Smith Tammy L, Haven Thomas R, Zuromski Lauren M, Luong Kyphuong, Clardy Stacey L, Peterson Lisa K
Geriatric Research Education and Clinical Center, George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, UT, United States.
Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, United States.
Front Neurol. 2023 Jul 12;14:1192644. doi: 10.3389/fneur.2023.1192644. eCollection 2023.
As recognition of myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease becomes more widespread, the importance of appropriately ordering and interpreting diagnostic testing for this antibody increases. Several assays are commercially available for MOG testing, and based on a few small studies with very few discrepant results, some have suggested that live cell-based assays (CBA) are superior to fixed CBA for clinical MOG antibody testing. We aimed to determine the real-world agreement between a fixed and live CBA for MOG using two of the most commonly available commercial testing platforms.
We compared paired clinical samples tested at two national clinical reference laboratories and determined the real-world agreement between the fixed CBA and live CBA.
Of 322 paired samples tested on both platforms, 53 were positive and 246 were negative by both methodologies (agreement 92.9%, Cohen's kappa 0.78, [0.69-0.86]). Spearman correlation coefficient was 0.80 ( < 0.0001). Of the discrepant results, only 1 of 14 results positive by the live CBA had a titer greater than 1:100, and only 1 of 9 results positive by the fixed CBA had a titer of greater than 1:80. Lower titers on the fixed CBA correlate to higher titers on the live CBA.
Overall, there is excellent agreement between fixed and live CBA for MOG antibody testing in a real-world clinical laboratory setting. Clinicians should be aware of which method they use to assess any given patient, as titers are comparable, but not identical between the assays.
随着对髓鞘少突胶质细胞糖蛋白（MOG）抗体相关疾病的认识日益广泛，针对该抗体进行适当的检测并解读诊断结果的重要性也随之增加。目前有几种商业化的MOG检测方法，基于一些规模较小且结果差异极少的研究，有人认为基于活细胞的检测方法（CBA）在临床MOG抗体检测方面优于固定细胞CBA。我们旨在使用两种最常用的商业化检测平台，确定固定细胞CBA和活细胞CBA在实际应用中检测MOG的一致性。
我们比较了在两家国家临床参考实验室检测的配对临床样本，并确定了固定细胞CBA和活细胞CBA之间的实际一致性。
在两个平台上检测的322对样本中，两种方法均为阳性的有53对，均为阴性的有246对（一致性为92.9%，科恩kappa系数为0.78，[0.69 - 0.86]）。斯皮尔曼相关系数为0.80（<0.0001）。在结果不一致的情况中，活细胞CBA检测为阳性的14个结果中只有1个滴度大于1:100，固定细胞CBA检测为阳性的9个结果中只有1个滴度大于1:80。固定细胞CBA上较低的滴度与活细胞CBA上较高的滴度相关。
总体而言，在实际临床实验室环境中，固定细胞CBA和活细胞CBA检测MOG抗体的一致性非常好。临床医生应了解他们用于评估任何特定患者的方法，因为两种检测方法的滴度具有可比性，但并不完全相同。
