Contributions
Abstract: EP1603
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 25 Biomarkers
Background: Multiple sclerosis with antinuclear antibody (ANA) has been reported to demonstrate more benign disease course than the disease without ANA. In neuromyelitis optica spectrum disorder (NMOSD), it is unclear whether autoantibodies including ANA are protective or toxic markers. We aimed to compare clinical characteristics and prognosis between NMOSD patients with and without ANA.
Methods: We reviewed the Asan Medical Center registry between January 2007 and June 2015 retrospectively, and analyzed data of patients who were diagnosed of seropositive NMOSD. Patients were classified into two groups according to the presence of ANA. The frequency of autoantibodies, annual relapse rates, spinal and orbital magnetic resonance imaging (MRI) findings during attacks were compared between the groups. The presence of poor functional outcome, defined by Expanded Disability Status Scale score ≥6 or visual acuity ≤0.1, was also compared. For the MRI findings, numbers of vertebral segments and optic nerve segments (retrobulbar/canalicular/intracranial/optic chiasm/tract) involved during attacks were investigated for myelitis and optic neuritis, respectively.
Results: A total of 63 patients with NMOSD was identified, and the median follow-up duration from the disease onset was 7 (IQR 3−11) years. Of them, 26 patients had ANA in their disease courses. The ANA-positive group demonstrated more frequent autoantibodies such as SSA/Ro, SSB/La, and double stranded DNA antibody. Clinically, however, between the ANA-negative and ANA-positive groups, annual relapse rates (median [IQR], 0.6 [0.4−1] vs. 0.5 [0.3−0.8], p=0.321) and average lesion extents of myelitis (vertebral segments: 8 [5−12] vs. 7 [4−12], p=0.421) and of optic neuritis (optic nerve segments: 2 [1−3] vs. 2 [1−2], p=0.477) on MRI during attacks were comparable. The presence of poor functional outcome (17 [45.9%] in the ANA-negative group vs. 13 [50.0%] in the ANA-positive group) also did not differ.
Conclusions: In our NMOSD cohorts, patients with ANA showed more frequent autoantibodies than those without. However, these autoantibodies were not associated with benign or malignant disease characteristics. Autoantibodies other than aquaporin-4 antibody are commonly observed, but may be a bystander in NMOSD patients.
Disclosure: Noting to disclose
Abstract: EP1603
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 25 Biomarkers
Background: Multiple sclerosis with antinuclear antibody (ANA) has been reported to demonstrate more benign disease course than the disease without ANA. In neuromyelitis optica spectrum disorder (NMOSD), it is unclear whether autoantibodies including ANA are protective or toxic markers. We aimed to compare clinical characteristics and prognosis between NMOSD patients with and without ANA.
Methods: We reviewed the Asan Medical Center registry between January 2007 and June 2015 retrospectively, and analyzed data of patients who were diagnosed of seropositive NMOSD. Patients were classified into two groups according to the presence of ANA. The frequency of autoantibodies, annual relapse rates, spinal and orbital magnetic resonance imaging (MRI) findings during attacks were compared between the groups. The presence of poor functional outcome, defined by Expanded Disability Status Scale score ≥6 or visual acuity ≤0.1, was also compared. For the MRI findings, numbers of vertebral segments and optic nerve segments (retrobulbar/canalicular/intracranial/optic chiasm/tract) involved during attacks were investigated for myelitis and optic neuritis, respectively.
Results: A total of 63 patients with NMOSD was identified, and the median follow-up duration from the disease onset was 7 (IQR 3−11) years. Of them, 26 patients had ANA in their disease courses. The ANA-positive group demonstrated more frequent autoantibodies such as SSA/Ro, SSB/La, and double stranded DNA antibody. Clinically, however, between the ANA-negative and ANA-positive groups, annual relapse rates (median [IQR], 0.6 [0.4−1] vs. 0.5 [0.3−0.8], p=0.321) and average lesion extents of myelitis (vertebral segments: 8 [5−12] vs. 7 [4−12], p=0.421) and of optic neuritis (optic nerve segments: 2 [1−3] vs. 2 [1−2], p=0.477) on MRI during attacks were comparable. The presence of poor functional outcome (17 [45.9%] in the ANA-negative group vs. 13 [50.0%] in the ANA-positive group) also did not differ.
Conclusions: In our NMOSD cohorts, patients with ANA showed more frequent autoantibodies than those without. However, these autoantibodies were not associated with benign or malignant disease characteristics. Autoantibodies other than aquaporin-4 antibody are commonly observed, but may be a bystander in NMOSD patients.
Disclosure: Noting to disclose