MOG-IgG 细胞检测的多中心比较。
A multicenter comparison of MOG-IgG cell-based assays.
机构信息
From the Oxford Autoimmune Neurology Group (P.J.W., M.W., S.R.I.), Nuffield Department of Clinical Neurosciences, UK; Institute for Experimental Immunology (L.K., S.L.), Affiliated to Euroimmun AG, Luebeck, Germany; and Departments of Neurology (M.M., E.P.F., A.C.K., A.M., S.J.P.) and Laboratory Medicine and Pathology (J.F., J.M., E.P.F., A.C.K., A.M., S.J.P.), Mayo Clinic, College of Medicine, Rochester, MN.
出版信息
Neurology. 2019 Mar 12;92(11):e1250-e1255. doi: 10.1212/WNL.0000000000007096. Epub 2019 Feb 6.
OBJECTIVES
To compares 3 different myelin oligodendrocyte glycoprotein-immunoglobulin G (IgG) cell-based assays (CBAs) from 3 international centers.
METHODS
Serum samples from 394 patients were as follows: acute disseminated encephalomyelitis (28), seronegative neuromyelitis optica (27), optic neuritis (21 single, 2 relapsing), and longitudinally extensive (10 single, 3 recurrent). The control samples were from patients with multiple sclerosis (244), hypergammaglobulinemia (42), and other (17). Seropositivity was determined by visual observation on a fluorescence microscope (Euroimmun fixed CBA, Oxford live cell CBA) or flow cytometry (Mayo live cell fluorescence-activated cell sorting assay).
RESULTS
Of 25 samples positive by any methodology, 21 were concordant on all 3 assays, 2 were positive at Oxford and Euroimmun, and 2 were positive only at Oxford. Euroimmun, Mayo, and Oxford results were as follows: clinical specificity 98.1%, 99.6%, and 100%; positive predictive values (PPVs) 82.1%, 95.5%, and 100%; and negative predictive values 79.0%, 78.8%, and 79.8%. Of 5 false-positives, 1 was positive at both Euroimmun and Mayo and 4 were positive at Euroimmun alone.
CONCLUSIONS
Overall, a high degree of agreement was observed across 3 different MOG-IgG CBAs. Both live cell-based methodologies had superior PPVs to the fixed cell assays, indicating that positive results in these assays are more reliable indicators of MOG autoimmune spectrum disorders.
目的
比较来自 3 个国际中心的 3 种不同的髓鞘少突胶质细胞糖蛋白免疫球蛋白 G（IgG）细胞测定法（CBA）。
方法
共检测了 394 例患者的血清样本：急性播散性脑脊髓炎（28 例）、血清阴性视神经脊髓炎（27 例）、视神经炎（21 例单发性，2 例复发性）和纵向广泛型（10 例单发性，3 例复发性）。对照组样本来自多发性硬化症（244 例）、高丙种球蛋白血症（42 例）和其他疾病（17 例）。通过荧光显微镜（Euroimmun 固定 CBA、Oxford 活细胞 CBA）或流式细胞术（Mayo 活细胞荧光激活细胞分选测定法）进行目测观察来确定血清阳性。
结果
在 25 种用任何方法学检测为阳性的样本中，有 21 种在所有 3 种测定法中均为阳性，有 2 种在 Oxford 和 Euroimmun 中为阳性，有 2 种仅在 Oxford 中为阳性。Euroimmun、Mayo 和 Oxford 的结果如下：临床特异性分别为 98.1%、99.6%和 100%；阳性预测值（PPV）分别为 82.1%、95.5%和 100%；阴性预测值分别为 79.0%、78.8%和 79.8%。在 5 种假阳性中，有 1 种在 Euroimmun 和 Mayo 中均为阳性，有 4 种仅在 Euroimmun 中为阳性。
结论
总的来说，3 种不同的 MOG-IgG CBA 之间观察到了高度的一致性。这两种活细胞方法的 PPV 均优于固定细胞测定法，这表明这些测定法中的阳性结果是 MOG 自身免疫谱疾病的更可靠指标。
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