Myelin Oligodendrocyte Glycoprotein Antibodies in Adults with a First Demyelinating Event Suggestive of Multiple Sclerosis
Villacieros-Álvarez, Javier (Universitat Autònoma de Barcelona)
Espejo, Carmen (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Arrambide, Georgina (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Castillo Juárez, Mireia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Carbonell-Mirabent, Pere (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rodriguez, Marta (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Bollo, Luca (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Castilló, Joaquín (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Comabella López, Manuel (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Galan, Ingrid (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Midaglia, Luciana (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Mongay-Ochoa, Neus (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Nos, Carlos (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rio, Jordi (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rodríguez Acevedo, Breogán (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Sastre-Garriga, Jaume (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Tur, Carmen (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Vidal-Jordana, Angela (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Vilaseca, Andreu (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Zabalza, Ana (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Auger, Cristina (Universitat Autònoma de Barcelona. Departament de Medicina)
Rovira, Alex (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Montalban, Xavier (Universitat Autònoma de Barcelona. Departament de Medicina)
Tintoré, Mar (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Cobo-Calvo, Álvaro (Hospital Universitari Vall d'Hebron. Institut de Recerca)

Data:	2024
Resum:	Objective: Myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) distinguish multiple sclerosis (MS) from MOG-associated disease in most cases. However, studies analyzing MOG-Ab at the time of a first demyelinating event suggestive of MS in adults are lacking. We aimed to (1) evaluate the prevalence of MOG-Ab in a first demyelinating event suggestive of MS and (2) compare clinical and paraclinical features between seropositive (MOG-Ab+) and seronegative (MOG-Ab-) patients. Methods: Six hundred thirty adult patients with available serum samples obtained within 6 months from the first event were included. MOG-Ab were analyzed using a live cell-based assay. Statistical analyses included parametric and nonparametric tests, logistic regression, and survival models. Results: MOG-Ab were positive in 17 of 630 (2. 7%). Fourteen out of 17 (82. 4%) MOG-Ab+ patients presented with optic neuritis (ON) compared to 227of 613 (37. 0%) MOG-Ab- patients (p = 0. 009). Cerebrospinal fluid-restricted oligoclonal bands (CSF-OBs) were found in 2 of 16 (12. 5%) MOG-Ab+ versus 371 of 601 (61. 7%) MOG-Ab- subjects (p < 0. 001). Baseline brain magnetic resonance imaging (MRI) was normal in 9 of 17 (52. 9%) MOG-Ab+ versus 153 of 585 (26. 2%) MOG-Ab- patients (p = 0. 029). Absence of CSF-OBs and ON at onset were independently associated with MOG-Ab positivity (odds ratio [OR] = 9. 03, 95% confidence interval [CI] = 2. 04-53. 6, p = 0. 009; and OR = 4. 17, 95% CI = 1. 15-19. 8, p = 0. 042, respectively). Of MOG-Ab+ patients, 22. 9% (95% CI = 0. 0-42. 7) compared to 67. 6% (95% CI = 63. 3-71. 3) of MOG-Ab- patients fulfilled McDonald 2017 criteria at 5 years (log-rank p = 0. 003). Interpretation: MOG-Ab are infrequent in adults with a first demyelinating event suggestive of MS. However, based on our results, we suggest to determine these antibodies in those patients with ON and absence of CSF-OBs, as long as the brain MRI is not suggestive of MS. ANN NEUROL 2024;95:116-128.
Ajuts:	Instituto de Salud Carlos III FI21/00282 Instituto de Salud Carlos III JR19/00007 Instituto de Salud Carlos III PI20/00800
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Annals of neurology, Vol. 95, Núm. 1 (january 2024) , p. 116-128, ISSN 1531-8249

DOI: 10.1002/ana.26793

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