从分子免疫病理学的角度看视神经脊髓炎谱系疾病诊断标准的演变

Evolution of diagnostic criteria of spinal cord diseases from the perspective of molecular immunopathology

视神经脊髓炎(optic nerve myelitis,NMO)是区别于多发性硬化(multiple sclerosis,MS)的神经系统炎性脱髓鞘性疾病。由于特异性水通道蛋白-4(aquaporin-4,AQP4)抗体的发现,人们对NMO有了崭新的认识和理解,并提出了视神经脊髓炎谱系疾病(neuromyelitis optica spectrum disorders,NMOSDs)的概念。最近研究发现髓鞘少突胶质细胞糖蛋白(myelin oligodendrocyte glycoprotein,MOG)作为新的靶抗原,在血清AQP4抗体阴性患者中有很大意义。本研究根据分子免疫病理学的新发现、专家共识结合临床经验解读NMOSDs国际诊断标准,对NMOSDs的诊断和治疗提出一些意见。

Optic nerve myelitis（NMO）is an inflammatory demyelinating disease of the central nervous system（CNS）that differs from multiple sclerosis（MS）. With the discovery of NMO highly specific the aquaporin-4（AQP4）antibody,the understanding of NMO has been changed fundamentally,and the concept of neuromyelitis optica spectrum disorders（NMOSDs）is proposed. Recently,it has been found that myelin oligodendrocyte glycoprotein（MOG）,as a new target antigen,is of great significance in patients with negative AQP4 antibody. In this paper,according to the new findings of molecular immunology,expert consensus and clinical experience,we can interpret the NMOSDs international diagnostic criteria,and give some advice on the diagnosis and treatment of NMOSDs.