RT Journal Article
SR Electronic
T1 Autoantibodies to MOG in a distinct subgroup of adult multiple sclerosis
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e257
DO 10.1212/NXI.0000000000000257
VO 3
IS 5
A1 Spadaro, Melania
A1 Gerdes, Lisa Ann
A1 Krumbholz, Markus
A1 Ertl-Wagner, Birgit
A1 Thaler, Franziska Sabrina
A1 Schuh, Elisabeth
A1 Metz, Imke
A1 Blaschek, Astrid
A1 Dick, Andrea
A1 Brück, Wolfgang
A1 Hohlfeld, Reinhard
A1 Meinl, Edgar
A1 Kümpfel, Tania
YR 2016
UL http://nn.neurology.org/content/3/5/e257.abstract
AB Objectives: To evaluate the presence of antibodies to conformation-intact myelin oligodendrocyte glycoprotein (MOG) in a subgroup of adult patients with clinically definite multiple sclerosis (MS) preselected for a specific clinical phenotype including severe spinal cord, optic nerve, and brainstem involvement.Methods: Antibodies to MOG were investigated using a cell-based assay in 3 groups of patients: 104 preselected patients with MS (group 1), 55 age- and sex-matched, otherwise unselected patients with MS (group 2), and in 22 brain-biopsied patients with demyelinating diseases of the CNS (n = 19 with MS), 4 of whom classified as MS type II (group 3). Recognized epitopes were identified with mutated variants of MOG.Results: Antibodies to MOG were found in about 5% (5/104) of preselected adult patients with MS. In contrast, in groups 2 and 3, none of the patients tested positive for MOG antibodies. Patients with MS with antibodies to MOG predominantly manifested with concomitant severe brainstem and spinal cord involvement and had a severe disease course with high relapse rates and failure to several disease-modifying therapies. Three of them had been treated with plasma exchange with a favorable response. All anti-MOG–positive patients with MS showed typical MS lesions on brain MRI. Longitudinal analysis up to 9 years revealed fluctuations and reappearance of anti-MOG reactivity. Epitope mapping indicated interindividual heterogeneity, yet intraindividual stability of the antibody response.Conclusions: Antibodies to MOG can be found in a distinct subgroup of adult MS with a specific clinical phenotype and may indicate disease heterogeneity.Ab=antibody; cMRI=cerebral MRI; DMT=disease-modifying therapy; EGFP=enhanced green fluorescent protein; HLA=human leucocyte antigen; IgG=immunoglobulin G; IgM=immunoglobulin M; MFI=mean fluorescence intensity; MOG=myelin oligodendrocyte glycoprotein; MS=multiple sclerosis; NMOSD=neuromyelitis optica spectrum disorders; OCBs=oligoclonal bands; ON=optic neuritis