Neuromyelitis optica and Asian phenotype of multiple sclerosis

Research output: Chapter in Book/Report/Conference proceedingChapter

53 Citations (Scopus)

Abstract

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS), whereas neuromyelitis optica (NMO) is an inflammatory disease of the CNS selectively affecting the optic nerves and spinal cord. The pathological hallmark in MS is sharply demarcated demyelinating plaque with axons relatively preserved, whereas in NMO both axons and myelin are involved, resulting in necrotic cavitation. The nosological position of NMO has long been a matter of debate. In Asians, MS is rare; however, when it appears, the selective but severe involvement of the optic nerves and spinal cord is characteristic. This form, termed opticospinal MS (OSMS), has similar features to those of the relapsing form of NMO in Western populations. Recent discovery of a specific immunoglobulin G (IgG) against NMO, designated NMO-IgG, suggests that NMO is a distinct disease entity with a fundamentally different etiology from that of MS. Because NMO-IgG has been reported to be present in about 50%-60% of OSMS patients with longitudinally extensive spinal cord lesions (LESCLs), OSMS in Asians has been suggested to be the same entity as NMO. About half of the patients with the anti-aquaporin 4 (AQP4) antibody demonstrate brain lesions fulfilling the Barkhof criteria, whereas OSMS patients without the anti-AQP4 antibody show significantly fewer brain lesions. These findings indicate that the mechanism of LESCLs in Asians is heterogeneous, both related and unrelated to anti-AQP4 antibody, and that the disease condition with anti-AQP4 antibody does not completely overlap OSMS in Asians. This review discusses possible mechanisms for OSMS and anti-AQP4 autoimmune syndrome of the CNS.

Original languageEnglish
Title of host publicationThe Year in Neurology 2008
PublisherBlackwell Publishing Inc.
Pages58-71
Number of pages14
ISBN (Print)9781573317306
DOIs
Publication statusPublished - Jan 1 2008

Publication series

NameAnnals of the New York Academy of Sciences
Volume1142
ISSN (Print)0077-8923
ISSN (Electronic)1749-6632

Fingerprint

Aquaporin 4
Neuromyelitis Optica
Multiple Sclerosis
Phenotype
Neurology
Antibodies
Immunoglobulin G
Spinal Cord
Optics
Brain
Optic Nerve
Axons
Cavitation
Central Nervous System
Asia
Central Nervous System Diseases
Demyelinating Diseases
Cord
Myelin Sheath
Opticospinal Multiple Sclerosis

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • History and Philosophy of Science

Cite this

Kira, J-I. (2008). Neuromyelitis optica and Asian phenotype of multiple sclerosis. In The Year in Neurology 2008 (pp. 58-71). (Annals of the New York Academy of Sciences; Vol. 1142). Blackwell Publishing Inc.. https://doi.org/10.1196/annals.1444.002

Neuromyelitis optica and Asian phenotype of multiple sclerosis. / Kira, Jun-Ichi.

The Year in Neurology 2008. Blackwell Publishing Inc., 2008. p. 58-71 (Annals of the New York Academy of Sciences; Vol. 1142).

Research output: Chapter in Book/Report/Conference proceedingChapter

Kira, J-I 2008, Neuromyelitis optica and Asian phenotype of multiple sclerosis. in The Year in Neurology 2008. Annals of the New York Academy of Sciences, vol. 1142, Blackwell Publishing Inc., pp. 58-71. https://doi.org/10.1196/annals.1444.002
Kira J-I. Neuromyelitis optica and Asian phenotype of multiple sclerosis. In The Year in Neurology 2008. Blackwell Publishing Inc. 2008. p. 58-71. (Annals of the New York Academy of Sciences). https://doi.org/10.1196/annals.1444.002
Kira, Jun-Ichi. / Neuromyelitis optica and Asian phenotype of multiple sclerosis. The Year in Neurology 2008. Blackwell Publishing Inc., 2008. pp. 58-71 (Annals of the New York Academy of Sciences).
@inbook{c18278d8f6c94d9183de6ef1c288d4df,
title = "Neuromyelitis optica and Asian phenotype of multiple sclerosis",
abstract = "Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS), whereas neuromyelitis optica (NMO) is an inflammatory disease of the CNS selectively affecting the optic nerves and spinal cord. The pathological hallmark in MS is sharply demarcated demyelinating plaque with axons relatively preserved, whereas in NMO both axons and myelin are involved, resulting in necrotic cavitation. The nosological position of NMO has long been a matter of debate. In Asians, MS is rare; however, when it appears, the selective but severe involvement of the optic nerves and spinal cord is characteristic. This form, termed opticospinal MS (OSMS), has similar features to those of the relapsing form of NMO in Western populations. Recent discovery of a specific immunoglobulin G (IgG) against NMO, designated NMO-IgG, suggests that NMO is a distinct disease entity with a fundamentally different etiology from that of MS. Because NMO-IgG has been reported to be present in about 50{\%}-60{\%} of OSMS patients with longitudinally extensive spinal cord lesions (LESCLs), OSMS in Asians has been suggested to be the same entity as NMO. About half of the patients with the anti-aquaporin 4 (AQP4) antibody demonstrate brain lesions fulfilling the Barkhof criteria, whereas OSMS patients without the anti-AQP4 antibody show significantly fewer brain lesions. These findings indicate that the mechanism of LESCLs in Asians is heterogeneous, both related and unrelated to anti-AQP4 antibody, and that the disease condition with anti-AQP4 antibody does not completely overlap OSMS in Asians. This review discusses possible mechanisms for OSMS and anti-AQP4 autoimmune syndrome of the CNS.",
author = "Jun-Ichi Kira",
year = "2008",
month = "1",
day = "1",
doi = "10.1196/annals.1444.002",
language = "English",
isbn = "9781573317306",
series = "Annals of the New York Academy of Sciences",
publisher = "Blackwell Publishing Inc.",
pages = "58--71",
booktitle = "The Year in Neurology 2008",

