors.initials: N
authors.lastname: Téllez
authors.affiliation: Department of Neurology, Hospital Álvaro Cunqueiro, Vigo, Spain.
authors.forename: Luciana
authors.initials: L
authors.lastname: Midaglia
authors.affiliation: Service of Neurology, Department of Neurology, Hospital Clínic, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain.|Neuroimmunology Program, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Helena
authors.initials: H
authors.lastname: Ariño
authors.affiliation: Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Patrick
authors.initials: P
authors.lastname: Peschl
authors.affiliation: Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Reindl
authors.affiliation: Magnetic Resonance Unit, Department of Radiology (IDI), Hospital Universitari Vall d´Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Alex
authors.initials: A
authors.lastname: Rovira
authors.affiliation: Servei de Neurologia-Neuroimmunologia, 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: Xavier
authors.initials: X
authors.lastname: Montalban
authors.affiliation: Service of Neurology, Department of Neurology, Hospital Clínic, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain.|Neuroimmunology Program, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Blanco
authors.affiliation: Neuroimmunology Program, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.|Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.|Institució Catalana de Recerca i Estudos Avançats (ICREA), Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Dalmau
authors.affiliation: Service of Neurology, Department of Neurology, Hospital Clínic, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain.|Neuroimmunology Program, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Graus
authors.affiliation: Service of Neurology, Department of Neurology, Hospital Clínic, University of Barcelona, Villarroel 170, 08036, Barcelona, Spain. asaiz@clinic.ub.es.|Neuroimmunology Program, Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. asaiz@clinic.ub.es.
authors.forename: Albert
authors.initials: A
authors.lastname: Saiz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D051401:Aquaporin 4 / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity / Q000502:physiology*; D001921:Brain / Q000378:metabolism; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D057809:HEK293 Cells; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D063308:Myelin-Oligodendrocyte Glycoprotein / Q000276:immunology*; D009471:Neuromyelitis Optica / Q000097:blood* / Q000473:pathology / Q000503:physiopathology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D051401:Aquaporin 4; D001323:Autoantibodies; D063308:Myelin-Oligodendrocyte Glycoprotein
keywords: Antibodies to myelin oligodendrocyte glycoprotein; Cell-based assays; Immunohistochemistry; Longitudinally extensive myelitis; MRI; Neuromyelitis optica; Optic neuritis