MOG-IgG associated optic neuritis is not multiple sclerosis

ABSTRACT

Autoantibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been reported in patients with inflammatory central nervous system disorders including isolated optic neuritis (ON). We compared our MOG-IgG ON patients with multiple sclerosis (MS) patients presenting with ON. Methods and results: Among the total of 38 patients with optic neuropathies, six patients with isolated ON were MOG-IgG positive and eight patients with ON fulfilled the diagnostic criteria for MS. All MS patients were negative for MOG-IgG using a cell-based assay. When compared with the MS group, the MOG-IgG patients were older (mean 47 years), more frequently male (ratio 2:1) and had a higher frequency of bilateral and/or recurrent ON. The brain magnetic resonance imaging of all MOG-IgG positive patients was normal or had only unspecific white matter T2 lesions. Conclusion: These findings suggest that MOG-IgG is a biomarker of an inflammatory demyelinating CNS disease distinct from MS.

RESUMO

Autoanticorpos contra a glicoproteína da mielina do oligodendrócito (MOG-IgG) têm sido descritos em pacientes com neurite óptica (NO) isolada, entre outras doenças inflamatórias do sistema nervoso central. Comparamos os nossos pacientes com NO MOG-IgG positivos com pacientes com NO associada a esclerose múltipla (EM). Materias e métodos: De um total de 38 pacientes com neuropatia óptica, seis foram MOG-IgG positivos e oito preencheram critérios diagnósticos para EM. Todos os pacientes com EM foram negativos para MOG-IgG (ensaio baseado em células). Quando comparados ao grupo com EM, os pacientes MOG-IgG positivos apresentam idade mais avançada (mediana de 47 anos) e tiveram uma frequência maior de NO bilateral e/ou recorrente. Houve predomínio masculino (relação 2:1). A ressonância magnética de encéfalo de todos os pacientes MOG-IgG positivos foi normal ou demonstrou apenas lesões inespecíficas em T2. Conclusão: Nossos achados sugerem que o MOG-IgG é um biomarcador de doença desmielinizante diferente da EM.

Keywords:

optic neuritis - multiple sclerosis - myelin oligodendrocyte glycoprotein - autoantibodies - demyelinating diseases

Palavras-chave:

neurite óptica - esclerose múltipla - glicoproteína mielina-oligodendrócito - autoanticorpos - doenças desmielinizantes

• References

• 1 Popescu BF, Lucchinetti CF. Pathology of demyelinating diseases. Annu Rev Pathol. 2012;7(1):185-217. https://doi.org/10.1146/annurev-pathol-011811-132443
• 2 Ferguson B, Matyszak MK, Esiri MM, Perry VH. Axonal damage in acute multiple sclerosis lesions. Brain. 1997;120(Pt 3):393-9. https://doi.org/10.1093/brain/120.3.393
• 3 Lennon VA, Wingerchuk DM, Kryzer TJ, Pittock SJ, Lucchinetti CF, Fujihara K et al. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet. 2004;364(9451):2106-12. https://doi.org/10.1016/S0140-6736(04)17551-X
• 4 Mayer MC, Meinl E. Glycoproteins as targets of autoantibodies in CNS inflammation: MOG and more. Ther Adv Neurol Disorder. 2012;5(3):147-59. https://doi.org/10.1177/1756285611433772
• 5 Reindl M, Di Pauli F, Rostásy K, Berger T. The spectrum of MOG autoantibody-associated demyelinating diseases. Nat Rev Neurol. 2013;9(8):455-61. https://doi.org/10.1038/nrneurol.2013.118
• 6 Sato DK, Callegaro D, Lana-Peixoto MA, Waters PJ, Jorge FMH, Takahashi T et al. Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders. Neurology. 2014;82(6):474-81. https://doi.org/10.1212/WNL.20170121201701210101
• 7 Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015;85(2):177-89. https://doi.org/10.1212/WNL.20170121201701211729
• 8 Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292-302. https://doi.org/10.1002/ana.22366
• 9 Chalmoukou K, Alexopoulos H, Akrivou S, Stathopoulos P Reindl M, Dalakas MC. Anti-MOG antibodies are frequently associated with steroid-sensitive recurrent optic neuritis. Neurol Neuroimmunol Neuroinflamm. 2015;2(4):e131. https://doi.org/10.1212/NXI.20170121201701210131
• 10 Ramanathan S, Reddel SW, Henderson A, Parratt JD, Barnett M, Gatt PN et al. Antibodies to myelin oligodendrocyte glycoprotein in bilateral and recurrent optic neuritis. Neurol Neuroimmunol Neuroinflamm. 2014;1(4):e40. https://doi.org/10.1212/NXI.20170121201701210040
• 11 Nakajima H, Motomura M, Tanaka K, Fujikawa A, Nakata R, Maeda Y et al. Antibodies to myelin oligodendrocyte glycoprotein in idiopathic optic neuritis. BMJ Open. 2015;5(4):e007766. https://doi.org/10.1136/bmjopen-2015-007766