血液中性粒细胞、寡克隆带和桥接皮质类固醇是 MOGAD 病程的预测因素：来自葡萄牙多中心队列的启示。

IF 2.9 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2024-10-10 DOI:10.1016/j.msard.2024.105935

Ana Lídia Neves , Andrea Cabral , Catarina Serrão , Daniela Santos Oliveira , Janice Alves , José Miguel Alves , Mafalda Soares , Ernestina Santos , Mafalda Seabra , Helena Felgueiras , João Ferreira , Eva Brandão , Rui Guerreiro , Carla Cecília Nunes , Filipa Ladeira , José Vale , Maria José Sá , André Jorge

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引用次数: 0

摘要

背景：髓鞘少突胶质细胞糖蛋白（MOG）抗体相关疾病（MOGAD）是一种异质性疾病，病程可为单发或复发。目前尚缺乏对复发性疾病的可靠预测指标：确定复发性 MOGAD 的预测因素，尤其是发病时的预测因素：方法：开展了一项多中心观察性回顾研究，以了解葡萄牙成年 MOGAD 患者群的特征。患者从参与研究的中心数据库中确认。从医疗记录中收集临床和人口统计学数据。对复发性和单相性 MOGAD 患者进行了双变量分析比较。重要变量被纳入逐步多元回归分析，以确定复发的独立预测因素：结果：纳入了来自 8 家公立医院的 87 名 MOGAD 患者。复发的 MOGAD 患者占 35.6%（n = 31）。平均诊断延迟时间为 3.2 (±6.2) 年，复发时间为 4.4 (±6.4) 年。多元逻辑回归显示，首次发病时中性粒细胞计数较高（p < 0.01）、存在寡克隆带（p = 0.025）和未使用桥接皮质类固醇（p = 0.038）是复发 MOGAD 的预测因素：结论：首次发病时的中性粒细胞计数和寡克隆带有助于及早做出维持性免疫治疗的决策。结论：首次发病时的中性粒细胞计数和寡克隆带有助于及早做出维持性免疫治疗的决定。有必要进一步开展前瞻性研究。

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Blood neutrophils, oligoclonal bands and bridging corticosteroids as predictive factors for MOGAD course: Insights from a multicentric Portuguese cohort

Background

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a heterogeneous entity with either a monophasic or relapsing course. Well-established predictors of relapsing disease are lacking.

Objective

Identifying predictors of relapsing MOGAD, particularly at disease onset.

Methods

A multicentre observational retrospective study was conducted to characterise a cohort of Portuguese adult MOGAD patients. Patients were identified from participating centre databases. Clinical and demographic data were collected from medical records. Bivariate analysis was conducted to compare patients with relapsing and monophasic MOGAD. Significant variables were included in a stepwise multiple regression analysis to identify independent predictors of relapse.

Results

Eighty-seven MOGAD patients from 8 public hospitals were included. Relapsing MOGAD was found in 35.6% (n = 31). Mean diagnostic delay was 3.2 (±6.2) years and time to relapse was 4.4 (±6.4) years. Multiple logistic regression showed that higher neutrophil count (p < 0.01), presence of oligoclonal bands (p = 0.025) and no bridging corticosteroids (p = 0.038) at first attack were predictive of relapsing MOGAD.

Conclusion

Neutrophil count and oligoclonal bands at first attack may facilitate early decision-making regarding maintenance immunotherapy. Bridging corticosteroids may also influence the course of MOGAD. Further studies with prospective design are warranted.

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.