Centre for Advanced Neurological Research, K.S Hegde Medical Academy, NIitte University, Karnataka, India.
Front Immunol. 2023 May 26;14:1162248. doi: 10.3389/fimmu.2023.1162248. eCollection 2023.
( persists after colonizing the gut in childhood, and potentially regulates host immune system through this process. Earlier studies have shown that infection in childhood, may protect against MS in later life. Such an association was not seen with AQP4-IgG positive NMOSD, while the association with MOGAD is unclear.
To evaluate frequency of among patients with MOGAD, MS, NMOSD and matched controls and its effect on disease course. To ascertain whether childhood socio economic factors were linked to prevalence of infection.
In all, 99 patients diagnosed to have MOGAD, 99 AQP4 IgG+ NMOSD, 254MS and 243 matched controls were included. Patient demographics, diagnosis, age at disease onset, duration and the last recorded expanded disability status scale (EDSS) were obtained from our records. Socioeconomic and educational status was queried using a previously validated questionnaire. Serum IgG was detected using ELISA kits (Vircell, Spain).
Frequency of IgG was significantly lower among MOGAD (28.3% vs 44%, p-0.007) and MS (21.2% vs 44%, p-0.0001) but not AQP4-IgG+ NMOSD patients (42.4% vs 44%, p-0.78) when compared to controls. Frequency of IgG in MOGAD & MS patients combined (MOGAD-MS) was significantly lower than those with NMOSD (23.2% vs 42.4%, p- 0.0001). Seropositive patients with MOGAD- MS were older (p-0.001. OR -1.04, 95% CI- 1.01- 1.06) and had longer disease duration (p- 0.04, OR- 1.04, 95% CI- 1.002- 1.08) at time of testing. Educational status was lower among parents/caregivers of this study cohort (p- 0.001, OR -2.34, 95% CI- 1.48-3.69) who were IgG
In developing countries infection may be a significant environmental factor related to autoimmune demyelinating CNS disease. Our preliminary data suggests that may exert a differential influence - a largely protective role for MS-MOGAD but not NMOSD and may influence disease onset and course. This differential response maybe related to immuno-pathological similarities between MOGAD and MS in contrast to NMOSD. Our study further underscores the role of as a surrogate marker for poor gut hygiene in childhood and its association with later onset of autoimmune diseases.
（在儿童时期定植肠道后持续存在，并可能通过这一过程调节宿主免疫系统。早期研究表明，儿童时期的感染可能会预防成年后的多发性硬化症。然而，这种关联在 AQP4-IgG 阳性 NMOSD 中并未观察到，而 MOGAD 的关联尚不清楚。
评估 MOGAD、MS、NMOSD 患者与匹配对照者中 感染的频率，并评估其对疾病病程的影响。确定儿童社会经济因素是否与 感染的流行有关。
共纳入 99 例 MOGAD 患者、99 例 AQP4-IgG+NMOSD 患者、254 例 MS 患者和 243 例匹配对照者。从病历中获取患者的人口统计学数据、诊断、发病年龄、病程和最后记录的扩展残疾状况量表（EDSS）。使用先前验证过的问卷询问社会经济和教育状况。使用 ELISA 试剂盒（Vircell，西班牙）检测血清 IgG。
与对照组相比，MOGAD（28.3%比 44%，p-0.007）和 MS（21.2%比 44%，p-0.0001）患者的 IgG 感染频率显著降低，但 AQP4-IgG+NMOSD 患者的 IgG 感染频率无显著差异（42.4%比 44%，p-0.78）。MOGAD 和 MS 患者（MOGAD-MS）的 IgG 感染频率明显低于 NMOSD 患者（23.2%比 42.4%，p-0.0001）。MOGAD-MS 血清阳性患者年龄更大（p-0.001，OR-1.04，95%CI-1.01-1.06），且在检测时病程更长（p-0.04，OR-1.04，95%CI-1.002-1.08）。本研究队列中，父母/照顾者的教育程度较低（p-0.001，OR-2.34，95%CI-1.48-3.69），他们是 IgG
在发展中国家， 感染可能是一种与自身免疫性脱髓鞘中枢神经系统疾病相关的重要环境因素。我们的初步数据表明， 可能发挥不同的影响-对 MS-MOGAD 具有主要的保护作用，但对 NMOSD 没有作用，并且可能影响疾病的发病和病程。这种不同的反应可能与 MOGAD 和 MS 之间在免疫病理学上的相似性有关，而与 NMOSD 不同。我们的研究进一步强调了 作为儿童期肠道卫生不良的替代标志物及其与自身免疫性疾病后期发病的关联。
