Background We evaluated the seroprevalence of myelin oligodendrocyte glycoprotein immunoglobulin G1 (MOG-IgG) and associated clinical features of patients from a large adult-dominant unselected cohort with mainly relapsing central nervous system (CNS) inflammatory diseases. We also investigate the clinical relevance of MOG-IgG through a longitudinal analysis of serological status over a 2-year follow-up period.
Methods Serum samples from 505 patients with CNS inflammatory diseases at the National Cancer Center were analysed using cell-based assays for MOG-IgG and aquaporin-4 immunoglobulin G (AQP4-IgG). MOG-IgG serostatus was longitudinally assessed in seropositive patients with available serum samples and at least 2 years follow-up.
Results Twenty-two of 505 (4.4%) patients with CNS inflammatory diseases were positive for MOG-IgG. Patients with MOG-IgG had neuromyelitis optica spectrum disorder (NMOSD, n=10), idiopathic AQP4-IgG-negative myelitis (n=4), idiopathic AQP4-IgG-negative optic neuritis (n=4), other demyelinating syndromes (n=3) and multiple sclerosis (n=1). No relapses were seen in patients when they became MOG-IgG seronegative, whereas a persistent positive serological status was observed in patients with clinical relapses despite immunotherapy.
Conclusions In a large adult-predominant unselected cohort of mainly relapsing CNS inflammatory diseases, we confirmed that NMOSD phenotype was most commonly observed in patients with MOG-IgG. A longitudinal analysis with 2-year follow-up suggested that persistence of MOG-IgG is associated with relapses.
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PW and HJK are joint senior authors
Contributors HJK and PW had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: JWH, SHK, HJK and PW. Acquisition, analysis or interpretation of data: all authors. Drafting of manuscript: JWH, HJK and PW. Critical revision of manuscript for important intellectual content: all authors. Study supervision: HJK and PW.
Competing interests JWH, MRW, SHK, IHJ, BSK, GYK, YSK report no disclosures. SRI is supported by the Wellcome Trust, British Medical Association Research grant, Vera Down grant and Epilepsy Research UK. PW has received honoraria from Biogen Idec Japan, Euroimmun AG, Germany and Mereo Biopharma, UK; SRI and PW are named coinventors and receive royalties for assays for the detection of antibodies. HJK has lectured, consulted and received honoraria from Bayer Schering Pharma, Biogen, Genzyme, HanAll BioPharma, MedImmune, Merck Serono, Novartis, Teva-Handok and UCB; received a grant from the Ministry of Science, ICT & Future Planning; accepted research funding from Genzyme, Kael-GemVax, Merck Serono, Teva-Handok and UCB; serves on a steering committee for MedImmune; is a coeditor for the Multiple Sclerosis Journal—Experimental, Translational and Clinical, and an associated editor for the Journal of Clinical Neurology.
Patient consent Obtained.
Ethics approval The Institutional Review Board of NCC approved the present study.
Provenance and peer review Not commissioned; externally peer reviewed.
Correction notice Since this article was first published online an update has been made to the author name Byeong-su Kong. This author name has been updated to Byungsoo Kong.