Resumen
Introducción: la enfermedad asociada a anticuerpos contra la glicoproteína de mielina del oligodendrocito (MOGAD, por sus siglas en inglés) es una entidad clínica recientemente identificada. La frecuencia de presentación del MOGAD es desconocida, pero se considera baja con respecto a otras enfermedades inflamatorias desmielinizantes.
Materiales y métodos: revisión narrativa de la literatura.
Resultados: las manifestaciones clínicas de esta condición son heterogéneas e incluyen neuritis óptica, mielitis, desmielinización multifocal del sistema nervioso central y encefalitis cortical. Se han descrito algunos hallazgos radiológicos que aumentan la sospecha diagnóstica, como el realce perineural del nervio óptico, el signo de la H en el cordón espinal y la resolución de lesiones T2 con el tiempo. El diagnóstico se basa en la detección de inmunoglobulinas G específicas contra MOG, en el contexto clínico adecuado. El tratamiento consiste en manejo de los ataques agudos con dosis altas de corticoides y en algunos casos se deberá considerar la inmunosupresión crónica (pacientes con recurrencia o con discapacidad severa residual tras el primer evento).
Conclusiones: en esta revisión narrativa se resumen los aspectos clave con respecto a la fisiopatología, las manifestaciones, el diagnóstico y el tratamiento de la MOGAD.
Citas
Linnington C, Webb M, Woodhams PL. A Novel myelin-associated glycoprotein defined by a mouse monoclonal antibody. J Neuroimmunol. 1984;6:387-96. https://doi.org/10.1016/0165-5728(84)90064-X
Pham-Dinh D, Matteit M-G, Nussbaum J-L, Rousselt G, Pontarotti P, Roeckelt N, et al. Myelin/oligodendrocyte glycoprotein is a member of a subset of the immunoglobulin superfamily encoded within the major histocompatibility complex. Proc Natl Acad Sci U S A. 1993;90(17):7990-4. https://doi.org/10.1073/pnas.90.17.7990
von Büdingen HC, Palanichamy A, Lehmann-Horn K, Michel BA, Zamvil SS. Update on the autoimmune pathology of multiple sclerosis: B-cells as disease-drivers and therapeutic targets. Eur Neurol. 2015;73(3-4):238-46. https://doi.org/10.1159/000377675
Marta CB, Montano MB, Taylor CM, Taylor AL, Bansal R, Pfeiffer SE. Signaling cascades activated upon antibody cross-linking of myelin oligodendrocyte glycoprotein: potential implications for multiple sclerosis. J Biol Chem. 2005;280(10):8985-93. https://doi.org/10.1074/jbc.M413174200
Scolding NJ, Frith S, Linington C, Morgan BP, Campbell AK, Compston DAS. Myelin-oligodendrocyte glycoprotein (MOG) is a surface marker of oligodendrocyte maturation. J Neuroimmunol. 1989;22(3):169-76. https://doi.org/10.1016/0165-5728(89)90014-3
Cobo-Calvo A, Ruiz A, Rollot F, Arrambide G, Deschamps R, Maillart E, et al. Clinical Features and risk of relapse in children and adults with myelin oligodendrocyte glycoprotein antibody-associated disease. Ann Neurol. 2020;66(5):732-40.
