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Abstract Details

MOG-IgA characterizes a subgroup of patients with central nervous system demyelination
Multiple Sclerosis
ES2 - Emerging Science 2 (5:54 PM-6:00 PM)
005

The differential diagnosis of patients with seronegative demyelinating CNS disease is challenging. In this regard, mounting evidence suggests that IgA plays a role in the pathogenesis of different autoimmune diseases. Yet, little is known about the presence and clinical relevance of IgA antibodies against MOG in CNS demyelination.

To investigate the frequency and clinical features of immunoglobulin (Ig) A antibodies against myelin oligodendrocyte glycoprotein (MOG) in patients with central nervous system (CNS) demyelination and healthy controls.

We conducted an observational, retrospective, longitudinal, multicenter study measuring MOG-IgA in serum using a live cell-based assay. We included a total of 1345 patients with neuromyelitis optica spectrum disorder (NMOSD), other CNS demyelinating diseases, and multiple sclerosis (MS), as well as healthy controls (HC).

Of all patients double-seronegative for MOG-IgG and AQP4-IgG (84%), isolated MOG-IgA was identified in 6% of patients with NMOSD, in 2% of patients with other CNS demyelinating diseases, and in 1% of patients with MS but in none of the HC. The most common disease manifestation in MOG-IgA seropositive patients was myelitis, followed by more frequent brainstem syndrome (p=0.047), and infrequent manifestation of ON (p=0.02) compared to MOG-IgG patients. Among patients fulfilling 2017 McDonald criteria for MS, MOG-IgA was associated with less frequent occurrence of type II oligoclonal bands (OCBs) compared to MOG-IgG/IgA seronegative MS patients (p<0.0001). Further, events of demyelination in MOG-IgA positive patients were more often preceded by infections and/or vaccinations than in MOG-IgG patients. 

We identified MOG-specific antibodies of the IgA isotype in a distinct subgroup of patients, suggesting MOG-IgA as a novel diagnostic biomarker for patients with AQP4-IgG and MOG-IgG double-seronegative CNS demyelination.

