Highlights
- •Abnormal albumin quotients are more common in patients with MOG-IgG than AQP4-IgG.
- •BBB damage between MOG-IgG and AQP4-IgG patients in severe disability is similar.
- •MOG-IgG-positive males were less able to improve from treatment than females.
- •Females with AQP4-IgG were more likely to aggravate in disability than males.
Abstract
Background
The disruption of the blood–brain barrier (BBB) is common in patients with neuromyelitis
optica spectrum disorder (NMOSD), causing pro-inflammatory immune cells to migrate
into the central nervous system (CNS) and active demyelinating lesions. Albumin quotient
is commonly used as an indicator for BBB permeability or dysfunction, but its potential
clinical value in NMOSD treatment has never been explored. The present study investigated
the differences in the albumin quotient level among NMOSD patients with different
antibodies (AQP4-IgG and MOG-IgG) and the relationship between the albumin quotient
and neurological dysfunction.
Methods
We retrospectively collected data from 141 patients with NMOSD (104 with AQP4-IgG
and 37 with MOG-IgG) and reviewed their clinical features and albumin quotient levels.
Results
The percentage of patients with an abnormal albumin quotient was significantly higher
in the MOG-IgG group than in the AQP4-IgG group (48.6% vs 27.9%, P = 0.026); albumin quotient levels in the AQP4-IgG-positive group were similar to
those in the MOG-IgG groups (5.65 vs 5.8, P = 0.23). Among those with an abnormal quotient, no differences in the proportions
of severe neurological disability across treatment were found between patients with
AQP4-IgG and those with MOG-IgG (pre-treatment: AQP4-IgG group vs MOG-IgG group: 58.6%
vs 38.9%, P = 0.24; post-treatment: AQP4-IgG group vs MOG-IgG group: 31.0% vs 22.2%, P = 0.74).
Conclusions
The BBB breakdown in NMOSD patients with MOG-IgG may be more common than in those
with AQP4-IgG. AQP4-IgG-positive patients and MOG-IgG-positive patients with severe
neurological disability tend to exhibit similar disruptions to the BBB.
Keywords
Abbreviations:
BBB (blood–brain barrier), NMOSD (neuromyelitis optica spectrum disorder), AQP4-IgG (aquaporin 4 immunoglobulin), MOG-IgG (myelin oligodendrocyte glycoprotein immunoglobulin), CNS (central nervous system)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 02, 2019
Accepted:
November 30,
2019
Received in revised form:
November 24,
2019
Received:
October 27,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
