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04.07.2020 | Original Communication

Cell-based assays for the detection of MOG antibodies: a comparative study

verfasst von: Matteo Gastaldi, Silvia Scaranzin, Sven Jarius, Brigitte Wildeman, Elisabetta Zardini, Giulia Mallucci, Eleonora Rigoni, Elisa Vegezzi, Thomas Foiadelli, Salvatore Savasta, Paola Banfi, Maurizio Versino, Luana Benedetti, Giovanni Novi, Margherita Maria Mancardi, Thea Giacomini, Pietro Annovazzi, Damiano Baroncini, Diana Ferraro, Vito Lampasona, Markus Reindl, Patrick Waters, Diego Franciotta

Erschienen in: Journal of Neurology | Ausgabe 12/2020

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Abstract

Background

The detection of antibodies to myelin oligodendrocyte glycoprotein (MOG) is fundamental for the identification of MOG antibody-associated disorders (MOGAD), and the differential diagnosis of acquired demyelinating syndromes of the CNS, among which multiple sclerosis (MS). We compared the diagnostic performance of four cell-based assays (CBAs) for their detection.

Methods

Consecutive sera from 204 patients with ‘possible MOGAD’ (55), MS (112), and other neurological disorders (OND, 37) were tested for MOG-IgG with a live-CBA with anti-heavy-and-light chain secondary-antibody (LCBA-IgG_H+L), and a live-CBA for IgG₁ (LCBA-IgG₁). A subgroup of 71 patients was additionally tested with a live-CBA with anti-Fcγ secondary-antibody (LCBA-IgG_Fcγ), and a commercial fixed-CBA with anti-Fcγ secondary-antibody (FCBA-IgG_Fcγ)_.

Results

Fifty-seven/204 patients (27.9%) were MOG-IgG-positive. Sensitivity was 89.1% (CI:77.8–95.9) and specificity 93.3% (CI:88.0–96.7) for LCBA-IgG_H+L, and 74.6% (CI:61.0–85.3) and 100% (CI:97.6–100) for LCBA-IgG₁. Eighteen of 57 (31%) samples showed discrepant results (all negative on LCBA-IgG₁); of these, three with ‘possible MOGAD’ showed high-titer MOG-IgG (≥ 1:640), and positivity for MOG-IgG₂, whereas 15/18 had low-titer MOG-IgG (1:160/1:320) and mixed diagnoses (5 ‘possible MOGAD’, 6 MS, 4 OND). In the subgroup analysis, sensitivity was 92.3% (CI:79.1–98.4) and specificity 97.0% (CI:83.8–99.9) for LCBA-IgG_Fcγ, and 87.2% (CI:72.6–95.7) and 97.0% (CI:83.8–99.9) for FCBA-IgG_Fcγ.

Conclusions

LCBA-IgG₁ showed the highest specificity but can miss MOG-IgG₂ reactivities, whose meaning warrants further investigations. Titration of samples tested with LCBA-IgG_H+L/ IgG_Fcγ is important for meaningful interpretation of the results. In the subgroup analysis, LCBA-IgG_Fcγ yielded the highest accuracy, and FCBA-IgG_Fcγ good specificity, but it was at risk of false-negative results.

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Titel: Cell-based assays for the detection of MOG antibodies: a comparative study
verfasst von: Matteo Gastaldi
Silvia Scaranzin
Sven Jarius
Brigitte Wildeman
Elisabetta Zardini
Giulia Mallucci
Eleonora Rigoni
Elisa Vegezzi
Thomas Foiadelli
Salvatore Savasta
Paola Banfi
Maurizio Versino
Luana Benedetti
Giovanni Novi
Margherita Maria Mancardi
Thea Giacomini
Pietro Annovazzi
Damiano Baroncini
Diana Ferraro
Vito Lampasona
Markus Reindl
Patrick Waters
Diego Franciotta
Publikationsdatum: 04.07.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 12/2020
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10024-0

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Cell-based assays for the detection of MOG antibodies: a comparative study

Abstract

Background

Methods

Results

Conclusions

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Abstract

Background

Methods

Results

Conclusions

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