It is well known that autoantibody against aquaporin 4 (AQP4) is responsible for NMOSD (neuromyelitis Optica spectrum disorder).
However, there are several NMOSD cases in which the titer of anti-AQP4 antibody is undetectable by ELISA or WB analysis.
Could you tell me your opinion and/or information on what kind of pathological factors are involved in NMOSD?
Go J Yoshida: In a Neurology Today article on MOG antibodies in the CSF of patients with transverse myelitis and/or ADEM the authors found that such patients go on to develop MS that is similar to NMOSD rather than the other types. these patients were negative for the usual NMO antibodies in the CSF. also, another problem with commercial NMO antibody in the CSF testing is that there is a high false negative rate compared to the testing done by Mayo Clinic in Minnesota, which both discovered and developed the testing for NMO antibodies in the CSF and blood. Also, one should remember that the NMO antibodies were first discovered in the CSF and the testing was done on it. it was later found that those antibodies can also be found in the blood. in my opinion, the blood test, which most of the commercial labs use, is not as accurate as the CSF. I try to test the NMO antibodies in the CSF in patients I suspect of NMOSD. I do the blood test only if I cannot do the test on the CSF due to logistic reasons. thanks.
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