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Low Prevalence of Anti Aquaporin 4 Antibody in Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis in Western Australia

Fabis-Pedrini, M.J., Bundell, C., Wee, C.K., Qui, W., Lucas, M., Carroll, W.M. and Kermode, A.G. (2018) Low Prevalence of Anti Aquaporin 4 Antibody in Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis in Western Australia. Multiple Sclerosis Journal, 24 (3). pp. 404-405.

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Background: NMOSD is an inflammatory disease of the CNS distinct from MS, and relatively rare in Western countries. Many patients with NMOSD have detectable serum antibodies that target the water channel aquaporin-4 (AQP4-immunoglobulin G [IgG]).

Objective: To evaluate the prevalence of anti-AQP4 antibody in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) patients from the Western Australian cohort using highly sensitive test.

Methods: 420 sera of patients with NMOSD, MS and suspicious demyelinating diseases were assessed for the presence of AQP4 antibody using a cell-based assay in cells transfected with 2 isoforms of AQP4 (M1 and M23) and in primate cerebellum tissue (Euroimmun, Luebeck, Germany). The anti-AQP4 antibody test was performed at PathWest Laboratory Medicine, QEII Medical Centre.

Results: Only 6 out of 420 patient sera were AQP4 antibody-positive. Our study showed a low frequency of anti-AQP4 antibody in this predominantly Anglo-Celtic Western Australian population. All of the 6 AQP4 antibody-positive patients had a final diagnosis of NMOSD; four out of six AQP-4 positive patients had longitudinally extensive myelitis (LEM). Prevalence of AQP4 antibody positivity in Western Australia was as low as 0.25 (0.05-0.43) per 100,000. We did not find any statistical difference in age between AQP4 antibody-positive and negative patients. All AQP4 antibody-positive patients were females.

Conclusions: Testing AQP4 antibody positivity on cerebellar tissue is less sensitive than the cell-based assay. Our study confirmed the low anti-AQP4 antibody prevalence in the Western Australian idiopathic inflammatory CNS disease population. Our results are comparable with data from other Western populations.

Item Type: Journal Article
Murdoch Affiliation(s): Institute for Immunology and Infectious Diseases
Publisher: Sage Publications
Copyright: © 2018 by SAGE Publications
Other Information: Poster presentation PACTRIMs 2017
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