Authors/Disclosures
Anne-Katrin Proebstel, MD (University Hospital Basel)
PRESENTER
The institution of Dr. Proebstel has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Dr. Proebstel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Dr. Proebstel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Proebstel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. The institution of Dr. Proebstel has received research support from Biogen. Dr. Proebstel has received intellectual property interests from a discovery or technology relating to health care.
Ana Beatriz Ayroza Galvao Ribeiro Gomes, MD (University Hospital Basel) Dr. Ayroza Galvao Ribeiro Gomes has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Guidepoint. The institution of Dr. Ayroza Galvao Ribeiro Gomes has received research support from Roche.
Laila Kulsvehagen Mrs. Kulsvehagen has nothing to disclose.
Patrick Lipps (Department Biomedizin Basel) Mr. Lipps has nothing to disclose.
Alessandro Cagol, MD Dr. Cagol has nothing to disclose.
Nuria Cerda-Fuertes, MD Ms. Cerda-Fuertes has nothing to disclose.
Tradite Neziraj, MD Dr. Neziraj has nothing to disclose.
Julia Flammer, MD (USB) Mrs. Flammer has nothing to disclose.
Jasmine Lerner Ms. Lerner has nothing to disclose.
Anne-Catherine Lecourt Anne-Catherine Lecourt has nothing to disclose.
Nina De Oliveira Soares Siebenbor, MD (Department of Biomedical Engineering, University of Basel) Dr. De Oliveira Soares Siebenbor has received personal compensation for serving as an employee of MIAC AG Basel.
Rosa Cortese (University of Siena) No disclosure on file
Sabine Schaedelin Sabine Schaedelin has nothing to disclose.
Vinicius Andreoli Schoeps, MD (University of California, San Francisco) Dr. Schoeps has nothing to disclose.
Aline de Moura Brasil Matos, MD The institution of Dr. Matos has received research support from Hoffmann LaRoche.
Natalia Trombini Mendes, MD (Santa Casa de Misericórdia de São Paulo) Dr. Mendes has nothing to disclose.
Clarissa Dos Reis Pereira, MD Miss PEREIRA has received research support from CAPES - Coordenação de Aperfeiçoamento de Nível Superior, Brasília, Brazil, and CNPq- Conselho Nacional de Desenvolvimento Científico e Tecnológico, (No 308172/2018-3), Brasília, Brazil..
Mario Luiz Ribeiro Monteiro, MD (University of São Paulo Medical School) Prof. MONTEIRO has nothing to disclose.
Samira Apostolos-Pereira (Hospital Das Clinicas College of Medicine Sao Paulo University) Samira Apostolos-Pereira has nothing to disclose.
Patrick Schindler, MD Dr. Schindler has nothing to disclose.
Claudia Chien The institution of Claudia Chien has received research support from Novartis. The institution of Claudia Chien has received research support from Alexion. Claudia Chien has a non-compensated relationship as a Standing Committee on Science Member with Canadian Institutes for Health Research that is relevant to AAN interests or activities.
Carolin Schwake, MD (St. Josef Hospital Bochum) Mrs. Schwake has nothing to disclose.
Ruth Schneider Ruth Schneider has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Roche Pharma AG. Ruth Schneider has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Alexion Pharma.
Thivya Pakeerathan (St. Josef-Hospital) Miss Pakeerathan has nothing to disclose.
Orhan Aktas, MD (Neurologische Klinik) Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Aktas has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Aktas has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Horizon. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Aktas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. The institution of Dr. Aktas has received research support from German Research Foundation. The institution of Dr. Aktas has received research support from German Ministry of Science. The institution of Dr. Aktas has received research support from Neuromyelitis optica Study Group (NEMOS).
Urs Martin Fischer, MD, PA (University Hospital Basel, Neurology) The institution of Urs Fischer has received research support from Medtronic. The institution of Urs Fischer has received research support from Medtronic.
Matthias Mehling, MD (Neurology Clinic University Hospital Basel/Switzerland) The institution of Dr. Mehling has received research support from Swiss National Science Foundation. The institution of Dr. Mehling has received research support from Roche. The institution of Dr. Mehling has received research support from Merck.
Tobias Derfuss An immediate family member of Tobias Derfuss has received personal compensation for serving as an employee of Novartis. The institution of Tobias Derfuss has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. The institution of Tobias Derfuss has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. The institution of Tobias Derfuss has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. The institution of Tobias Derfuss has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. The institution of Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. The institution of Tobias Derfuss has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GeNeuro. Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MedDay. Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Actelion. Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Merck. Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Roche. An immediate family member of Tobias Derfuss has received stock or an ownership interest from Novartis. The institution of Tobias Derfuss has received research support from Roche. The institution of Tobias Derfuss has received research support from Biogen.
Ludwig Kappos, MD, FAAN ( RC2NB, University Hospital Basel) The institution of Dr. Kappos has received research support from Bayer. The institution of Dr. Kappos has received research support from Biogen. The institution of Dr. Kappos has received research support from Genentech. The institution of Dr. Kappos has received research support from Genzyme. The institution of Dr. Kappos has received research support from Janssen. The institution of Dr. Kappos has received research support from Merck Serono. The institution of Dr. Kappos has received research support from Minoryx. The institution of Dr. Kappos has received research support from Novartis. The institution of Dr. Kappos has received research support from Roche. The institution of Dr. Kappos has received research support from Sanofi. The institution of Dr. Kappos has received research support from Santhera. The institution of Dr. Kappos has received research support from Swiss MS Society, Swiss National Research Foundation, European Union, Roche Research Foundation, Innosuisse. The institution of Dr. Kappos has received research support from Shionogi. The institution of Dr. Kappos has received research support from Japan Tobacco. The institution of Dr. Kappos has received research support from Auriga Vision AG. The institution of Dr. Kappos has received research support from EMD Serono. The institution of Dr. Kappos has received research support from Glaxo Smith Kline. The institution of Dr. Kappos has received research support from Wellmera AG. The institution of Dr. Kappos has received research support from Eli Lilly (Suisse) SA. The institution of Dr. Kappos has received research support from Bristol Myers Squibb. The institution of Dr. Kappos has received research support from Celltrion Inc. Dr. Kappos has received intellectual property interests from a discovery or technology relating to health care.
Ilya *use 181355 Ayzenberg (St. Josef-Hospital, Klinikum der Ruhr-Universität Bochum) No disclosure on file
Marius Ringelstein Marius Ringelstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Marius Ringelstein has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion.
Friedemann Paul (Charite Universitatsmedizin in Berlin) The institution of Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Tanabe PC (MTPC). The institution of Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aarhus University. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Paul has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CELGENE. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for ACRELION. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Viela Bio. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pfizter. Dr. Paul has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck Serono. The institution of Dr. Paul has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer.
Dagoberto Callegaro, Sr. (HC-FMUSP ) Dr. Callegaro has nothing to disclose.
Jens Kuhle, MD Dr. Kuhle has nothing to disclose.
Athina Papadopoulou, MD (University Hospital Basel) The institution of Dr. Papadopoulou has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck Schweiz AG. The institution of Dr. Papadopoulou has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AbbVie AG. The institution of Dr. Papadopoulou has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eli Lilly. The institution of Dr. Papadopoulou has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for TEVA. The institution of Dr. Papadopoulou has received research support from Freie Akademische Gesellschaft Basel . Dr. Papadopoulou has received personal compensation in the range of $500-$4,999 for serving as a Travel Support (for Congress) with Eli Lilly. Dr. Papadopoulou has received personal compensation in the range of $500-$4,999 for serving as a Travel support (for Congress) with TEVA.
Cristina Granziera, MD, PhD (Basel University Hospital) Dr. Granziera has nothing to disclose.