Aquaporin-4 Antibodies and Neuromyelitis Optica Disease Activity

Titers of aquaporin-4–specific antibodies rise in association with attacks and decline during remissions and after clinically effective drug treatments.

Neuromyelitis optica (NMO) is a disorder characterized by optic neuritis and by transverse myelitis that is accompanied by spinal cord lesions exceeding three vertebral segments in length. Presence of an immunoglobin G (IgG) antibody that targets epitopes on the extracellular domain of aquaporin-4 (AQP4) is a specific finding in NMO. However, whether finding AQP4 autoantibodies is simply a marker of or actually pathogenic in NMO remains uncertain. In this study, investigators retrospectively analyzed archived sera from eight patients with NMO-spectrum disorders who had been treated with steroids and immunomodulatory agents (mean follow-up, 62 months). The authors correlated titers of AQP4-specific antibodies with clinical course and CD19 ce…

Reviewing Author

Brian G. Weinshenker, MD, FRCP(C)