Anti-aquaporin 4 antibody and neuromyelitis optica

Neuromyelitis optica (NMO) is an autoimmune disease of the central nervous system that is associated with a serum anti-aquaporin 4 (AQP4) autoantibody. A commercial-based anti-AQP4 antibody detection system using an enzyme-linked immunosorbent assay (ELISA) has recently become available in Japan. Because this ELISA has low sensitivity, a more sensitive cell-based assay is required in some cases. Some seronegative patients with NMO are reported positive for the anti-myelin oligodendrocyte glycoprotein (MOG) antibody. Because anti-MOG antibody is known to be associated with pediatric acute disseminated encephalomyelitis (ADEM), it is of great interest to determine whether anti-MOG antibody-positive NMO is in the same spectrum as ADEM. Moreover, many adult patients with idiopathic optic neuritis (ON) are positive for the anti-MOG antibody. We suggest that anti-MOG antibody-positive ON tends to occur more frequently in male patients and tends to be milder than anti-AQP4 antibody-positive ON.