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Abstract
Objective: To study the longitudinal dynamics of anti–myelin oligodendrocyte glycoprotein (MOG) autoantibodies in childhood demyelinating diseases.
Methods: We addressed the kinetics of anti-MOG immunoglobulins in a prospective study comprising 77 pediatric patients. This was supplemented by a cross-sectional study analyzing 126 pediatric patients with acute demyelination and 62 adult patients with multiple sclerosis (MS). MOG-transfected cells were used for detection of antibodies by flow cytometry.
Results: Twenty-five children who were anti-MOG immunoglobulin (Ig) positive at disease onset were followed for up to 5 years. Anti-MOG antibodies rapidly and continuously declined in all 16 monophasic patients with acute disseminated encephalomyelitis and in one patient with clinically isolated syndrome. In contrast, in 6 of 8 patients (75%) eventually diagnosed with childhood MS, the antibodies to MOG persisted with fluctuations showing a second increase during an observation period of up to 5 years. Antibodies to MOG were mainly IgG 1 and their binding was largely blocked by pathogenic anti-MOG antibodies derived from a spontaneous animal model of autoimmune encephalitis. The cross-sectional part of our study elaborated that anti-MOG Ig was present in about 25% of children with acute demyelination, but in none of the pediatric or adult controls. Sera from 4/62 (6%) adult patients with MS had anti-MOG IgG at low levels.
Conclusions: The persistence or disappearance of antibodies to MOG may have prognostic relevance for acute childhood demyelination.
GLOSSARY
- ADEM=
- acute disseminated encephalomyelitis;
- CIS=
- clinically isolated syndrome;
- HD=
- healthy donor;
- Ig=
- immunoglobulin;
- IgG=
- immunoglobulin G;
- IgM=
- immunoglobulin M;
- mAb=
- monoclonal antibody;
- MCF=
- mean channel fluorescence;
- MOG=
- myelin oligodendrocyte glycoprotein;
- MS=
- multiple sclerosis;
- NTL=
- nontransgenic littermate;
- OND=
- other neurologic disease;
- ONND=
- other non-neurologic disease;
- PE=
- phycoerythrin
Footnotes
-
Study funding: Supported by the Deutsche Forschungsgemeinschaft (Sonderforschungsbereich 571), the BMBF (Krankheitsbezogenes Kompetenznetz Multiple Sklerose), Excellence Initiative of the Ludwig-Maximilians-University Munich, the FoeFoLe of the Ludwig-Maximilians-University, the Gemeinnützige Hertie Stiftung, and the Research Foundation of the MS Society of Canada to the Canadian Pediatric Demyelinating Disease Study Group.
-
Supplemental data at www.neurology.org
- Received November 24, 2010.
- Accepted April 6, 2011.
- Copyright © 2011 by AAN Enterprises, Inc.
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