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JNNP:脑脊液与血清中的MOG-IgG的含量关系

2021-07-16 MedSci原创 MedSci原创

髓鞘少突胶质细胞糖蛋白(MOG-IgG)的免疫球蛋白γ自身抗体与特定的神经系统综合征相关,最常见的是急性播散性脑脊髓炎、视神经炎和纵向广泛性横纹肌炎。对于所有神经系统抗体,包括MOG-Ig

髓鞘少突胶质细胞糖蛋白(MOG-IgG)的免疫球蛋白γ自身抗体与特定的神经系统综合征相关,最常见的是急性播散性脑脊髓炎、视神经炎和纵向广泛性横纹肌炎。对于所有神经系统抗体,包括MOG-IgG,其血清浓度高于脑脊液(CSF)。因此,脑脊液检测在临床中是不常见的。然而,最近的研究报道了脑脊液中有MOG-IgG但没有检测到血清MOG-IgG的患者。本文的目的是通过分析来国家检测数据库的所有配对血清和脑脊液样本中的MOG IgG结果来解释这个问题。

数据来自2011年至2019年间牛津大学自身免疫神经病学诊断实验室(Oxford Autoimmune Neurology Diagnostic Laboratory)的MOG-IgG细胞检测(CBA)数据库。这些数据包括内科医生提交给中心进行MOG-IgG检测的所有样本。血清样本来自272个中心,脑脊液来自97个中心。MOG-IgG检测采用基于细胞的检测方法进行。阳性或阴性的MOG-IgG结果有22例/ 554例。对于血清阴性和CSF-MOG-IgG阳性的患者,患者的全科医生和转诊的神经科医生提供病例说明和检测结果,从中提取预先指定的临床和临床参数(年龄、性别、复发的临床表现、,自身免疫性个人或家族病史、恶性肿瘤、癫痫、MRI表现、脑脊液结果、过去和现在的治疗和残疾结果)。数据与已公布的队列进行比较。

118/533(22.1%)配对样本的患者在血清或脑脊液中显示MOG-IgG阳性,其中66/118(55.9%)仅在血清中显示阳性,48/118(40.7%)在血清或脑脊液均为阳性。本文对仅在脑脊液中检测到MOG-IgG的患者(4/118)进行半定量视觉评估CBA评分(4分中的1分、1分、2分和4分,1分至1.5分的样本被视为低阳性,高于1.5者为阳性),与血清和脑脊液MOG-IgG阳性患者的脑脊液样本CBA评分无显著差异(p=0.53,Wilcoxon秩和检验)。一名患者被诊断为肺炎球菌性脑膜炎,既未接受治疗,也未被认为有MOG-IgG相关疾病。其余2例(CSF-CBA评分4分和1分)MRI检查中显示纵行广泛性横纹肌炎。1例患者脑脊液显示淋巴细胞增多,蛋白轻度升高。两例患者脑脊液寡克隆带均为阴性。两名患者均接受短期类固醇治疗,随后接受静脉注射免疫球蛋白或血浆置换。将其临床特征和结果指标与牛津大学已发表的MOG-IgG血清阳性患者队列进行了比较,没有发现明显的特征。

研究结果表明,血清可供检测的队列中阳性检测的比例(n=21 731)为8.7%,对于仅有脑脊液的患者,脑脊液阳性结果的比例(6.7%,n=231)低于配对样本的患者(9.8%)。发现一例肺炎球菌性脑膜炎患者的脑脊液MOG-IgG与临床表现无关。局限性包括研究期间MOG-IgG与IgG1检测方法的改变(尽管无论采用何种方法,MOG-IgG与IgG1阳性结果的比例没有显著变化)。脑脊液MOG-IgG阳性率可能会随着时间的推移而降低。CSF MOG IgG阳性率低于以前的研究。本文建议CSF-MOG-IgG检测应根据每个个体的临床情况判断,并在有临床指征时进行。了解用于测量CSF-MOG-IgG的特定方法如何确定不同患者队列的敏感性和特异性将是重要的。进一步的研究应集中于研究患者和对照组(包括临床确诊的多发性硬化患者)的配对血清和脑脊液样本。

Pace SOrrell MWoodhall M, et al Frequency of MOG-IgG in cerebrospinal fluid versus serum

 

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    2021-07-18 Boyinsh
  2. [GetPortalCommentsPageByObjectIdResponse(id=1585397, encodeId=ff8d158539eba, content=<a href='/topic/show?id=2e681208016' target=_blank style='color:#2F92EE;'>#MOG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12080, encryptionId=2e681208016, topicName=MOG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a85417178370, createdName=Boyinsh, createdTime=Sun Jul 18 12:39:58 CST 2021, time=2021-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615227, encodeId=78df161522e64, content=<a href='/topic/show?id=010c9506a3' target=_blank style='color:#2F92EE;'>#IgG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9506, encryptionId=010c9506a3, topicName=IgG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c4f19588882, createdName=ms5768352621950538, createdTime=Sun Jul 18 12:39:58 CST 2021, time=2021-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1000320, encodeId=ea65100032081, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210129/1f7bcc47e19e459f84f162cbdd4e7e4c/f96be1903e2644a39fb32c7d667dbc9c.jpg, createdBy=312c5456893, createdName=ms温馨, createdTime=Sat Jul 17 09:58:22 CST 2021, time=2021-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1000254, encodeId=004e100025445, content=如何确定不同患者队列的敏感性和特异性将是重要的。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bd984965877, createdName=1453df99m58暂无昵称, createdTime=Fri Jul 16 23:04:24 CST 2021, time=2021-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1000236, encodeId=be461000236f0, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Fri Jul 16 22:24:36 CST 2021, time=2021-07-16, status=1, ipAttribution=)]
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    2021-07-17 ms温馨

    谢谢分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1585397, encodeId=ff8d158539eba, content=<a href='/topic/show?id=2e681208016' target=_blank style='color:#2F92EE;'>#MOG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12080, encryptionId=2e681208016, topicName=MOG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a85417178370, createdName=Boyinsh, createdTime=Sun Jul 18 12:39:58 CST 2021, time=2021-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615227, encodeId=78df161522e64, content=<a href='/topic/show?id=010c9506a3' target=_blank style='color:#2F92EE;'>#IgG#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9506, encryptionId=010c9506a3, topicName=IgG)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6c4f19588882, createdName=ms5768352621950538, createdTime=Sun Jul 18 12:39:58 CST 2021, time=2021-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1000320, encodeId=ea65100032081, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210129/1f7bcc47e19e459f84f162cbdd4e7e4c/f96be1903e2644a39fb32c7d667dbc9c.jpg, createdBy=312c5456893, createdName=ms温馨, createdTime=Sat Jul 17 09:58:22 CST 2021, time=2021-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1000254, encodeId=004e100025445, content=如何确定不同患者队列的敏感性和特异性将是重要的。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bd984965877, createdName=1453df99m58暂无昵称, createdTime=Fri Jul 16 23:04:24 CST 2021, time=2021-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1000236, encodeId=be461000236f0, content=好文章,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Fri Jul 16 22:24:36 CST 2021, time=2021-07-16, status=1, ipAttribution=)]
    2021-07-16 1453df99m58暂无昵称

    如何确定不同患者队列的敏感性和特异性将是重要的。。

    0

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    2021-07-16 yangchou

    好文章,谢谢分享。

    0

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