Faissner Simon, Nikolayczik Johanna, Chan Andrew, Gold Ralf, Yoon Min-Suk, Haghikia Aiden
Department of Neurology, St. Josef-Hospital, Ruhr-University, Gudrunstr. 56, D-44791 Bochum, Germany.
Department of Neurology, St. Josef-Hospital, Ruhr-University, Bochum, Germany.
Ther Adv Neurol Disord. 2016 Jul;9(4):281-6. doi: 10.1177/1756285616646332. Epub 2016 May 15.
Neuromyelitis optica spectrum disorder (NMOSD) is a neuroinflammatory disorder of the central nervous system, distinct from multiple sclerosis by affecting predominantly the optic nerve and the spinal cord, and mediated by antibodies directed against aquaporin 4 (AQP4-ab) as a possible pathomechanistic hallmark of NMOSD. Therapeutic options include immunosuppression with steroids or B-cell-depleting agents as baseline therapies, as well as plasma exchange (PLEX) and/or immunoadsorption (IA) during relapses. Until now, data concerning the efficacy of IA alone are scarce.
Visual evoked potentials (VEPs), visual acuity and changes of symptoms at relapse leading to admission in NMOSD patients (n = 10) treated with IA in a single-centre setting were evaluated retrospectively.
All patients profited from the procedure and showed an amelioration of admission symptoms. Three patients improved in visual acuity, another three patients remained stable, whereas five patients showed an improvement in VEPs.
In this small cohort, IA constitutes a valid therapeutic option for patients with NMOSD as an equivalent to PLEX. Analysis in larger cohorts is warranted.
视神经脊髓炎谱系障碍（NMOSD）是一种中枢神经系统的神经炎症性疾病，与多发性硬化症不同，主要影响视神经和脊髓，由针对水通道蛋白4的抗体（AQP4-ab）介导，这可能是NMOSD的一种病理机制标志。治疗选择包括使用类固醇或B细胞清除剂进行免疫抑制作为基础治疗，以及在复发期间进行血浆置换（PLEX）和/或免疫吸附（IA）。到目前为止，关于单独使用IA疗效的数据很少。
回顾性评估在单中心接受IA治疗的NMOSD患者（n = 十）复发时导致入院的视觉诱发电位（VEP）、视力和症状变化。
所有患者均从该治疗中获益，入院症状有所改善。三名患者视力提高，另外三名患者保持稳定，而五名患者的VEP有所改善。
在这个小队列中，IA作为与PLEX等效的治疗方法，是NMOSD患者的一种有效治疗选择。有必要在更大的队列中进行分析。
