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Prognostic factors and disease course in aquaporin-4 antibody-positive Chinese patients with acute optic neuritis

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Abstract

The objective is to assess the frequency of AQP4-Ab in Chinese patients with optic neuritis (ON) and to investigate the prognostic implications of AQP4-Ab seropositivity in such patients. The presence of aquaporin-4 (AQP4) antibodies in human AQP4-transfected cells was determined by indirect immunofluorescence, and the diagnostic and prognostic relevance of AQP4 antibodies in 215 Chinese patients with optic neuritis was evaluated. The patients were enrolled from the Chinese People’s Liberation Army General Hospital (PLAGH) and followed up to 1–228 months. Kaplan–Meier survival analysis was used to investigate the visual outcomes and prognostic characteristics of 70 patients who were aquaporin-4 antibody seropositive, and altogether 115 eyes were involved. AQP4-Ab was detectable in 70/215 (32.6%) patients with acute monosymptomatic optic neuritis. These AQP4-Ab seropositive patients were diagnosed as sufferers of neuromyelitis optica (NMO) (n = 10), NMO spectrum disease (NMOSD) (n = 41), multiple sclerosis (MS) (n = 1), and acute optic neuritis (AON) (n = 18). Moreover, AQP4-Ab levels did not vary between seropositive AON and NMO-ON and did not correlate with disease severity. Finally, the male gender, older age at onset, number of relapses, concomitant autoimmune antibodies, and optic lesions in magnetic resonance imaging (MRI) were associated with the AQP4-Ab seropositive status and the risk of developing permanent visual disability. Acute optic neuritis has a higher incidence of anti-aquaporin-4 antibody in China than in Western countries, and AQP4 antibody is a sensitive and specific biomarker for discriminating NMO-ON from other types of optic neuritis during the early stage of the disease course.

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Acknowledgements

This work is supported by the National High Technology Research and Development Program of China (Number: 2015AA020511).

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Authors and Affiliations

  1. Department of Ophthalmology, Chinese People’s Liberation Army General Hospital, Fuxing Road No. 28, Haidian District, Beijing, 100853, China

    Tingjun Chen, Quangang Xu, Shanshan Cao & Shihui Wei

  2. Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China

    Hao Kang

  3. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China

    Hongyang Li

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  1. Hao Kang
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  2. Tingjun Chen
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  3. Hongyang Li
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  4. Quangang Xu
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  6. Shihui Wei
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Contributions

Design and conduct of the study by HK and SW. Collection, management, analysis, and interpretation of the data by HK, TC, HL, QX, and SC. Preparation of the manuscript by HK and HL. Review and final approval of the manuscript by all the authors.

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Correspondence to Shihui Wei.

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All the authors declare that there are no competing interests.

Ethical statement

This study was approved by the People’s Liberation Army General Hospital Ethics Committee and was conducted following the Declaration of Helsinki in its currently applicable version. All individuals voluntarily participated in the study after a thorough oral and written information procedure. Oral and written consents were obtained from all participants.

Human and animal rights

Our study is a retrospective database analysis and therefore does not involve human or animal research.

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For this type of study informed consent was not required.

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Kang, H., Chen, T., Li, H. et al. Prognostic factors and disease course in aquaporin-4 antibody-positive Chinese patients with acute optic neuritis. J Neurol 264, 2130–2140 (2017). https://doi.org/10.1007/s00415-017-8606-9

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  • DOI: https://doi.org/10.1007/s00415-017-8606-9

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