Maillart Elisabeth, Deiva Kumaran, Marignier Romain
Centre de Référence des maladies inflammatoires rares du cerveau et de la moelle (MIRCEM).
Department of Neurology, Hôpital Pitié-Salpêtrière, APHP, Paris.
Curr Opin Neurol. 2024 Jun 1;37(3):338-344. doi: 10.1097/WCO.0000000000001265. Epub 2024 Mar 18.
The clinical landscape associated to myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) has undergone a remarkable transformation over the past two decades, primarily driven by advancements in antibody detection techniques that have enhanced both the specificity and sensitivity of assays, enabling the identification of novel clinical phenotypes.
Recent pivotal research publications, comprehensive reviews from established research groups, and most notably the first proposed international criteria for MOG-Ab associated disease (MOGAD) have substantially enriched our understanding of the clinical features associated with MOG-Ab. This review presents a comprehensive overview of the clinical characteristics of patients with MOG-Ab, systematically examining each core clinical syndrome defined by the proposed international MOGAD criteria. We incorporated recent insights and discussed potential challenges in applying these criteria across diverse clinical scenarios.
The proposed international MOGAD criteria provide a comprehensive, homogeneous, and specific framework for characterizing the clinical features of patients with MOG-Ab, encompassing both paediatric and adult populations. In the future, the widespread adoption of specific and reliable assays for MOG-Ab detection, complemented by the development of surrogate fluid and imaging markers, holds promise for better characterizing atypical presentations, only-cerebrospinal fluid positivity and the MOGAD "seronegative" situations.
在过去二十年中,与髓鞘少突胶质细胞糖蛋白抗体(MOG-Ab)相关的临床情况发生了显著变化,这主要是由抗体检测技术的进步推动的,这些技术提高了检测的特异性和灵敏度,从而能够识别新的临床表型。
近期关键的研究出版物、知名研究团队的全面综述,尤其是首个提出的MOG-Ab相关疾病(MOGAD)国际标准,极大地丰富了我们对与MOG-Ab相关临床特征的理解。本综述全面概述了MOG-Ab患者的临床特征,系统地审视了由提议的国际MOGAD标准定义的每个核心临床综合征。我们纳入了近期的见解,并讨论了在不同临床场景中应用这些标准时可能面临的挑战。
提议的国际MOGAD标准为描述MOG-Ab患者的临床特征提供了一个全面、统一且具体的框架,涵盖了儿童和成人人群。未来,广泛采用针对MOG-Ab检测的特异性和可靠检测方法,并辅以替代标志物和影像学标志物的开发,有望更好地表征非典型表现、仅脑脊液阳性情况以及MOGAD“血清阴性”情况。