Antibody To Aquaporin 4 In The Differential Diag-nosis Of Multiple Sclerosis And Neuromyelitis Optica

Objectives:To detect aquaporin-4 antibody(AQP-4 Ab) in the serum of the patients with multiple sclerosis and neuromyelitis optica, assess the clinical significance of AQP-4 antibodies.Methods:A medical database for the demyelinating diseases in the central nervous system was set up, the clinical informations and the serums of the patients were collected. And human water channel AQP-4-EGFP plasmids were transfected into the HEK-293 cells, the AQP-4-EGFP protein was extracted, and appropriate volumes of the serums and the extraction mixed, the antigen-antibody complexes were precipitated, the FU values were achieved from the fluorescent plate reader. The positive ratio of the AQP-4 antibody was analysed, compared with the clinical features.Results:(1) The AQP-4 antibody positive ratios in the ON, LETM, OSMS, NMO were 58.8%,70.6%,60%,85.7%,respectively;but AQP-4 antibody was negative in CMS group; (2) spinal cord magnetic resonance imaging reveals a T2-weighted lesion that extends contiguously over 3 or more vertebral segments in patients with NMO, Onset brain MRI almost showed normal, and after the first episode, brain MRI of 40.9%patients showed intracranial focus, most of them located on the periventricular area, the corpus callosum and subcortical white matter, brain stem etc; spinal cord in MS patients were less than three segments, most of them which display an ovoid shape located on the centrum semiovale, periventricular area, brain stem and cerebellum,etc;(3) recurrence of NMO group within 2 years was the most common, the recurrence rate was 57.8% and more frequent than in patients with MS;(4)In NMO patients with therapy by methylprednisolone, the FU values of AQP-4 antibodies increased indicates severe clinical symptoms, more recurrence and poor prognosis.Conclusions:(1) Detection of AQP-4 antibodies enables a reliable distinction to be made between NMO and MS;(2) Application of this FIPA showed that antibodies against AQP-4 exist in the majority of patients with NMO,corresponding to a sensitivity of 85.7%and a specificity of 100%; (3) Most NMO patients were common in middle-aged women,subacute onset, relapse and remitting of the disease course, almost associated with autoimmune diseases,cold is the most popular prodromic symptoms; spinal cord magnetic resonance imaging reveals a T2-weighted lesion that extends contiguously over 3 or more vertebral segments, Onset brain MRI almost showed normal, and after the first episode, brain MRI showed intracranial focus, most of them located on the periventricular area, the corpus callosum and subcortical white matter, brainstem,etc,and NMO can be distincted from MS by MRI features aboved mentioned.(4) AQP-4 antibody-positive can indicate recurrence of the NMO spectrum disorders.