Lampasona V, Franciotta D, Furlan R, Zanaboni S, Fazio R, Bonifacio E, et al. Similar low frequency of anti-MOG IgG and IgM in MS patients and healthy subjects. Neurology. 2004;62(11):2092-4. https://doi.org/10.1212/01.WNL.0000127615.15768.AE
Wang H, Munger KL, Reindl M, O'Reilly EJ, Levin LI, Berger T, et al. Myelin oligodendrocyte glycoprotein antibodies and multiple sclerosis in healthy young adults. Neurology. 2008;71(15):1142-6. https://doi.org/10.1212/01.wnl.0000316195.52001.e1
Mader S, Gredler V, Schanda K, Rostasy K, Dujmovic I, Pfaller K, et al. Complement activating antibodies to myelin oligodendrocyte glycoprotein in neuromyelitis optica and related disorders. J Neuroinflammation. 2011;8(1):184. https://doi.org/10.1186/1742-2094-8-184
Johns TG, Bernard CCA. The structure and function of myelin oligodendrocyte glycoprotein. J Neurochem. 1999;72(1):1-9. https://doi.org/10.1046/j.1471-4159.1999.0720001.x
Mayer MC, Breithaupt C, Reindl M, Schanda K, Rostásy K, Berger T, et al. Distinction and temporal stability of conformational epitopes on myelin oligodendrocyte glycoprotein recognized by patients with different inflammatory central nervous system diseases. J Immunol. 2013;191(7):3594-604. https://doi.org/10.4049/jimmunol.1301296
Reindl M, Waters P. Myelin oligodendrocyte glycoprotein antibodies in neurological disease. Nat Rev Neurol. 2019;15(2):89-102. https://doi.org/10.1038/s41582-018-0112-x
Spadaro M, Winklmeier S, Beltrán E, Macrini C, Höftberger R, Schuh E, et al. Pathogenicity of human antibodies against myelin oligodendrocyte glycoprotein. Ann Neurol. 2018;84(2):315-28. https://doi.org/10.1002/ana.25291
Höftberger R, Guo Y, Flanagan EP, Lopez-Chiriboga AS, Endmayr V, Hochmeister S, et al. The pathology of central nervous system inflammatory demyelinating disease accompanying myelin oligodendrocyte glycoprotein autoantibody. Acta Neuropathol. 2020;139(5):875-92. https://doi.org/10.1007/s00401-020-02132-y
Ong ZM, Arip M, Ching YM, Kumar L, Terumalay S, Sim SH, et al. The prevalence, demographics, clinical features, neuroimaging, and inter-ethnic differences of MOGAD in Malaysia with global perspectives. Mult Scler Relat Disord. 2022;67:104168. https://doi.org/10.1016/j.msard.2022.104168
Orlandi R, Mariotto S, Gajofatto A. Prevalence, incidence, and season distribution of MOG antibody-associated disease in the province of Verona, Italy. Mult Scler Relat Disord. 2022;63:103884. https://doi.org/10.1016/j.msard.2022.103884
Jurynczyk M, Messina S, Woodhall MR, Raza N, Everett R, Roca-Fernandez A, et al. Clinical presentation and prognosis in MOG-antibody disease: a UK study. Brain. 2017;140(12):3128-38. https://doi.org/10.1093/brain/awx276
Diem L, Hammer H, Hoepner R, Pistor M, Remlinger J, Salmen A. Sex and gender differences in autoimmune demyelinating CNS disorders: Multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD) and myelin-oligodendrocyte-glycoprotein antibody associated disorder (MOGAD). Int Rev Neurobiol. 2022;164:129-78. https://doi.org/10.1016/bs.irn.2022.06.011
Dos Passos GR, Oliveira LM, da Costa BK, Apostolos-Pereira SL, Callegaro D, Fujihara K, et al. MOG-IgG-associated optic neuritis, encephalitis, and myelitis: lessons learned from neuromyelitis optica spectrum disorder. Front Neurol. 2018;9:217. https://doi.org/10.3389/fneur.2018.00217
Cobo-Calvo A, Ruiz A, Maillart E, Audoin B, Zephir H, Bourre B, et al. Clinical spectrum and prognostic value of CNS MOG autoimmunity in adults: The MOGADOR study. Neurology. 2018;90(21):e1858-69. https://doi.org/10.1212/WNL.0000000000005560
Rojas JI, Pappolla A, Patrucco L, Cristiano E, Miguez J, Liwacki S, et al. Disability outcomes in NMOSD and MOGAD patients: data from a nationwide registry in Argentina. Neurol Sci. 2023;44(1):281-6. https://doi.org/10.1007/s10072-022-06409-w
