title: Role of AQP4 Antibody Serostatus and its Prediction of Visual Outcome in Neuromyelitis Optica: A Systematic Review and Meta-Analysis.
abstract: Backgroud: Neuromyelitis optica (NMO) is an autoimmune inflammatory disorder, which is characterized by severe attacks of optic neuritis and myelitis. Antibodies (Ab) to aquaporin-4 (AQP4) (or NMO-IgG) as a serological biomarker of NMO have been widespread used. Nevertheless, some NMO patients remain seronegative for AQP4-Ab and/or have no detected optic nerve involvement. In addition, no consensus exists on the association between AQP4-Ab serostatus and visual outcome in NMO. To drive a more precise estimate of this postulated relationship, a metaanalysis was performed based on existing relevant studies.
  
  
  METHODS
  Studies were searched by PubMed and MEDLINE up to March 2016. Study quality was assessed, and meta-analysis was conducted using the RevMan 5.1. Odds ratios with 95% confidence interval were calculated and funnel plot was applied to assess the potential publication bias.
  
  
  RESULTS
  In a total of 1288 relevant studies, 18 studies satisfied the eligibility criteria and were included in the systemic review. Only 9 studies appeared eligible for the meta-analysis, together including 624 AQP4-Ab-positive and 119 AQP4-Ab-negative NMO patients. The results revealed associations between AQP4-Ab seropositivity and visual impairment in NMO (OR, 3.16; 95% CI, 1.09, 9.19; P = 0.03). The results of subgroup analyses based on different methods of AQP-4 detection also showed significantly differences between AQP4-Ab seropositivity and visual impairment in NMO, especially in CBA subgroup.
  
  
  CONCLUSIONS
  This meta-analysis indicates that AQP4-Ab serostatus has the positive with poor visual outcome in NMO.
authors.forename: Nan
authors.initials: N
authors.lastname: Lin
authors.forename: Qing
authors.initials: Q
authors.lastname: Liu
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Anatomy, Dalian Medical University, Western 9 Lvshunnan Road, Lvshun District, Dalian, 116044, China.
authors.forename: Jianmei
authors.initials: J
authors.lastname: Ma
authors.affiliation: Advanced Institute for Medical Sciences, Dalian Medical University, Western 9 Lvshunnan Road, Lvshun District, Dalian, 116044, China.
authors.forename: Yuyuan
authors.initials: Y
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D051401:Aquaporin 4 / Q000037:antagonists & inhibitors / Q000097:blood* / Q000235:genetics / Q000276:immunology; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D015870:Gene Expression / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D012720:Severity of Illness Index
chemical_list: C496030:AQP4 protein, human; D051401:Aquaporin 4; D001323:Autoantibodies; D015415:Biomarkers; D007074:Immunoglobulin G
keywords: AQP4-Ab; NMO; NMO-IgG; Neuromyelitis optica; meta-analysis; serostatus; visual outcome