Comparative immunopathogenesis of acute disseminated encephalomyelitis, neuromyelitis optica, and multiple sclerosis

@article{Wingerchuk2007ComparativeIO,
  title={Comparative immunopathogenesis of acute disseminated encephalomyelitis, neuromyelitis optica, and multiple sclerosis},
  author={Dean M. Wingerchuk and Claudia F. Lucchinetti},
  journal={Current Opinion in Neurology},
  year={2007},
  volume={20},
  pages={343–350}
}
Purpose of reviewAdvanced immunopathological techniques hold promise for more precise diagnosis of idiopathic demyelinating diseases of the central nervous system. We review recent progress in differentiating and understanding the disease mechanisms of acute disseminated encephalomyelitis, neuromyelitis optica, and classical multiple sclerosis. Recent findingsFour distinct immunopathological patterns have been described in multiple sclerosis patients, potentially implicating different… 
Epidemiology, immunopathogenesis and management of pediatric central nervous system inflammatory demyelinating conditions
  • D. Pohl
  • Medicine, Psychology
    Current opinion in neurology
  • 2008
TLDR
Characteristics of pediatric inflammatory demyelinating central nervous system diseases, including monofocal and potentially monophasic disorders like optic neuritis and transverse myelitis, and multifocal chronic diseases like relapsing neuromyelitis optica and multiple sclerosis are discussed.
Myelin oligodendrocyte glycoprotein antibody-associated disease: an immunopathological study.
TLDR
This study suggests that ADEM-like perivenous inflammatory demyelination with MOG-dominant myelin loss is a characteristic finding of MOG antibody-associated disease regardless of whether the diagnostic criteria of ADEM are met.
Neuromyelitis optica IgG serostatus in fulminant central nervous system inflammatory demyelinating disease.
TLDR
This study is the first to compare NMO IgG serostatus among patients with fulminant central nervous system inflammatory demyelinating disease (CNS IDD) and concludes that N MO IgG is a specific biomarker for NMO spectrum disorders and is not simply a marker of destructive CNS IDD.
The Spectrum of Neuromyelitis Optica (NMO) in Childhood
TLDR
Current clinical, pathological, and pathogenetic knowledge is reviewed with a focus on clinical presentation, neuroimaging findings, serological investigations, and treatment of children with disorders within the spectrum of central nervous system aquaporin-4 autoimmunity.
Treatment of Acute Disseminated Encephalomyelitis
TLDR
A broad workup including infectious, immunologic, and metabolic tests, as well as a systematic follow-up including MRI, is indicated to establish an accurate diagnosis as a prerequisite for an optimized treatment approach.
Acute disseminated encephalomyelitis
  • S. Tenembaum
  • Medicine, Psychology
    Handbook of Clinical Neurology
  • 2013
Pathogenesis, diagnosis and treatment of neuromyelitis optica: Changing concept of an old disease
TLDR
Current concepts of diagnosis and treatment of NMO and NMO spectrum diseases are summarized and treatment decisions in different clinical situations are shown by discussion of cases.
Differential diagnosis of neuromyelitis optica spectrum disorders
TLDR
Despite some similarity in their phenotypes, these NMOSD andNMOSD-mimics are distinct from each other in their pathogenesis, prognosis, and most importantly treatment.
New onset neuromyelitis optica in a young Nigerian woman with possible antiphospholipid syndrome: a case report
TLDR
Neuromyelitis optica should be considered in the differential diagnoses of acute myelopathy in Africans and the unusual association with antiphospholipid syndrome should be highlighted.
Neuromyelitis optica pathogenesis and aquaporin 4
TLDR
Dysregulation of tolerance associated with autoimmune disease appears to have a role in NMO and reagents and experimental questions that need to be developed and addressed are identified to enhance the understanding of the pathogenesis of NMO.
...
...

References

SHOWING 1-10 OF 98 REFERENCES
A role for humoral mechanisms in the pathogenesis of Devic's neuromyelitis optica.
TLDR
The extent of complement activation, eosinophilic infiltration and vascular fibrosis observed in the Devic NMO cases is more prominent compared with that in prototypic multiple sclerosis, and supports a role for humoral immunity in the pathogenesis of NMO.
Pattern-specific loss of aquaporin-4 immunoreactivity distinguishes neuromyelitis optica from multiple sclerosis.
TLDR
Findings strongly support a role for a complement activating AQP4-specific autoantibody as the initiator of the NMO lesion, and further distinguish NMO from MS.
Loss of aquaporin-4 in active perivascular lesions in neuromyelitis optica: a case report.
TLDR
The findings suggest that astrocytic impairment associated with humoral immunity against AQP4 may be primarily involved in the lesion formation of N MO, and that the pathomechanisms of NMO are different from those of MS in which demyelination is the primary pathology.
Heterogeneity of multiple sclerosis lesions: Implications for the pathogenesis of demyelination
TLDR
At a given time point of the disease, the patterns of demyelination were heterogeneous between patients, but were homogenous within multiple active lesions from the same patient, suggesting that MS may be a disease with heterogeneous pathogenetic mechanisms.
Identification of new serum autoantibodies in neuromyelitis optica using protein microarrays
TLDR
A protein microarray approach was used to profile the Ag reactivity of serum IgG from NMO patients and found that following treatment with rituximab, patients experienced improved strength and sensation in their legs and recovered spontaneously without additional treatment.
Antimyelin antibodies as a predictor of clinically definite multiple sclerosis after a first demyelinating event.
TLDR
Analysis of antibodies against MOG and MBP in patients with a clinically isolated syndrome is a rapid, inexpensive, and precise method for the prediction of early conversion to clinically definite multiple sclerosis.
Clinical course, pathological correlations, and outcome of biopsy proved inflammatory demyelinating disease
TLDR
Most patients undergoing biopsy, who had pathologically confirmed demyelinating disease, were likely to develop MS and remain ambulatory after a median disease duration of 4.4 years, and data suggest that pathogenic implications derived largely from MS biopsy studies may be extrapolated to the general MS population.
Activation of humoral immunity and eosinophils in neuromyelitis optica
TLDR
It is suggested that neuromyelitis optica is associated with a major humoral immune response (particularly anti-MOG IgM production) and eosinophil activation present exclusively in CSF.
...
...