Wu Lei, Yang Yang, Huang De-Hui, Wu Wei-Ping
Department of Neurology, General Hospital of PLA, Beijing 100853, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2011 Feb;31(2):350-2.
To assess the seroprevalence and diagnostic value of aquaporin-4 antibody (AQP4-Ab) in patients with inflammatory central nervous system demyelinating diseases.
Seventy-two patients with neuromyelitis optica (NMO), 68 with multiple sclerosis (MS), 4 with optic neuritis (ON), and 41 with transverse myelitis (TM) were included in this study. The TM group comprised 19 patients with non-longitudinally extensive transverse myelitis (nLETM), 14 with monophasic longitudinally extensive transverse myelitis (mLETM), and 8 with recurrent longitudinally extensive transverse myelitis (rLETM). The serum levels of AQP4-Ab was detected by indirect immunofluorence assay in these patients.
AQP4-Ab was detected in 72.2% (52/72) patients with NMO, 5.9% (4/68) patients with MS, 25.0% (1/4) patients with ON, and 17.1% (7/41) patients with TM, showing a significant difference in the positivity between NMO and MS groups (P<0.01). AQP4-Ab seropositivity rate was 5.3% (1/19) in nLETM patients, 62.5% (5/8) in rLETM patients and 7.1% (1/14) in mLETM patients, significantly higher in rLETM than in nLETM (P<0.01) and mLETM groups (P<0.05), but no statistical difference was found between rLETM and NMO groups.
A high seroprevalence of AQP4-Ab is observed in patients with NMO and rLETM, which support the hypothesis that NMO and rLETM belong to NMO spectrum disorders. AQP4-Ab can serve as a useful index for diagnosing NMO and differential diagnosis from MS. More attention and effective immunosuppressive treatments should be given to patients positive for AQP4-Ab.
评估水通道蛋白4抗体（AQP4-Ab）在炎症性中枢神经系统脱髓鞘疾病患者中的血清阳性率及诊断价值。
本研究纳入72例视神经脊髓炎（NMO）患者、68例多发性硬化（MS）患者、4例视神经炎（ON）患者和41例横贯性脊髓炎（TM）患者。TM组包括19例非纵向广泛横贯性脊髓炎（nLETM）患者、14例单相纵向广泛横贯性脊髓炎（mLETM）患者和8例复发纵向广泛横贯性脊髓炎（rLETM）患者。采用间接免疫荧光法检测这些患者血清中AQP4-Ab水平。
NMO患者中72.2%（52/72）检测到AQP4-Ab，MS患者中5.9%（4/68）检测到，ON患者中25.0%（1/4）检测到，TM患者中17.1%（7/41）检测到，NMO组和MS组阳性率差异有统计学意义（P<0.01）。nLETM患者中AQP4-Ab血清阳性率为5.3%（1/19），rLETM患者中为62.5%（5/8），mLETM患者中为7.1%（1/14），rLETM组显著高于nLETM组（P<0.01）和mLETM组（P<0.05），但rLETM组与NMO组之间无统计学差异。
NMO和rLETM患者中AQP4-Ab血清阳性率较高，支持NMO和rLETM属于视神经脊髓炎谱系疾病的假说。AQP4-Ab可作为诊断NMO及与MS鉴别诊断的有用指标。对AQP4-Ab阳性患者应给予更多关注及有效的免疫抑制治疗。
