The role of anti-aquaporin-4 antibody in Asian patients with multiple sclerosis: Confusions and controversies
- Author:
HT Chong
;
AG Kermode
;
CT Tan
- Publication Type:Review
- From:Neurology Asia
2007;12(1):135-139
- CountryMalaysia
- Language:English
-
Abstract:
Neuromyelitis optica (NMO) was first described as a severe monophasic syndrome of acute bilateral
optic neuritis and transverse myelitis. Whether it is a form of multiple sclerosis (MS) or a separate
disease entity has been continually debated since the beginning of last century. The redefinition of
NMO as a relapsing disease, the wider use of magnetic resonance imaging showing longer spinal cord
lesion, and the recently discovered anti-aquaporin-4 (AQP4) water channel antibody, or NMO-IgG,
has rekindled this controversy. The many recent publications including the abstracts published in this
issue of Neurology Asia have shown that anti-AQP4 antibody is of variable sensitivity in different
populations. It appears to be associated mainly with longitudinal extensive spinal cord lesions and
frequent relapses. The site of pathology of NMO also do not co-localize with the widespread expression
of AQP4 in the body, throwing doubts on the suggestion that the anti-AQP4 antibody plays primary
role in the pathogenesis of NMO. In the day-to-day clinical practice in Asia, anti-AQP4 antibody
remains a research investigatory test. As for optic-spinal MS, which is closely similar to NMO based
on recently revised criteria, interferon should remain the treatment of first choice.
- Full text:P020150828405296451794.pdf