Wynford-Thomas R, Jacob A, Tomassini V. Neurological update: MOG antibody disease. J Neurol. 2019;266(5):1280-6. https://doi.org/10.1007/s00415-018-9122-2
Jarius S, Ruprecht K, Kleiter I, Borisow N, Asgari N, Pitarokoili K, et al. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 1: Frequency, syndrome specificity, influence of disease activity, long-term course, association with AQP4-IgG, and origin. J Neuroinflammation. 2016;13(1):279. https://doi.org/10.1186/s12974-016-0717-1
Ciotti JR, Eby NS, Wu GF, Naismith RT, Chahin S, Cross AH. Clinical and laboratory features distinguishing MOG antibody disease from multiple sclerosis and AQP4 antibody-positive neuromyelitis optica. Mult Scler Relat Disord. 2020;45:102399. https://doi.org/10.1016/j.msard.2020.102399
Ramanathan S, Mohammad S, Tantsis E, Nguyen TK, Merheb V, Fung VSC, et al. Clinical course, therapeutic responses and outcomes in relapsing MOG antibody-associated demyelination. J Neurol Neurosurg Psychiatry. 2018;89(2):127-37. https://doi.org/10.1136/jnnp-2017-316880
Lee HJ, Kim B, Waters P, Woodhall M, Irani S, Ahn S, et al. Chronic relapsing inflammatory optic neuropathy (CRION): A manifestation of myelin oligodendrocyte glycoprotein antibodies. J Neuroinflammation. 2018;15(1):302. https://doi.org/10.1186/s12974-018-1335-x
Petzold A, Plant GT. Chronic relapsing inflammatory optic neuropathy: a systematic review of 122 cases reported. J Neurol. 2014;261(1):17-26. https://doi.org/10.1007/s00415-013-6957-4
Dubey D, Pittock SJ, Krecke KN, Morris PP, Sechi E, Zalewski NL, et al. Clinical, radiologic, and prognostic features of myelitis associated with myelin oligodendrocyte glycoprotein autoantibody. JAMA Neurol. 2019;76(3):301-9. https://doi.org/10.1001/jamaneurol.2018.4053
Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015;85(2):177-89. https://doi.org/10.1212/WNL.0000000000001729
Tenembaum S, Chitnis T, Ness J, Hahn JS, International Pediatric MS Study Group. Acute disseminated encephalomyelitis. Neurology. 2007;68(16 Suppl 2):S23-36. https://doi.org/10.1212/01.wnl.0000259404.51352.7f
O'Connor KC, McLaughlin KA, De Jager PL, Chitnis T, Bettelli E, Xu C, et al. Self-antigen tetramers discriminate between myelin autoantibodies to native or denatured protein. Nat Med. 2007;13(2):211-7. https://doi.org/10.1038/nm1488
Baumann M, Sahin K, Lechner C, Hennes EM, Schanda K, Mader S, et al. Clinical and neuroradiological differences of paediatric acute disseminating encephalomyelitis with and without antibodies to the myelin oligodendrocyte glycoprotein. J Neurol Neurosurg Psychiatry. 2015;86(3):265-72. https://doi.org/10.1136/jnnp-2014-308346
López-Chiriboga AS, Majed M, Fryer J, Dubey D, McKeon A, Flanagan EP, et al. Association of MOG-IgG serostatus with relapse after acute disseminated encephalomyelitis and proposed diagnostic criteria for MOG-IgG-associated disorders. JAMA Neurol. 2018;75(11):1355-63. https://doi.org/10.1001/jamaneurol.2018.1814
Ogawa R, Nakashima I, Takahashi T, Kaneko K, Akaishi T, Takai Y, et al. MOG antibody-positive, benign, unilateral, cerebral cortical encephalitis with epilepsy. Neurol Neuroimmunol Neuroinflamm. 2017;4(2):e322. https://doi.org/10.1212/NXI.0000000000000322
Duignan S, Wright S, Rossor T, Cazabon J, Gilmour K, Ciccarelli O, et al. Myelin oligodendrocyte glycoprotein and aquaporin-4 antibodies are highly specific in children with acquired demyelinating syndromes. Dev Med Child Neurol. 2018;60(9):958-62. https://doi.org/10.1111/dmcn.13703
Armangue T, Olivé-Cirera G, Martínez-Hernandez E, Sepulveda M, Ruiz-Garcia R, Muñoz-Batista M, et al. Associations of paediatric demyelinating and encephalitic syndromes with myelin oligodendrocyte glycoprotein antibodies: a multicentre observational study. Lancet Neurol. 2020;19(3):234-46. https://doi.org/10.1016/S1474-4422(19)30488-0
