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Serum-Positive and -Negative AQP4 Antibody NMO in Chinese Patients

Published online by Cambridge University Press:  02 December 2014

Youming Long
Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University Department of Neurology, Clinical College, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, People's Republic of China
Zhengqi Lu
Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University
Xueqiang Hu*
Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University
Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong Province, People's Republic of China.
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To compare the clinical features of our sero-negative and sero-positive neuromyelitis optica (NMO) patients.


Thirty-nine patients with NMO were recruited and analyzed retrospectively. Serum aquaporin 4 (AQP4) antibody status was determined by a cell-based assay. For the sero-negative patients, cerebrospinal fluid (CSF) and serum samples were re-tested using the cell-based assay and an indirect immunofluorescence assay.


By the cell-based assay, 30 patients (76.92%, 30/39), were positive for AQP4 antibodies in serum and 37 patients (94.9%, 37/39), had a CSF-positive antibody status. Seven NMO patients (17.9%, 7/39) were sero-negative by the cell-based assay but demonstrated positive CSF results. By indirect immunofluorescence, the remaining two patients, who had no AQP4 antibodies in serum or CSF by the cell-based assay, were positive for IgG antibodies in serum, which selectively targeted the central nervous system microvessels, pia, subpia, Virchow-Robin space, kidney, and stomach. There were no significant differences between the sero-positive and sero-negative NMO groups among their demographic and clinical data.


Repeating the test using a different assay or CSF is helpful to clarify whether sero-negative NMO patients do in fact carry AQP4 antibodies.

Research Article
Copyright © The Canadian Journal of Neurological 2012


1Hamnik, SE, Hacein-Bey, L, Biller, J, Gruener, G, Jay, W.Neuromyelitis optica (NMO) antibody positivity in patients with transverse myelitis and no visual manifestations. Semin Ophthalmol. 2008;23:191200.Google Scholar
2Lucchinetti, CF, Mandler, RN, McGavern, D, et al.Role for humoral mechanisms in the pathogenesis of Devic’s neuromyelitis optica. Brain. 2002;125:145061.Google Scholar
3Lennon, VA, Wingerchuk, DM, Kryzer, TJ, et al.A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet. 2004;364:210612.Google Scholar
4Lennon, VA, Kryzer, TJ, Pittock, SJ, Verkman, AS, Hinson, SR.IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med. 2005;202:4737.Google Scholar
5Cheng, Q, Miao, L, Zhang, J, et al.Clinical features of patients with multiple sclerosis from a survey in Shanghai, China. Mult Scler. 2008;14:6718.Google Scholar
6Fazio, R, Malosio, ML, Lampasona, V, et al.Antiacquaporin 4 antibodies detection by different techniques in neuromyelitis optica patients. Mult Scler. 2009;15:115363.Google Scholar
7Jarius, S, Wildemann, B.AQP4 antibodies in neuromyelitis optica: diagnostic and pathogenetic relevance. Nat Rev Neurol. 2010;6: 38392.Google Scholar
8Jarius, S, Paul, F, Franciotta, D, et al.Mechanisms of disease: aquaporin-4 antibodies in neuromyelitis optica. Nat Clin Pract Neurol. 2008;4:20214.Google Scholar
9Matsushita, T, Isobe, N, Matsuoka, T, et al.Aquaporin-4 autoimmune syndrome and anti-aquaporin-4 antibody-negative opticospinal multiple sclerosis in Japanese. Mult Scler. 2009;15:83447.Google Scholar
10Matsushita, T, Isobe, N, Matsuoka, T, et al.Anti-aquaporin-4 antibody is involved in the pathogenesis of NMO: a study on antibody titre. Brain. 2007;130:123543.Google Scholar
11Wingerchuk, DM, Lennon, VA, Pittock, SJ, Lucchinetti, CF, Weinshenker, BG.Revised diagnostic criteria for neuromyelitis optica. Neurology. 2006;66:14859.Google Scholar
12Kurtzke, JF.Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33: 144452.Google Scholar
13Jarius, S, Franciotta, D, Paul, F, et al.Cerebrospinal fluid antibodies to aquaporin-4 in neuromyelitis optica and related disorders: frequency, origin, and diagnostic relevance. J Neuroinflammation. 2010;7:52.Google Scholar
14Li, R, Qiu, W, Lu, Z, et al.Acute transverse myelitis in demyelinating diseases among the Chinese. J Neurol. 2011 [Epub ahead of print].Google Scholar
15Marignier, R, De Sèze, J, Vukusic, S, et al.NMO-IgG and Devic’s neuromyelitis optica: a French experience. Mult Scler. 2008;14:4405.Google Scholar
16Kanzaki, M, Mochizuki, H, Ogawa, G, et al.Clinical features of opticospinal multiple sclerosis with anti-aquaporin 4 antibody. Eur Neurol. 2008;60:3742.Google Scholar
17Nakashima, I, Fujihara, K, Miyazawa, I, et al.Clinical and MRI features of Japanese patients with multiple sclerosis positive for NMO-IgG. J Neurol Neurosurg Psychiatry. 2006;77:10735.Google Scholar
18Matsuoka, T, Matsushita, T, Kawano, Y, et al.Heterogeneity of aquaporin-4 autoimmunity and spinal cord lesions in multiple sclerosis in Japanese. Brain. 2007;130:120623.Google Scholar
19Klawiter, EC, Alvarez, E 3rd, Xu, J, et al.NMO-IgG detected in CSF in seronegative neuromyelitis optica. Neurology. 2009;72:11013.Google ScholarPubMed
20Bennett, JL, Lam, C, Kalluri, SR, et al.Intrathecal pathogenic anti-aquaporin-4 antibodies in early neuromyelitis optica. Ann Neurol. 2009;66:61729.Google Scholar