MOG-IgG 在原发性和继发性慢性进行性多发性硬化中的作用：200 例患者的多中心研究及文献复习。
MOG-IgG in primary and secondary chronic progressive multiple sclerosis: a multicenter study of 200 patients and review of the literature.
机构信息
Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany.
Otto Meyerhof Center, Im Neuenheimer Feld 350, 69120, Heidelberg, Germany.
出版信息
J Neuroinflammation. 2018 Mar 19;15(1):88. doi: 10.1186/s12974-018-1108-6.
BACKGROUND
Antibodies to human full-length myelin oligodendrocyte glycoprotein (MOG-IgG) as detected by new-generation cell-based assays have recently been described in patients presenting with acute demyelinating disease of the central nervous system, including patients previously diagnosed with multiple sclerosis (MS). However, only limited data are available on the relevance of MOG-IgG testing in patients with chronic progressive demyelinating disease. It is unclear if patients with primary progressive MS (PPMS) or secondary progressive MS (SPMS) should routinely be tested for MOG-IgG.
OBJECTIVE
To evaluate the frequency of MOG-IgG among patients classified as having PPMS or SPMS based on current diagnostic criteria.
METHODS
For this purpose, we retrospectively tested serum samples of 200 patients with PPMS or SPMS for MOG-IgG using cell-based assays. In addition, we performed a review of the entire English language literature on MOG-IgG published between 2011 and 2017.
RESULTS
None of 139 PPMS and 61 SPMS patients tested was positive for MOG-IgG. Based on a review of the literature, we identified 35 further MOG-IgG tests in patients with PPMS and 55 in patients with SPMS; the only reportedly positive sample was positive just at threshold level and was tested in a non-IgG-specific assay. In total, a single borderline positive result was observed among 290 tests.
CONCLUSION
Our data suggest that MOG-IgG is absent or extremely rare among patients with PPMS or SPMS. Routine screening of patients with typical PPMS/SPMS for MOG-IgG seems not to be justified.
背景
新一代基于细胞的检测方法最近发现，在出现急性中枢神经系统脱髓鞘疾病的患者中存在针对完整人髓鞘少突胶质细胞糖蛋白（MOG-IgG）的抗体，包括以前被诊断为多发性硬化症（MS）的患者。然而，关于 MOG-IgG 检测在慢性进行性脱髓鞘疾病患者中的相关性，仅有有限的数据。目前尚不清楚原发性进展型多发性硬化症（PPMS）或继发性进展型多发性硬化症（SPMS）患者是否应常规进行 MOG-IgG 检测。
目的
评估根据当前诊断标准将患者分类为 PPMS 或 SPMS 后 MOG-IgG 的出现频率。
方法
为此，我们使用基于细胞的检测方法，对 200 例 PPMS 或 SPMS 患者的血清样本进行了 MOG-IgG 的回顾性检测。此外，我们还对 2011 年至 2017 年期间发表的关于 MOG-IgG 的整个英文文献进行了回顾。
结果
在 139 例 PPMS 和 61 例 SPMS 患者中，均未检测到 MOG-IgG 阳性。基于文献回顾，我们在 PPMS 患者中发现了 35 例进一步的 MOG-IgG 检测，在 SPMS 患者中发现了 55 例；唯一报道的阳性样本仅在阈值水平呈阳性，并且在非 IgG 特异性检测中进行了检测。在总共 290 次检测中，仅观察到一次边界阳性结果。
结论
我们的数据表明，PPMS 或 SPMS 患者中不存在或极罕见 MOG-IgG。对典型 PPMS/SPMS 患者进行 MOG-IgG 常规筛查似乎没有依据。
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