Abstract
Background
Antibodies to aquaporin-4 (AQP4-Ab) are found in 60–80% of patients with neuromyelitis
optica (NMO), a severely disabling inflammatory CNS disorder of putative autoimmune
aetiology, which predominantly affects the optic nerves and spinal cord.
Objective
To assess the frequency of AQP4-Ab in patients with optic neuritis (ON), and to investigate
the prognostic implications of AQP4-Ab seropositivity in such patients.
Patients and methods
AQP4-Ab serum levels were determined in 224 individuals from Austria, Denmark, France,
Germany, Italy, and Turkey using a newly developed fluorescence immunoprecipitation
assay employing recombinant human AQP4.
Results
AQP4-Ab were detectable in 8/139 (5.8%) patients with acute monosymptomatic optic
neuritis (AMON) and in 10/17 (58.8%) patients with established NMO and a last relapse
of acute ON (NMO/ON), but not in 32 patients with multiple sclerosis or in 36 healthy
controls. At last examination, 4/8 (50%) seropositive AMON patients had met the criteria
for NMO but 0/128 seronegative AMON patients. Disease severity differed significantly
between seropositive and seronegative AMON. Complete bilateral or unilateral blindness
occurred in six AQP4-Ab positive patients, but only in one AQP4-Ab negative patient.
AQP4-Ab levels did not vary between seropositive AMON and NMO/ON and did not correlate
with disease severity. Female gender, a relapsing course, and concomitant autoimmunity
were associated with AQP4-Ab seropositive status and risk of developing NMO.
Conclusion
AQP4-Ab is relatively rare among patients with AMON, but if present it predicts a
high rate of conversion to NMO within one year.
Keywords
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Article info
Publication history
Published online: September 20, 2010
Accepted:
July 21,
2010
Received in revised form:
July 15,
2010
Received:
March 11,
2010
Identification
Copyright
© 2010 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
