Testing for Antibodies Against Aquaporin-4 and Myelin Oligodendrocyte Glycoprotein in the Diagnosis of Patients With Suspected Autoimmune Myelopathy

Samir Alkabie; Adrian Budhram

doi:10.3389/fneur.2022.912050

Testing for Antibodies Against Aquaporin-4 and Myelin Oligodendrocyte Glycoprotein in the Diagnosis of Patients With Suspected Autoimmune Myelopathy

Front Neurol. 2022 May 20:13:912050. doi: 10.3389/fneur.2022.912050. eCollection 2022.

Authors

Samir Alkabie¹, Adrian Budhram^{1

2}

Affiliations

¹ Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada.
² Deparment of Pathology and Laboratory Medicine, London Health Sciences Centre, Western University, London, ON, Canada.

Abstract

Autoimmune myelopathies are immune-mediated disorders of the spinal cord that can cause significant neurologic disability. Discoveries of antibodies targeting aquaporin-4 (AQP4-IgG) and myelin oligodendrocyte glycoprotein (MOG-IgG) have facilitated the diagnosis of autoimmune myelopathies that were previously considered to be atypical presentations of multiple sclerosis (MS) or idiopathic, and represent major advancements in the field of autoimmune neurology. The detection of these antibodies can substantially impact patient diagnosis and management, and increasing awareness of this has led to a dramatic increase in testing for these antibodies among patients with suspected autoimmune myelopathy. In this review we discuss test methodologies used to detect these antibodies, the role of serum vs. cerebrospinal fluid testing, and the value of antibody titers when interpreting results, with the aim of helping laboratorians and clinicians navigate this testing when ordered as part of the diagnostic evaluation for suspected autoimmune myelopathy.

Keywords: autoantibody; autoimmune neurology; myelitis; neuroimmunology; neuroinflammation.

Publication types

Review