}

TY - CHAP

T1 - Neuromyelitis optica and Asian phenotype of multiple sclerosis

AU - Kira, Jun-Ichi

PY - 2008/1/1

Y1 - 2008/1/1

N2 - Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS), whereas neuromyelitis optica (NMO) is an inflammatory disease of the CNS selectively affecting the optic nerves and spinal cord. The pathological hallmark in MS is sharply demarcated demyelinating plaque with axons relatively preserved, whereas in NMO both axons and myelin are involved, resulting in necrotic cavitation. The nosological position of NMO has long been a matter of debate. In Asians, MS is rare; however, when it appears, the selective but severe involvement of the optic nerves and spinal cord is characteristic. This form, termed opticospinal MS (OSMS), has similar features to those of the relapsing form of NMO in Western populations. Recent discovery of a specific immunoglobulin G (IgG) against NMO, designated NMO-IgG, suggests that NMO is a distinct disease entity with a fundamentally different etiology from that of MS. Because NMO-IgG has been reported to be present in about 50%-60% of OSMS patients with longitudinally extensive spinal cord lesions (LESCLs), OSMS in Asians has been suggested to be the same entity as NMO. About half of the patients with the anti-aquaporin 4 (AQP4) antibody demonstrate brain lesions fulfilling the Barkhof criteria, whereas OSMS patients without the anti-AQP4 antibody show significantly fewer brain lesions. These findings indicate that the mechanism of LESCLs in Asians is heterogeneous, both related and unrelated to anti-AQP4 antibody, and that the disease condition with anti-AQP4 antibody does not completely overlap OSMS in Asians. This review discusses possible mechanisms for OSMS and anti-AQP4 autoimmune syndrome of the CNS.

AB - Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS), whereas neuromyelitis optica (NMO) is an inflammatory disease of the CNS selectively affecting the optic nerves and spinal cord. The pathological hallmark in MS is sharply demarcated demyelinating plaque with axons relatively preserved, whereas in NMO both axons and myelin are involved, resulting in necrotic cavitation. The nosological position of NMO has long been a matter of debate. In Asians, MS is rare; however, when it appears, the selective but severe involvement of the optic nerves and spinal cord is characteristic. This form, termed opticospinal MS (OSMS), has similar features to those of the relapsing form of NMO in Western populations. Recent discovery of a specific immunoglobulin G (IgG) against NMO, designated NMO-IgG, suggests that NMO is a distinct disease entity with a fundamentally different etiology from that of MS. Because NMO-IgG has been reported to be present in about 50%-60% of OSMS patients with longitudinally extensive spinal cord lesions (LESCLs), OSMS in Asians has been suggested to be the same entity as NMO. About half of the patients with the anti-aquaporin 4 (AQP4) antibody demonstrate brain lesions fulfilling the Barkhof criteria, whereas OSMS patients without the anti-AQP4 antibody show significantly fewer brain lesions. These findings indicate that the mechanism of LESCLs in Asians is heterogeneous, both related and unrelated to anti-AQP4 antibody, and that the disease condition with anti-AQP4 antibody does not completely overlap OSMS in Asians. This review discusses possible mechanisms for OSMS and anti-AQP4 autoimmune syndrome of the CNS.

UR - http://www.scopus.com/inward/record.url?scp=54949094681&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=54949094681&partnerID=8YFLogxK

U2 - 10.1196/annals.1444.002

DO - 10.1196/annals.1444.002

M3 - Chapter

C2 - 18990121

AN - SCOPUS:54949094681

SN - 9781573317306

T3 - Annals of the New York Academy of Sciences

SP - 58

EP - 71

BT - The Year in Neurology 2008

PB - Blackwell Publishing Inc.

ER -