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04-05-2024 | Neuromyelitis Optica Spectrum Disease | Original Communication

Correlation between severe attacks and serum aquaporin-4 antibody titer in neuromyelitis optica spectrum disorder

Authors: Rui Wang, Dongren Sun, Xiaofei Wang, Ziyan Shi, Lingyao Kong, Qin Du, Ying Zhang, Hongxi Chen, Wenqin Luo, Nana Zhang, Hongyu Zhou

Published in: Journal of Neurology

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Aquaporin 4-immunoglobulin G (AQP4-IgG) specifically targets aquaporin 4 in approximately 80% of Neuromyelitis Optica Spectrum Disorder (NMOSD) cases. NMOSD is presently categorized as anti-AQP4-antibody (Ab) positive or negative based on AQP4-Ab presence. The association between antibody titers and patient prognosis remains unclear. Therefore, the present study explores the correlation between severe attacks and serum AQP4 Ab titers in patients with neuromyelitis optica spectrum disorder. Data were gathered retrospectively from 546 patients with NMOSD between September 1, 2009, and December 1, 2021. Patients were categorized based on their AQP4-Ab titers: AQP4 titer ≥ 1:320 were classified as the high-titer group, AQP4 (+ +), and AQP4 titer of ≤ 1:100 were classified as the low-titer group, AQP4 ( +). Clinical characteristics and prognoses between the two groups were compared. Patients with AQP4 ( +) exhibited few severe optic neuritis (SON) attacks (false discovery rate [FDR] corrected p < 0.001), a reduced percentage experiencing SON attacks, and a lower incidence of visual disability than patients with AQP4 (+ +). Patients with AQP4 (+ +) and AQP4 ( +) NMOSD exhibited significant difference in annual recurrence rate (ARR) (FDR-corrected p < 0.001). The lower AQP4 Ab titer group demonstrated reduced susceptibility to severe relapse with conventional immunosuppressive agents and rituximab (RTX) than the higher titer group. No significant differences in sex, age at onset, coexisting connective tissue diseases, motor disability, or mortality rates were observed between the two groups. Higher AQP4 Ab titers correlated with increased disease severity and visual disability in patients with NMOSD.
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Correlation between severe attacks and serum aquaporin-4 antibody titer in neuromyelitis optica spectrum disorder
Rui Wang
Dongren Sun
Xiaofei Wang
Ziyan Shi
Lingyao Kong
Qin Du
Ying Zhang
Hongxi Chen
Wenqin Luo
Nana Zhang
Hongyu Zhou
Publication date
Springer Berlin Heidelberg
Published in
Journal of Neurology
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
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