TY - JOUR
T1 - Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD)
T2 - current understanding and challenges
AU - Al-Ani, Abdullah
AU - Chen, John J.
AU - Costello, Fiona
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
PY - 2023/8
Y1 - 2023/8
N2 - New diagnostic criteria for myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) have recently been proposed, distinguishing this syndrome from other inflammatory diseases of the central nervous system. Seropositivity status for MOG-IgG autoantibodies is important for diagnosing MOGAD, but only in the context of robust clinical characterization and cautious interpretation of neuroimaging. Over the last several years, access to cell-based assay (CBA) techniques has improved diagnostic accuracy, yet the positive predictive value of serum MOG-IgG values varies with the prevalence of MOGAD in any given patient population. For this reason, possible alternative diagnoses need to be considered, and low MOG-IgG titers need to be carefully weighted. In this review, cardinal clinical features of MOGAD are discussed. Key challenges to the current understanding of MOGAD are also highlighted, including uncertainty regarding the specificity and pathogenicity of MOG autoantibodies, the need to identify immunopathologic targets for future therapies, the quest to validate biomarkers that facilitate diagnosis and detect disease activity, and the importance of deciphering which patients with MOGAD require long-term immunotherapy.
AB - New diagnostic criteria for myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) have recently been proposed, distinguishing this syndrome from other inflammatory diseases of the central nervous system. Seropositivity status for MOG-IgG autoantibodies is important for diagnosing MOGAD, but only in the context of robust clinical characterization and cautious interpretation of neuroimaging. Over the last several years, access to cell-based assay (CBA) techniques has improved diagnostic accuracy, yet the positive predictive value of serum MOG-IgG values varies with the prevalence of MOGAD in any given patient population. For this reason, possible alternative diagnoses need to be considered, and low MOG-IgG titers need to be carefully weighted. In this review, cardinal clinical features of MOGAD are discussed. Key challenges to the current understanding of MOGAD are also highlighted, including uncertainty regarding the specificity and pathogenicity of MOG autoantibodies, the need to identify immunopathologic targets for future therapies, the quest to validate biomarkers that facilitate diagnosis and detect disease activity, and the importance of deciphering which patients with MOGAD require long-term immunotherapy.
KW - Inflammatory demyelinating diseases (IDDs)
KW - MOG-IgG
KW - Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD)
KW - Neuro-ophthalmology
KW - Neurology
KW - Ophthalmology
UR - http://www.scopus.com/inward/record.url?scp=85158105695&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85158105695&partnerID=8YFLogxK
U2 - 10.1007/s00415-023-11737-8
DO - 10.1007/s00415-023-11737-8
M3 - Review article
C2 - 37154894
AN - SCOPUS:85158105695
SN - 0340-5354
VL - 270
SP - 4132
EP - 4150
JO - Journal of Neurology
JF - Journal of Neurology
IS - 8
ER -