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. 2010 Sep;67(9):1102-8.
doi: 10.1001/archneurol.2010.197.

Elevated intrathecal myelin oligodendrocyte glycoprotein antibodies in multiple sclerosis

Eric C Klawiter  1 , Laura Piccio, Jeri-Anne Lyons, Robert Mikesell, Kevin C O'Connor, Anne H Cross
Affiliations

Elevated intrathecal myelin oligodendrocyte glycoprotein antibodies in multiple sclerosis

Eric C Klawiter et al. Arch Neurol. 2010 Sep.

Abstract

Objective: To evaluate antibodies to myelin oligodendrocyte glycoprotein (MOG) in the serum and cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS) and control individuals.

Design: Prospective case-control series.

Setting: Academic referral center.

Patients: Twenty-six controls with noninflammatory neurologic disease and 35 patients with MS donated serum and CSF for recombinant MOG (rMOG) antibody determination.

Main outcome measures: Serum and CSF rMOG antibody and albumin levels were used to calculate an rMOG index. Clinical disability, CSF markers, and magnetic resonance metrics were correlated with the rMOG index.

Results: The rMOG index was elevated in MS patients compared with controls (P = .01). Patients with progressive MS exhibited elevated rMOG indexes compared with patients with relapsing-remitting MS (P = .04). The rMOG index was inferior to the IgG index in differentiating MS patients from controls. However, 7 of 16 patients with MS who had normal immunoglobulin G indexes had an elevated rMOG index. The rMOG index did not correlate with clinical disability, other CSF markers, or radiographic outcome measures.

Conclusions: The rMOG index, a marker of intrathecal MOG antibody production, may provide complementary information to routine CSF testing in the diagnosis of MS. Furthermore, intrathecal anti-MOG antibody production may be more pronounced in progressive than in relapsing forms of MS.

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Figures

Figure 1
Figure 1
rMOG index in controls versus MS. The box plot compares rMOG indices between 26 control subjects and 35 MS subjects. MS subjects have elevated rMOG indices compared to controls (p=0.012).
Figure 2
Figure 2
rMOG indices of MS subtypes. A box plot of controls, and MS subjects separated by disease subtype (RRMS, SPMS, PPMS) reflects elevated rMOG index in progressive MS subjects (p=0.041).
Figure 3
Figure 3
Receiver Operator Curve (ROC) of rMOG index and IgG index. A larger area under the curvereflects a better diagnostic test. TheROC demonstrates superiority of IgG index (area under the curve 0.891) over rMOG index (0.685) as a diagnostic test for differentiating MS from controls.
See this image and copyright information in PMC

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