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Updated: May 4, 2026
Human Serum Anti-aquaporin-4 Immunoglobulin G Detection by Cell-based Assay
Published on: April 5, 2019
Distinction between MOG antibody-positive and AQP4 antibody-positive NMO spectrum disorders
Douglas Kazutoshi Sato1, Dagoberto Callegaro, Marco Aurelio Lana-Peixoto
1From the Departments of Neurology (D.K.S., T.T., I.N., M.A.) and Multiple Sclerosis Therapeutics (T.M., K.F.), Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Neurology (D.C., F.M.d.H.J., S.L.A.-P., R.F.S., A.M.M.L.), Faculty of Medicine, University of São Paulo, Brazil; CIEM MS Research Center (M.A.L.-P., N.T.), Federal University of Minas Gerais Medical School, Belo Horizonte, Brazil; Neuroimmunology Group (P.J.W., M.I.L.), Nuffield Department of Clinical Neurosciences, Oxford University, UK.
Objective:
To evaluate clinical features among patients with neuromyelitis optica spectrum disorders (NMOSD) who have myelin oligodendrocyte glycoprotein (MOG) antibodies, aquaporin-4 (AQP4) antibodies, or seronegativity for both antibodies.
Methods:
Sera from patients diagnosed with NMOSD in 1 of 3 centers (2 sites in Brazil and 1 site in Japan) were tested for MOG and AQP4 antibodies using cell-based assays with live transfected cells.
Results:
Among the 215 patients with NMOSD, 7.4% (16/215) were positive for MOG antibodies and 64.7% (139/215) were positive for AQP4 antibodies. No patients were positive for both antibodies. Patients with MOG antibodies represented 21.1% (16/76) of the patients negative for AQP4 antibodies. Compared with patients with AQP4 antibodies or patients who were seronegative, patients with MOG antibodies were more frequently male, had a more restricted phenotype (optic nerve more than spinal cord), more frequently had bilateral simultaneous optic neuritis, more often had a single attack, had spinal cord lesions distributed in the lower portion of the spinal cord, and usually demonstrated better functional recovery after an attack.
Conclusions:
Patients with NMOSD with MOG antibodies have distinct clinical features, fewer attacks, and better recovery than patients with AQP4 antibodies or patients seronegative for both antibodies.
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