The Clinical Features Of MS-ON And NMO-ON And The Differences Distribution Of HSP90β Antibodies In CSF

Objective:By summarizing the multiple sclerosis related optic neuritis and neuromyelitis optica related optic neuritis, and carries on the analysis, to explore the characteristics of the index can be used to predict the clinical outcome of demyelinating optic neuritis; detection method through the establishment of detection of heat shock protein 90 beta antibody in cerebrospinal fluid of patients with multiple sclerosis related optic neuritis and neuromyelitis optica related optic neuritis, analysis of its distribution in different diseases, to determine the demyelinating optic neuritis early and sensitive biomarker to do some beneficial exploration.Methods:1 From 2012 September to 2015 February in department of ophthalmology of our hospital MS-ON, NMO-ON and optic nerve disease in patients with a total of 185 people as the object of study. Among the 62 MS-ON patients,70 NMO-ON patients,53 patients with non optic nerve diseases. All patients after signing the informed consent, in general, detailed records of patients (age, gender), chief complaint, history of present illness, accompanying symptoms, past history, family history and so on; after admission a experienced doctor does the ophthalmology examination, including visual acuity, corrected visual acuity, relative afferent pupillary defect, optic disc edema, intraocular pressure, anterior segment and fundus examination. If the binocular were incidence, the poor eye were recorded as clinical data, at the same time, dynamic perimetry, visual evoked potential examination, optical coherence tomography examination, and orbital magnetic resonance imaging. The cerebrospinal fluid and blood specimens were sent for routine and immunological examination.2 With a total of 25 enrolled patients from 2012 November to 2015 February in our hospital,8 MS-ON patients,9 NMO-ON patients, and 8 non optic nerve diseases patients were enrolled. Through the training of SH-SY5Y and NB69 cells on the cell membrane, extraction of heat shock protein 90 beta, cerebrospinal fluid and heat shock protein 90 beta antibody detection by membrane protein extraction, analysis of the differences between the groups.Results:1 Age and sex composition between groups had no differences, neuromyelitis optica related optic neuritis were related to the best corrected visual acuity 0.10 (0.01,0.30), multiple sclerosis related optic neuritis was 0.20 (0.05,0.65), there was significant difference compared between the two groups, P=0.029. Between groups mean defect of visual field examination was no statistically significant difference. In the examination of visual evoked potential, neuromyelitis optica related optic neuritis were related to latency of 135.10 milliseconds (123.25,169.25), multiple sclerosis related optic neuritis in group of 118.00 milliseconds (85.90,132.00), has significant differences compared between the two groups, P=0.014. Optical coherence tomography examination showed multiple sclerosis related optic neuritis and neuromyelitis optica related optic neuritis with differences in mean retinal nerve fiber layer thickness on P=0.021, also in the retinal nerve fiber layer thickness of upper quadrant are also different,P=0.022. There was no statistical difference between the optic disc edema. Orbital magnetic resonance imaging showed, compared with the control group, multiple sclerosis related optic neuritis and neuromyelitis optica related optic neuritis have a statistical difference, P=0.000.There was no difference between the groups in cerebrospinal fluid examination.Blood tests showed neuromyelitis optica related optic neuritis associated with serum AQP-4 antibodies of patients with respect to multiple sclerosis related optic neuritis (P=0.023) group and control group (P=0.034).2 In cultured SH-SY5Y and NB69 cells, which can detect the heat shock protein 90 beta, the membrane protein extraction, the detection of CSF antibody immune response in multiple sclerosis related optic neuritis in cerebrospinal fluid of the patients, the positive rate was 75%(6/8), neuromyelitis optica related optic neuritis in cerebrospinal fluid of the patients the positive rate was 14.3%(1/7), the control group had no positive cerebrospinal fluid detection. Compared with MS-ON group and NMO-ON group, there was a significant difference,P=0.041.Conclusion:1. Although the clinical manifestations is complicated during the course of the demyelinating optic neuritis, if careful research, there are still rules to follow. This study showed that neuromyelitis optica related optic neuritis and multiple sclerosis related optic neuritis in best corrected visual acuity, peak value of visual evoked potential, retinal nerve fiber layer thickness, serum AQP-4 antibodies and other aspects of optic neuritis differences, suggesting that the effect of visual function is more serious, and the serum AQP-4 antibody positive rate was higher in neuromyelitis optica related optic neuritis.2.Detection of heat shock protein 90 beta antibodies in the cerebrospinal fluid of multiple sclerosis related optic neuritis compared with neuromyelitis optica related optic neuritis was statistically different. The antibody was further used in clinical course of the disease to predict potential...