RSS-Feed abonnieren
DOI: 10.1055/s-0031-1274021
Anti-MOG autoantibodies in children with acute demyelination: Comparison of assays and longitudinal analysis
Aims: Myelin oligodendrocyte glycoprotein (MOG) is a target of demyelinating antibodies in several species. Anti-MOG IgG are found in a proportion of children with acute central nervous system demyelinating disease, but the long-term kinetic of anti-MOG autoantibodies is unknown.
Methods: For detection of anti-MOG antibodies two different methods were compared: Western blot with purified myelin and grey matter glycoproteins and flow cytometry with MOG-transfected cells. We addressed the presence of serum anti-MOG Ig in a cross-sectional study analyzing 126 pediatric patients with acute demyelination and 64 adult patients with multiple sclerosis (MS). This was supplemented by a prospective study comprising 77 pediatric patients.
Results: The cross-sectional part of our study elaborated that MOG-transfected cells were recognized by 25% of children with acute demyelination, but by none of the pediatric or adult controls. Sera from 4/64 (6%) adult MS patients had anti-MOG IgG at low levels. Antibodies to MOG were mainly IgG1 and their binding was largely blocked by pathogenic anti-MOG antibodies derived from a spontaneous animal model of autoimmune encephalitis. In contrast, the Western blot did not distinguish between patients and controls. In the prospective part of our study, twenty-five children who were anti-MOG Ig positive at disease onset were followed for up to five years. Anti-MOG antibodies rapidly and continuously declined in all 16 monophasic patients with acute disseminated encephalomyelitis (ADEM) and in one patient with clinically isolated syndrome (CIS). In contrast, in 6 of 8 patients (75%) eventually diagnosed with childhood MS the antibodies to MOG persisted with fluctuations showing a second increase during an observation period of up to 5 years.
Conclusions: The persistence or disappearance of antibodies to MOG may have prognostic relevance for acute childhood demyelination.