Opticospinal multiple sclerosis in Japanese
- Author:
Jun-ichi Kira
;
Takuya Matsushita
;
Noriko Isobe
;
Takaaki Ishizu
- Publication Type:Case Reports
- From:Neurology Asia
2008;13(1):167-173
- CountryMalaysia
- Language:English
-
Abstract:
Antibodies to aquaporin-4 (AQP4) are found in a number of Japanese opticospinal multiple sclerosis
(OSMS) patients. Whether anti-AQP4 antibody-positive and -negative OSMS patients are afflicted with
an identical disease remains unknown. To clarify immunological differences between the two groups of
patients, we studied serum antibody titres against AQP4 in 191 patients with idiopathic central nervous
system demyelinating diseases and clarified any relationships with immunological parameters. The
anti-AQP4 antibody positivity rate was higher in patients with OSMS (36.2%), idiopathic recurrent
myelitis (23.5%), and recurrent optic neuritis (26.9%) than in conventional MS patients (8.0%), and those
with other diseases (0%). Anti-AQP4 antibody titre was significantly higher in patients with SS-A/B
antibodies than in those without. Anti-AQP4 antibody-negative OSMS patients showed significantly
higher CD4+
IFN-γ+
IL-4-
T cell percentages and intracellular IFN-γ/IL-4 ratios than anti-AQP4 antibodypositive
patients, anti-AQP4 antibody-negative conventional MS patients, and healthy controls. As
well, CD4+
IFN-γ+
IL-4-
T cell percentages were negatively correlated with anti-AQP4 antibody titres.
In CSF, OSMS patients had significantly higher levels of IFN-γ and granulocyte colony-stimulating
factor levels than patients with non-inflammatory neurological diseases and other causes of myelitis.
A significant increase of IL-17 compared with non-inflammatory neurological diseases patients was
only found in OSMS patients, irrespective of the presence or absence of anti-AQP4 antibody. These
findings suggest that high titres of anti-AQP4 antibodies are produced as a result of heightened
humoral autoimmunity, and that they are likely to contribute to extensive lesion development through
disturbed resolution of vasogenic oedema. Moreover, since intrathecal up-regulation of IL-17 and IFN-γ
is characteristic of OSMS, Th17/Th1 cells may be critical for the initiation of inflammation and the
disruption of blood-brain barrier (BBB); rendering anti-AQP4 antibody get across the BBB.
- Full text:P020150901442607542885.pdf
