Neuromyelitis optica(NMO)refers to an antibody mediated,inflammatory disorder of the central nervous system(CNS)characterized by recurrent or monophasic attacks of optic neuritis and myelitis.Most patients with NMO po...Neuromyelitis optica(NMO)refers to an antibody mediated,inflammatory disorder of the central nervous system(CNS)characterized by recurrent or monophasic attacks of optic neuritis and myelitis.Most patients with NMO possess a specific serum immunoglobin,NMO-IgG,which can serve as a biomarker for NMO.The autoantibodies target aquaporin-4(AQP4),the main water channel protein found in the CNS including the brain,spinal cord,and optic nerve.The remaining 10-25%of patients are seronegative for NMO-IgG despite meeting the diagnostic criteria for NMO.Recent studies have shown that a subset of these patients is seropositive for antibodies against myelin oligodendrocyte glycoprotein(MOG).This paper will provide an overview of the current English scientific literature published regarding the history,epidemiology,AQP4 biomarker,MOG biomarker,diagnosis,clinical features,related diseases in NMO spectrum disorder(NMOSD),and treatments of NMO.展开更多
目的探讨儿童髓鞘少突胶质细胞糖蛋白(MOG)抗体阳性的中枢神经系统脱髓鞘病(central nervous system demyelinating disease)临床、影像学等特征。方法回顾性分析2017年12月至2019年8月无锡市儿童医院诊断的7例MOG抗体阳性中枢神经系统...目的探讨儿童髓鞘少突胶质细胞糖蛋白(MOG)抗体阳性的中枢神经系统脱髓鞘病(central nervous system demyelinating disease)临床、影像学等特征。方法回顾性分析2017年12月至2019年8月无锡市儿童医院诊断的7例MOG抗体阳性中枢神经系统脱髓鞘病患儿的病例资料、随访情况等资料。结果7例患儿中,男2例,女5例,最终诊断2例为急性播散性脑脊髓炎(ADEM),2例为视神经脊髓炎谱系疾病(NMOSD),1例为视神经炎(ON),1例为急性横贯性脊髓炎(ATM),1例尚不能归类。脑脊液检查6例白细胞升高,2例蛋白升高。采用细胞转染色免疫荧光法(CBA)检测MOG抗体,7例血清均阳性,4例脑脊液阳性。影像学检查多部位受累,存在颅内病灶6例,脊髓2例。7例患儿静脉糖皮质激素和丙种球蛋白治疗效果好,随访7个月-2年不等,有2例复发。结论MOG抗体与多种儿童中枢神经系统脱髓鞘病有关,与感染和疫苗接种可能有关,对激素和丙种球蛋白治疗敏感,有易复发的特点。展开更多
Neuromyelitis optica spectrum disorders(NMOSD)is a demyelinating disease mainly involving the optic nerve and spinal cord.It has recurrent and aggravating attacks and high disability rate.Most patients have a stepwise...Neuromyelitis optica spectrum disorders(NMOSD)is a demyelinating disease mainly involving the optic nerve and spinal cord.It has recurrent and aggravating attacks and high disability rate.Most patients have a stepwise progression,resulting in complete blindness or paraplegia.NMOSD lesions contain not only the optic nerve and spinal cord,but also other neurological and non-neurological symptoms,which has clinical heterogeneity.The discovery of aquaporin-4-immunoglobulin G(AQP4-IgG)attributed it to autoimmune ion-channel disease,and rituximab(RTX)has achieved good clinical efficacy in the treatment of NMOSD.Myelin oligodendrocyte glycoprotein(MOG)antibodies have been found in some AQP4-IgG-negative NMOSD patients,which have different clinical and immunological features,posing new challenges to the diagnosis and treatment of NMOSD,which may require re-design and testing of new immune-targeted drugs.展开更多
文摘Neuromyelitis optica(NMO)refers to an antibody mediated,inflammatory disorder of the central nervous system(CNS)characterized by recurrent or monophasic attacks of optic neuritis and myelitis.Most patients with NMO possess a specific serum immunoglobin,NMO-IgG,which can serve as a biomarker for NMO.The autoantibodies target aquaporin-4(AQP4),the main water channel protein found in the CNS including the brain,spinal cord,and optic nerve.The remaining 10-25%of patients are seronegative for NMO-IgG despite meeting the diagnostic criteria for NMO.Recent studies have shown that a subset of these patients is seropositive for antibodies against myelin oligodendrocyte glycoprotein(MOG).This paper will provide an overview of the current English scientific literature published regarding the history,epidemiology,AQP4 biomarker,MOG biomarker,diagnosis,clinical features,related diseases in NMO spectrum disorder(NMOSD),and treatments of NMO.
文摘目的探讨儿童髓鞘少突胶质细胞糖蛋白(MOG)抗体阳性的中枢神经系统脱髓鞘病(central nervous system demyelinating disease)临床、影像学等特征。方法回顾性分析2017年12月至2019年8月无锡市儿童医院诊断的7例MOG抗体阳性中枢神经系统脱髓鞘病患儿的病例资料、随访情况等资料。结果7例患儿中,男2例,女5例,最终诊断2例为急性播散性脑脊髓炎(ADEM),2例为视神经脊髓炎谱系疾病(NMOSD),1例为视神经炎(ON),1例为急性横贯性脊髓炎(ATM),1例尚不能归类。脑脊液检查6例白细胞升高,2例蛋白升高。采用细胞转染色免疫荧光法(CBA)检测MOG抗体,7例血清均阳性,4例脑脊液阳性。影像学检查多部位受累,存在颅内病灶6例,脊髓2例。7例患儿静脉糖皮质激素和丙种球蛋白治疗效果好,随访7个月-2年不等,有2例复发。结论MOG抗体与多种儿童中枢神经系统脱髓鞘病有关,与感染和疫苗接种可能有关,对激素和丙种球蛋白治疗敏感,有易复发的特点。
文摘Neuromyelitis optica spectrum disorders(NMOSD)is a demyelinating disease mainly involving the optic nerve and spinal cord.It has recurrent and aggravating attacks and high disability rate.Most patients have a stepwise progression,resulting in complete blindness or paraplegia.NMOSD lesions contain not only the optic nerve and spinal cord,but also other neurological and non-neurological symptoms,which has clinical heterogeneity.The discovery of aquaporin-4-immunoglobulin G(AQP4-IgG)attributed it to autoimmune ion-channel disease,and rituximab(RTX)has achieved good clinical efficacy in the treatment of NMOSD.Myelin oligodendrocyte glycoprotein(MOG)antibodies have been found in some AQP4-IgG-negative NMOSD patients,which have different clinical and immunological features,posing new challenges to the diagnosis and treatment of NMOSD,which may require re-design and testing of new immune-targeted drugs.