Wang L, ZhangBao J, Zhou L, Zhang Y, Li H, Li Y, et al. Encephalitis is an important clinical component of myelin oligodendrocyte glycoprotein antibody associated demyelination: a single-center cohort study in Shanghai, China. Eur J Neurol. 2019;26(1):168-74. https://doi.org/10.1111/ene.13790
Lee WJ, Kwon YN, Kim B, Moon J, Park KI, Chu K, et al. MOG antibody-associated encephalitis in adult: clinical phenotypes and outcomes. J Neurol Neurosurg Psychiatry. 2023;94(2):102-12. https://doi.org/10.1136/jnnp-2022-330074
Yao T, Zeng Q, Xie Y, Bi F, Zhang L, Xiao B, et al. Clinical analysis of adult MOG antibody-associated cortical encephalitis. Mult Scler Relat Disord. 2022;60:103727. https://doi.org/10.1016/j.msard.2022.103727
Ding J, Li X, Tian Z. Clinical features of coexisting anti-NMDAR and MOG antibody-associated encephalitis: a systematic review and meta-analysis. Front Neurol. 2021;12:711376. https://doi.org/10.3389/fneur.2021.711376
Linington C, Lassmann H. Antibody responses in chronic relapsing experimental allergic encephalomyelitis: correlation of serum demyelinating activity with antibody titre to the myelin/oligodendrocyte glycoprotein (MOG). J Neuroimmunol. 1987;17(1):61-9. https://doi.org/10.1016/0165-5728(87)90031-2
Wang H, Munger KL, Reindl M, O'reilly EJ, Levin LI, Berger T, et al. Myelin oligodendrocyte glycoprotein antibodies and multiple sclerosis in healthy young adults. Neurology. 2008;71:1142-6. https://doi.org/10.1212/01.wnl.0000316195.52001.e1
Reindl M, Schanda K, Woodhall M, Tea F, Ramanathan S, Sagen J, et al. International multicenter examination of MOG antibody assays. Neurol Neuroimmunol Neuroinflamm. 2020;7(2):e674. https://doi.org/10.1212/NXI.0000000000000674
Dutra BG, Da Rocha AJ, Nunes RH, Maia ACM. Neuromyelitis optica spectrum disorders: Spectrum of MR imaging findings and their differential diagnosis. Radiographics. 2018;38(1):169-93. https://doi.org/10.1148/rg.2018170141
Biotti D, Bonneville F, Tournaire E, Ayrignac X, Dallière CC, Mahieu L, et al. Optic neuritis in patients with anti-MOG antibodies spectrum disorder: MRI and clinical features from a large multicentric cohort in France. J Neurol. 2017;264(10):2173-5. https://doi.org/10.1007/s00415-017-8615-8
Shor N, Aboab J, Maillart E, Lecler A, Bensa C, Le Guern G, et al. Clinical, imaging and follow-up study of optic neuritis associated with myelin oligodendrocyte glycoprotein antibody: a multicentre study of 62 adult patients. Eur J Neurol. 2020;27(2):384-91. https://doi.org/10.1111/ene.14089
Carnero Contentti E, López PA, Criniti J, Pettinicchi JP, Cristiano E, Patrucco L, et al. Chiasmatic lesions on conventional magnetic resonance imaging during the first event of optic neuritis in patients with neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein-associated disease in a Latin American cohort. Eur J Neurol. 2022;29(3):802-9. https://doi.org/10.1111/ene.15178
Jarius S, Ruprecht K, Kleiter I, Borisow N, Asgari N, Pitarokoili K, et al. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: Epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome. J Neuroinflammation. 2016;13:280. https://doi.org/10.1186/s12974-016-0718-0
Kitley J, Waters P, Woodhall M, Leite MI, Murchison A, George J, et al. Neuromyelitis optica spectrum disorders with aquaporin-4 and myelin-oligodendrocyte glycoprotein antibodies a comparative study. JAMA Neurol. 2014;71(3):276-83. https://doi.org/10.1001/jamaneurol.2013.5857
Salama S, Khan M, Shanechi A, Levy M, Izbudak I. MRI differences between MOG antibody disease and AQP4 NMOSD. Mult Scler. 2020;26(14):1854-65 https://doi.org/10.1177/1352458519893093
Ramanathan S, Prelog K, Barnes EH, Tantsis EM, Reddel SW, Henderson APD, et al. Radiological differentiation of optic neuritis with myelin oligodendrocyte glycoprotein antibodies, aquaporin-4 antibodies, and multiple sclerosis. Mult Scler. 2016;22(4):470-82. https://doi.org/10.1177/1352458515593406
