MOG抗体在不同类型免疫介导性视神经炎血清中的表达

摘要

目的 初步探索抗髓鞘少突胶质细胞糖蛋白抗体(MOG-Ab)在不同临床类型免疫介导性视神经炎(IM-ON)患者血清中的表达.方法 采用临床病例横断面研究.2010年5月至2011年2月至北京同仁医院神经内科就诊的免疫介导性视神经炎患者(IM-ON) 129例,根据其临床特点分为以下5组:多发性硬化相关视神经炎(MS-ON) 20例,视神经脊髓炎相关视神经炎(NMO-ON) 13例,自身免疫病相关视神经炎(AON) 33例,复发性孤立性视神经炎(RION) 43例及单发性孤立性视神经炎(SION)20例.用ELISA方法对其血清中MOG-Ab进行检测,应用SPSS17.0软件,采用x2检验及方差分析、t检验方法对数据进行统计学分析,比较其阳性率与抗体滴度在不同组间的区别.结果 所有129例IM-ON患者中12例(9.3％)患者的血清MOG-Ab阳性.其中MS-ON组血清MOG-Ab阳性者5例(5/20),NMO-ON组0例(0/13),AON组4例(4/33),RION组2例(2/43),SION组1例(1/20).5组间阳性率差异无统计学意义(Fisher确切概率法,x2=7.051,P=0.088).将除MS-ON组之外的其余4组合并为“视神经脊髓炎(NMO)谱系视神经炎”后与MS-ON组比较发现,MS-ON组的MOG-Ab阳性率和抗体滴度均明显高于“NMO谱系视神经炎”组.结论 MOG抗体见于除NMO-ON之外的各种类型的IM-ON,在MS-ON患者血清中的表达明显高于“NMO谱系视神经炎”.%Objective To investigate the expression of anti-myelin oligodendrocyte glycoprotein antibody (MOG-Ab) in different types of immune-mediated optic neuritis (IM-ON).Methods Case-control and cross section study.The serum of 129 consecutive cases of immune-mediated optic neuritis (IM-ON group) seen in Neuro-ophthalmology clinic in Department of Neurology,Beijing Tongren Hospital during May 2010 and February 2011 were collected.All IM-ON cases were further classified into five different types as:20 cases of multiple sclerosis related ON (MS-ON),13 cases of neuromyelitis optica related ON (NMO-ON),33 cases of autoimmune optic neuritis (AON),43 cases of relapsing isolated optic neuritis (RION)and 20 cases of solitary isolated optic neuritis (SION).MOG-Ab was tested by ELISA.The positivity rate and titer of MOG-Ab among these groups were compared using chi-square test and ANOVA,t test by SPSS17.0 software.Results MOG-Ab was positive in 12 of all 129 tested IM-ON patients (9.3％),in which there were 5 of 20 MS-ON,none of 13 NMO-ON,4 of 33 AON,2 of 43 RION,and 1 of 20 SION patients.There were no statistical significant difference among five groups (Fisher's exact test,x2 =7.051,P =0.088),but MS-ON group showed statistically higher MOG-Ab positivity and titer than the “ NMO spectrum optic neuritis” group which was merged from the other 4 IM-ON groups.Conclusion MOG-Ab could be detected in different types of immune-mediated optic neuritis except NMO-ON and the expression of MOG-Ab was statistically higher in MS-ON group than the 'NMO spectrum optic neuritis' group.