| Background Neuromyelitis optica (NMO), also known as Devic's disease or Devic'ssyndrome, is an autoimmune, inflammatory disorder in which a person's own immunesystem attacks the optic nerves and spinal cord. Opticospinal MS(OSMS) also called asiaMS, is thought to be one type of MS before, but these years we find it presents manydifferenees with the westem conventional MS in natural history,clininal presentation,imaging features and prognosis.As AQP-4 antibody is discovered , we assure OSMS isthe other pattern of inflammation from that seen in MS. The likely target of theautoimmune attack at least in some patients with NMO has been identified; it is a proteinof the nervous system cells called aquaporin 4 (AQP-4).In Japan,all OSMS with AQP-4antibody positive nearly all have longitudinally extensive spinal cordlesions(LESCLs),so it plays an important role in the process of OSMS.In China we alsofind about one-quarter OSMS patients with AQP-4 antibody prenting positive,but it iscurrently unknown how the AQP-4 antibody immune response leads to LESCLs. InChina there are few reports about this.Objective The purposes of our study is to qualitatively examine AQP-4 antibody byindirect immunofluorescence assay and compare the sensitivity and specicity of theAQP-4 antibody testing method in Chinese people.With the observation of thecorrelation between AQP-4 antibody and the clinical features of CNS demyelinatingdiseases,we can discover its correction between OSMS,NMO and MS ,then provide avaluable and easy-testing laboratory marker for the diagnosis and differential diagnosis.Methods The patients who presented with CNS demyelinating diseases in the FirstAffiliated Hospital of Shanxi Medical University between July 2009 and December 2010were studied(65 cases).It included 15 clinically ascertained NMO patients,17 OSMSpatients and 33 patients with classicMS. All sera taken from the patients who didn't havebreakfast were stored at -80℃refrigerator for use.The positive of all patients'serum AQP--4 antibodywere detected by indirect immunofluorescence ,and clinical analysis also considering patients'MRI(enhanced,T1,T2 and FLAIR Serum)and Extended Disability Status Scale(EDSS).Results Sensitivity and specificity of the anti-AQP4 antibody assay, 64.71% and 75%. Theanti-AQP4 antibody positivity rate was significantly higher in OSMS patients (11/17, 64.7%) thanthose with MS (2/33, 6%), but there was no significant difference between NMO andOSMS ( P> 0.05)．Among OSMS patients, the antibody positivity rate was highest in OSMS patients with longitudinally extensive spinal cord lesions (LESCLs) extending over three vertebral segmentsand brain lesionsConclusion AQP--4 antibody can be regarded as a specific biological marker in thedifferential diagnosis between MS,NMO and OSMS. |
