Patterns of antibody binding to aquaporin-4 isoforms in neuromyelitis optica.

BACKGROUND: Neuromyelitis optica (NMO), a severe demyelinating disease, represents itself with optic neuritis and longitudinally extensive transverse myelitis. Serum NMO-IgG autoantibodies (Abs), a specific finding in NMO patients, target the water channel protein aquaporin-4 (AQP4), which is expres...

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Main Authors: Simone Mader, Andreas Lutterotti, Franziska Di Pauli, Bettina Kuenz, Kathrin Schanda, Fahmy Aboul-Enein, Michael Khalil, Maria K Storch, Sven Jarius, Wolfgang Kristoferitsch, Thomas Berger, Markus Reindl
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2010-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC2864757?pdf=render
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author Simone Mader
Andreas Lutterotti
Franziska Di Pauli
Bettina Kuenz
Kathrin Schanda
Fahmy Aboul-Enein
Michael Khalil
Maria K Storch
Sven Jarius
Wolfgang Kristoferitsch
Thomas Berger
Markus Reindl
author_facet Simone Mader
Andreas Lutterotti
Franziska Di Pauli
Bettina Kuenz
Kathrin Schanda
Fahmy Aboul-Enein
Michael Khalil
Maria K Storch
Sven Jarius
Wolfgang Kristoferitsch
Thomas Berger
Markus Reindl
author_sort Simone Mader
collection DOAJ
description BACKGROUND: Neuromyelitis optica (NMO), a severe demyelinating disease, represents itself with optic neuritis and longitudinally extensive transverse myelitis. Serum NMO-IgG autoantibodies (Abs), a specific finding in NMO patients, target the water channel protein aquaporin-4 (AQP4), which is expressed as a long (M-1) or a short (M-23) isoform. METHODOLOGY/PRINCIPAL FINDINGS: The aim of this study was to analyze serum samples from patients with NMO and controls for the presence and epitope specificity of IgG and IgM anti-AQP4 Abs using an immunofluorescence assay with HEK293 cells expressing M-1 or M-23 human AQP4. We included 56 patients with definite NMO (n = 30) and high risk NMO (n = 26), 101 patients with multiple sclerosis, 27 patients with clinically isolated syndromes (CIS), 30 patients with systemic lupus erythematosus (SLE) or Sjögren's syndrome, 29 patients with other neurological diseases and 47 healthy controls. Serum anti-AQP4 M-23 IgG Abs were specifically detected in 29 NMO patients, 17 patients with high risk NMO and two patients with myelitis due to demyelination (CIS) and SLE. In contrast, IgM anti-AQP4 Abs were not only found in some NMO and high risk patients, but also in controls. The sensitivity of the M-23 AQP4 IgG assay was 97% for NMO and 65% for high risk NMO, with a specificity of 100% compared to the controls. Sensitivity with M-1 AQP4 transfected cells was lower for NMO (70%) and high risk NMO (39%). The conformational epitopes of M-23 AQP4 are the primary targets of NMO-IgG Abs, whereas M-1 AQP4 Abs are developed with increasing disease duration and number of relapses. CONCLUSIONS: Our results confirm M-23 AQP4-IgG Abs as reliable biomarkers in patients with NMO and high risk syndromes. M-1 and M-23 AQP4-IgG Abs are significantly associated with a higher number of relapses and longer disease duration.
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spelling doaj.art-eda66cbe2e3245a9a9139da90c8fc9842022-12-21T18:32:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032010-01-0155e1045510.1371/journal.pone.0010455Patterns of antibody binding to aquaporin-4 isoforms in neuromyelitis optica.Simone MaderAndreas LutterottiFranziska Di PauliBettina KuenzKathrin SchandaFahmy Aboul-EneinMichael KhalilMaria K StorchSven JariusWolfgang KristoferitschThomas BergerMarkus ReindlBACKGROUND: Neuromyelitis optica (NMO), a severe demyelinating disease, represents itself with optic neuritis and longitudinally extensive transverse myelitis. Serum NMO-IgG autoantibodies (Abs), a specific finding in NMO patients, target the water channel protein aquaporin-4 (AQP4), which is expressed as a long (M-1) or a short (M-23) isoform. METHODOLOGY/PRINCIPAL FINDINGS: The aim of this study was to analyze serum samples from patients with NMO and controls for the presence and epitope specificity of IgG and IgM anti-AQP4 Abs using an immunofluorescence assay with HEK293 cells expressing M-1 or M-23 human AQP4. We included 56 patients with definite NMO (n = 30) and high risk NMO (n = 26), 101 patients with multiple sclerosis, 27 patients with clinically isolated syndromes (CIS), 30 patients with systemic lupus erythematosus (SLE) or Sjögren's syndrome, 29 patients with other neurological diseases and 47 healthy controls. Serum anti-AQP4 M-23 IgG Abs were specifically detected in 29 NMO patients, 17 patients with high risk NMO and two patients with myelitis due to demyelination (CIS) and SLE. In contrast, IgM anti-AQP4 Abs were not only found in some NMO and high risk patients, but also in controls. The sensitivity of the M-23 AQP4 IgG assay was 97% for NMO and 65% for high risk NMO, with a specificity of 100% compared to the controls. Sensitivity with M-1 AQP4 transfected cells was lower for NMO (70%) and high risk NMO (39%). The conformational epitopes of M-23 AQP4 are the primary targets of NMO-IgG Abs, whereas M-1 AQP4 Abs are developed with increasing disease duration and number of relapses. CONCLUSIONS: Our results confirm M-23 AQP4-IgG Abs as reliable biomarkers in patients with NMO and high risk syndromes. M-1 and M-23 AQP4-IgG Abs are significantly associated with a higher number of relapses and longer disease duration.http://europepmc.org/articles/PMC2864757?pdf=render
spellingShingle Simone Mader
Andreas Lutterotti
Franziska Di Pauli
Bettina Kuenz
Kathrin Schanda
Fahmy Aboul-Enein
Michael Khalil
Maria K Storch
Sven Jarius
Wolfgang Kristoferitsch
Thomas Berger
Markus Reindl
Patterns of antibody binding to aquaporin-4 isoforms in neuromyelitis optica.
PLoS ONE
title Patterns of antibody binding to aquaporin-4 isoforms in neuromyelitis optica.
title_full Patterns of antibody binding to aquaporin-4 isoforms in neuromyelitis optica.
title_fullStr Patterns of antibody binding to aquaporin-4 isoforms in neuromyelitis optica.
title_full_unstemmed Patterns of antibody binding to aquaporin-4 isoforms in neuromyelitis optica.
title_short Patterns of antibody binding to aquaporin-4 isoforms in neuromyelitis optica.
title_sort patterns of antibody binding to aquaporin 4 isoforms in neuromyelitis optica
url http://europepmc.org/articles/PMC2864757?pdf=render
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