MOG-IgG in primary and secondary chronic progressive multiple sclerosis: a multicenter study of 200 patients and review of the literature

S Jarius,H Tumani,I Ayzenberg,C Trebst,F Paul,F Leypoldt,K Fechner,A Huss,B Wildemann,I Kleiter,K Ruprecht,J Haas,M Reindl,J P Stellmann,A Abdelhak,M Pawlitzki,T Grüter,A Willing

doi:10.1186/s12974-018-1108-6

Abstract

BackgroundAntibodies to human full-length myelin oligodendrocyte glycoprotein (MOG-IgG) as detected by new-generation cell-based assays have recently been described in patients presenting with acute demyelinating disease of the central nervous system, including patients previously diagnosed with multiple sclerosis (MS). However, only limited data are available on the relevance of MOG-IgG testing in patients with chronic progressive demyelinating disease. It is unclear if patients with primary progressive MS (PPMS) or secondary progressive MS (SPMS) should routinely be tested for MOG-IgG.ObjectiveTo evaluate the frequency of MOG-IgG among patients classified as having PPMS or SPMS based on current diagnostic criteria.MethodsFor this purpose, we retrospectively tested serum samples of 200 patients with PPMS or SPMS for MOG-IgG using cell-based assays. In addition, we performed a review of the entire English language literature on MOG-IgG published between 2011 and 2017.ResultsNone of 139 PPMS and 61 SPMS patients tested was positive for MOG-IgG. Based on a review of the literature, we identified 35 further MOG-IgG tests in patients with PPMS and 55 in patients with SPMS; the only reportedly positive sample was positive just at threshold level and was tested in a non-IgG-specific assay. In total, a single borderline positive result was observed among 290 tests.ConclusionOur data suggest that MOG-IgG is absent or extremely rare among patients with PPMS or SPMS. Routine screening of patients with typical PPMS/SPMS for MOG-IgG seems not to be justified.

Highlights

Antibodies to human full-length myelin oligodendrocyte glycoprotein (MOG-Immunoglobulin G (IgG)) as detected by newgeneration cell-based assays have recently been described in patients presenting with acute demyelinating disease of the central nervous system, including patients previously diagnosed with multiple sclerosis (MS)
Our data suggest that Myelin oligodendrocyte glycoprotein (MOG)-IgG is absent or extremely rare among patients with primary progressive MS (PPMS) or secondary progressive MS (SPMS)
The only reportedly MOG-IgG-positive case we could identify in the literature—a patient previously diagnosed with SPMS—was positive just at threshold level when tested in a semiquantitative assay [11]

Summary

Introduction

Antibodies to human full-length myelin oligodendrocyte glycoprotein (MOG-IgG) as detected by newgeneration cell-based assays have recently been described in patients presenting with acute demyelinating disease of the central nervous system, including patients previously diagnosed with multiple sclerosis (MS). Only limited data are available on the relevance of MOG-IgG testing in patients with chronic progressive demyelinating disease. It is unclear if patients with primary progressive MS (PPMS) or secondary progressive MS (SPMS) should routinely be tested for MOG-IgG. To obtain more definite data on the role of MOG-IgG in chronic progressive CNS demyelination, we decided to test a large cohort of patients previously diagnosed with primary progressive MS (PPMS) or secondary progressive MS (SPMS) for MOG-IgG

Methods

Results

Discussion

Conclusion