Baumann M, Bartels F, Finke C, Adamsbaum C, Hacohen Y, Rostásy K, et al. E.U. paediatric MOG consortium consensus: Part 2 - Neuroimaging features of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders. Eur J Paediatr Neurol. 2020;29:14-21. https://doi.org/10.1016/j.ejpn.2020.10.002
Cobo-Calvo Á, Ruiz A, D'Indy H, Poulat AL, Carneiro M, Philippe N, et al. MOG antibody-related disorders: common features and uncommon presentations. J Neurol. 2017;264(9):1945-55. https://doi.org/10.1007/s00415-017-8583-z
Kunchok A, Krecke KN, Flanagan EP, Jitprapaikulsan J, Lopez-Chiriboga AS, Chen JJ, et al. Does area postrema syndrome occur in myelin oligodendrocyte glycoprotein-IgG-associated disorders (MOGAD)? Neurology. 2020;94(2):85-8. https://doi.org/10.1212/WNL.0000000000008786
Banwell B, Bennett JL, Marignier R, Kim HJ, Brilot F, Flanagan EP, et al. Diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease: International MOGAD Panel proposed criteria. Lancet Neurol. 2023;22(3):268-82. https://doi.org/10.1016/S1474-4422(22)00431-8
A study to evaluate the efficacy and safety of rozanolixizumab in adult participants with myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOG-AD) (cosMOG). ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Identifier NCT05063162.
A study to evaluate the efficacy, safety, pharmacokinetics, and pharmacodynamics of satralizumab in patients with myelin oligodendrocyte glycoprotein antibody-associated disease (Meteoroid). ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Identifier NCT05271409.
Palace J, Leite MI, Jacob A. A practical guide to the treatment of neuromyelitis optica. Pract Neurol. 2012;12(4):209-14. https://doi.org/10.1136/practneurol-2012-000237
Chalmoukou K, Alexopoulos H, Akrivou S, Stathopoulos P, Reindl M, Dalakas MC. Anti-MOG antibodies are frequently associated with steroid-sensitive recurrent optic neuritis. Neurol Neuroimmunol Neuroinflamm. 2015;2(4):e131. https://doi.org/10.1212/NXI.0000000000000131
Bruijstens AL, Wendel E-M, Lechner C, Bartels F, Finke C, Breu M, et al. E.U. paediatric MOG consortium consensus: Part 5 - Treatment of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders. Eur J Paediatr Neurol. 2020;29:41-53. https://doi.org/10.1016/j.ejpn.2020.10.005
Tsantes E, Curti E, Siena E, Granella F. Successful intravenous immunoglobulin treatment in relapsing MOG-antibody-associated disease. Mult Scler Relat Disord. 2019;32:27-9. https://doi.org/10.1016/j.msard.2019.04.021
Hyun JW, Woodhall MR, Kim SH, Jeong IH, Kong B, Kim G, et al. Longitudinal analysis of myelin oligodendrocyte glycoprotein antibodies in CNS inflammatory diseases. J Neurol Neurosurg Psychiatry. 2017;88(10):811-7. https://doi.org/10.1136/jnnp-2017-315998
Chen JJ, Flanagan EP, Bhatti MT, Jitprapaikulsan J, Dubey D, Lopez Chiriboga ASS, et al. Steroid-sparing maintenance immunotherapy for MOG-IgG associated disorder. Neurology. 2020;95(2):e111-20. https://doi.org/10.1212/WNL.0000000000009758
Cobo-Calvo A, Sepúlveda M, Rollot F, Armangué T, Ruiz A, Maillart E, et al. Evaluation of treatment response in adults with relapsing MOG-Ab-associated disease. J Neuroinflammation. 2019;16(1):134. https://doi.org/10.1186/s12974-019-1525-1
Hacohen Y, Wong YY, Lechner C, Jurynczyk M, Wright S, Konuskan B, et al. Disease course and treatment responses in children with relapsing myelin oligodendrocyte glycoprotein antibody-associated disease. JAMA Neurol. 2018;75(4):478-87. https://doi.org/10.1001/jamaneurol.2017.4601
Durozard P, Rico A, Boutiere C, Maarouf A, Lacroix R, Cointe S, et al. Comparison of the response to rituximab between myelin oligodendrocyte glycoprotein and aquaporin-4 antibody diseases. Ann Neurol. 2020;87(2):256-66. https://doi.org/10.1002/ana.25648
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