AQP4 Antibody Assay Sensitivity Comparison in the Era of the 2015 Diagnostic Criteria for NMOSD

Kerri Prain; Mark Woodhall; Angela Vincent; Sudarshini Ramanathan; Sudarshini Ramanathan; Michael H. Barnett; Christine S. Bundell; Christine S. Bundell; John D. E. Parratt; John D. E. Parratt; Roger A. Silvestrini; Wajih Bukhari; Wajih Bukhari; The Australian and New Zealand NMO Collaboration; Fabienne Brilot; Fabienne Brilot; Patrick Waters; Simon A. Broadley; Simon A. Broadley

doi:10.3389/fneur.2019.01028

Frontiers in Neurology (Oct 2019)

AQP4 Antibody Assay Sensitivity Comparison in the Era of the 2015 Diagnostic Criteria for NMOSD

Kerri Prain,
Mark Woodhall,
Angela Vincent,
Sudarshini Ramanathan,
Sudarshini Ramanathan,
Michael H. Barnett,
Christine S. Bundell,
Christine S. Bundell,
John D. E. Parratt,
John D. E. Parratt,
Roger A. Silvestrini,
Wajih Bukhari,
Wajih Bukhari,
The Australian and New Zealand NMO Collaboration,
Fabienne Brilot,
Fabienne Brilot,
Patrick Waters,
Simon A. Broadley,
Simon A. Broadley

Affiliations

Kerri Prain: Pathology Queensland Central Laboratory, Division of Immunology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
Mark Woodhall: Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
Angela Vincent: Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
Sudarshini Ramanathan: Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital, Westmead, NSW, Australia
Sudarshini Ramanathan: Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
Michael H. Barnett: Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
Christine S. Bundell: School of Biomedical Science, Medicine, University of Western Australia, Nedlands, WA, Australia
Christine S. Bundell: PathWest Laboratory Medicine, Department of Immunology, QEII Medical Centre, Nedlands, WA, Australia
John D. E. Parratt: Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
John D. E. Parratt: Department of Neurology, Royal North Shore Hospital, Sydney, NSW, Australia
Roger A. Silvestrini: Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital, Westmead, NSW, Australia
Wajih Bukhari: School of Medicine, Gold Coast Campus, Griffith University, Southport, QLD, Australia
Wajih Bukhari: Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia
The Australian and New Zealand NMO Collaboration
Fabienne Brilot: Brain Autoimmunity Group, Kids Neuroscience Centre, Kids Research at the Children's Hospital, Westmead, NSW, Australia
Fabienne Brilot: Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
Patrick Waters: Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
Simon A. Broadley: School of Medicine, Gold Coast Campus, Griffith University, Southport, QLD, Australia
Simon A. Broadley: Department of Neurology, Gold Coast University Hospital, Southport, QLD, Australia

DOI: https://doi.org/10.3389/fneur.2019.01028
Journal volume & issue: Vol. 10

Abstract

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We have compared five different assays for antibodies to aquaporin-4 in 181 cases of suspected Neuromyelitis optica spectrum disorders (NMOSD) and 253 controls to assess their relative utility. As part of a clinically-based survey of NMOSD in Australia and New Zealand, cases of suspected NMOSD were referred from 23 centers. Clinical details and magnetic imaging were reviewed and used to apply the 2015 IPND diagnostic criteria. In addition, 101 age- and sex-matched patients with multiple sclerosis were referred. Other inflammatory disease (n = 49) and healthy controls (n = 103) were also recruited. Samples from all participants were tested using tissue-based indirect immunofluorescence assays and a subset were tested using four additional ELISA and cell-based assays. Antibodies to myelin oligodendrocyte glycoprotein (MOG) were also assayed. All aquaporin-4 antibody assays proved to be highly specific. Sensitivities ranged from 60 to 94%, with cell-based assays having the highest sensitivity. Antibodies to MOG were detected in 8/79 (10%) of the residual suspected cases of NMOSD. Under the 2015 IPND diagnostic criteria for NMOSD, cell-based assays for aquaporin-4 are sensitive and highly specific, performing better than tissue-based and ELISA assays. A fixed cell-based assay showed near-identical results to a live-cell based assay. Antibodies to MOG account for only a small number of suspected cases.

Published in Frontiers in Neurology

ISSN: 1664-2295 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://www.frontiersin.org/journals/neurology/

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