期刊
NEUROLOGY
卷 78, 期 9, 页码 665-671出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e318248dec1
关键词
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资金
- The Guthy-Jackson Charitable Foundation
- NIH [NS065829-01]
- NIHR
- NIHR Oxford Biomedical Research Centre
- Oxford NIHR Biomedical Research Centre
- Guthy Jackson Charitable Foundation
- Oxford Biomedical Research Centre
- National Commissioning Group
- Sir Halley Stewart Trust, UK
- Merck Serono
- Multiple Sclerosis Society
- Department of Health Risk Sharing Scheme (Clinical Coordinator)
- Lgi1
- Caspr2
- Contactin2
- Baxter International Inc.
- publication of Clinical Neuroimmunology
- Inflammatory and Autoimmune Disorders of the Nervous System in Children
- European Union
- Sir Halley Stewart Trust
- Athena Diagnostics, Inc.
- RSR Ltd.
- Cardiff, UK
- The University of Oxford
- BioMS Medical
- Bayhill Therapeutics
- Biogen Idec
- Genentech, Inc.
- Teva Pharmaceutical Industries Ltd.
- Alexion Pharmaceuticals, Inc.
- NIH
Objectives: Neuromyelitis optica (NMO) immunoglobulin G (IgG) (aquaporin-4 [AQP4] IgG) is highly specific for NMO and related disorders, and autoantibody detection has become an essential investigation in patients with demyelinating disease. However, although different techniques are now used, no multicenter comparisons have been performed. This study compares the sensitivity and specificity of different assays, including an in-house flow cytometric assay and 2 commercial assays (ELISA and transfected cell-based assay [CBA]). Methods: Six assay methods (in-house or commercial) were performed in 2 international centers using coded serum from patients with NMO (35 patients), NMO spectrum disorders (25 patients), relapsing-remitting multiple sclerosis (39 patients), miscellaneous autoimmune diseases (25 patients), and healthy subjects (22 subjects). Results: The highest sensitivities were yielded by assays detecting IgG binding to cells expressing recombinant AQP4 with quantitative flow cytometry (77%; 46 of 60) or visual observation (CBA, 73%; 44 of 60). The fluorescence immunoprecipitation assay and tissue-based immunofluorescence assay were least sensitive (48%-53%). The CBA and ELISA commercial assays (100% specific) yielded sensitivities of 68% (41 of 60) and 60% (36 of 60), respectively, and sensitivity of 72% (43 of 60) when used in combination. Conclusions: The greater sensitivity and excellent specificity of second-generation recombinant antigen-based assays for detection of NMO-IgG in a clinical setting should enable earlier diagnosis of NMO spectrum disorders and prompt initiation of disease-appropriate therapies. Neurology (R) 2012;78:665-671
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