Influencing factors and clinical value of anti-aquaporin-4 antibody in cerebrospinal fluid: a study of 82 patients with neuromyelitis optica spectrum disorder.

IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY
Jing Peng, Feifei Yu, Xiajun Zhou, Yifan Wu, Kan Wang, Jie Ding, Nan Zhao, Desheng Zhu, Yangtai Guan, Chong Xie
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引用次数: 0

Abstract

Objective: Serum AQP4 antibody (AQP4-IgG) is the causative antibody of neuromyelitis optica spectrum disorder (NMOSD) but AQP4-IgG in cerebrospinal fluid (CSF) has been seldom studied. We aimed to explore the clinical value and influencing factors of CSF AQP4-IgG in NMOSD.

Methods: In this study, we screened 137 patients with NMOSD diagnosed according to the 2015 International Consensus Diagnostic Criteria (IPND criteria). From this cohort, paired CSF and serum samples were simultaneously collected from 82 patients (including seropositive and seronegative subgroups) for antibody titer measurement. We explored the relationship between CSF AQP4-IgG and patient's clinical features. Their demographic, clinical, laboratory data and MRI images were collected and analyzed.

Results: 74 patients were seropositive for AQP4-IgG and 8 patients were seronegative. Among the 74 patients seropositive for AQP4-IgG, 46 were CSF-positive and 28 were CSF-negative, while none of the 8 seronegative patients were CSF-positive. CSF AQP4-IgG positive and negative patients showed significant differences in EDSS and relapse status. Out of the 82 patients, 67 patients were during relapse and only patients during relapse were included in the next analysis. Between the CSF-positive and CSF-negative patients, no significant differences were found in EDSS, relapse manifestation, CSF indicators, serum cytokine levels, lymphocyte subsets or MRI lesions. Responses to treatment during relapse and length of hospital stay showed no significant differences either. A positive correlation between the serum and CSF titers (rs: 0.64, p < 0.001) was found. Further binary logistic regression analysis revealed that CSF AQP4-IgG positivity was associated with serum AQP4-IgG titers and EDSS scores.

Conclusions: CSF AQP4-IgG positivity primarily results from passive diffusion of serum antibodies across the blood-brain barrier, which is different from the CNS-restricted antibody production in MOG-IgG associated disorders (MOGAD). Limited prognostic value of CSF AQP4-IgG was revealed in this study.

82例视神经脊髓炎谱系障碍患者脑脊液中抗水通道蛋白-4抗体的影响因素及临床价值
目的:血清AQP4抗体(AQP4- igg)是视神经脊髓炎频谱障碍(NMOSD)的致病抗体,但目前对脑脊液AQP4- igg的研究较少。目的探讨脑脊液AQP4-IgG在NMOSD中的临床价值及影响因素。方法:在本研究中,我们筛选了137例根据2015年国际共识诊断标准(IPND)诊断的NMOSD患者。从该队列中,同时收集82例患者(包括血清阳性和血清阴性亚组)的配对CSF和血清样本用于抗体滴度测定。探讨CSF AQP4-IgG与患者临床特征的关系。收集和分析他们的人口统计学、临床、实验室数据和MRI图像。结果:AQP4-IgG血清阳性74例,阴性8例。74例AQP4-IgG血清阳性患者中,csf阳性46例,csf阴性28例,8例血清阴性患者均无csf阳性。CSF AQP4-IgG阳性与阴性患者EDSS及复发情况差异有统计学意义。在82例患者中,67例患者处于复发期,只有复发期患者被纳入下一次分析。CSF阳性与CSF阴性患者在EDSS、复发表现、CSF指标、血清细胞因子水平、淋巴细胞亚群、MRI病变等方面均无显著差异。复发期间对治疗的反应和住院时间也无显著差异。结论:脑脊液AQP4-IgG阳性主要是由于血清抗体在血脑屏障上的被动扩散,这与MOGAD中cns限制性抗体的产生不同。本研究揭示了CSF AQP4-IgG对预后的有限价值。
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来源期刊
Acta neurologica Belgica
Acta neurologica Belgica 医学-临床神经学
CiteScore
4.20
自引率
3.70%
发文量
300
审稿时长
6-12 weeks
期刊介绍: Peer-reviewed and published quarterly, Acta Neurologica Belgicapresents original articles in the clinical and basic neurosciences, and also reports the proceedings and the abstracts of the scientific meetings of the different partner societies. The contents include commentaries, editorials, review articles, case reports, neuro-images of interest, book reviews and letters to the editor. Acta Neurologica Belgica is the official journal of the following national societies: Belgian Neurological Society Belgian Society for Neuroscience Belgian Society of Clinical Neurophysiology Belgian Pediatric Neurology Society Belgian Study Group of Multiple Sclerosis Belgian Stroke Council Belgian Headache Society Belgian Study Group of Neuropathology
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