TY - JOUR
T1 - Cell-based assays for the detection of MOG antibodies: a comparative study
T2 - Journal of Neurology
AU - Gastaldi, M.
AU - Scaranzin, S.
AU - Jarius, S.
AU - Wildeman, B.
AU - Zardini, E.
AU - Mallucci, G.
AU - Rigoni, E.
AU - Vegezzi, E.
AU - Foiadelli, T.
AU - Savasta, S.
AU - Banfi, P.
AU - Versino, M.
AU - Benedetti, L.
AU - Novi, G.
AU - Mancardi, M.M.
AU - Giacomini, T.
AU - Annovazzi, P.
AU - Baroncini, D.
AU - Ferraro, D.
AU - Lampasona, V.
AU - Reindl, M.
AU - Waters, P.
AU - Franciotta, D.
N1 - Cited By :6
Export Date: 26 March 2021
CODEN: JNRYA
Correspondence Address: Gastaldi, M.; Neuroimmunology Laboratory, Italy; email: matteo.gastaldi@mondino.it
PY - 2020/12
Y1 - 2020/12
N2 - Background: The detection of antibodies to myelin oligodendrocyte glycoprotein (MOG) is fundamental for the identification of MOG antibody-associated disorders (MOGAD), and the differential diagnosis of acquired demyelinating syndromes of the CNS, among which multiple sclerosis (MS). We compared the diagnostic performance of four cell-based assays (CBAs) for their detection. Methods: Consecutive sera from 204 patients with ‘possible MOGAD’ (55), MS (112), and other neurological disorders (OND, 37) were tested for MOG-IgG with a live-CBA with anti-heavy-and-light chain secondary-antibody (LCBA-IgG
H+L), and a live-CBA for IgG
1 (LCBA-IgG
1). A subgroup of 71 patients was additionally tested with a live-CBA with anti-Fcγ secondary-antibody (LCBA-IgG
Fcγ), and a commercial fixed-CBA with anti-Fcγ secondary-antibody (FCBA-IgG
Fcγ)
. Results: Fifty-seven/204 patients (27.9%) were MOG-IgG-positive. Sensitivity was 89.1% (CI:77.8–95.9) and specificity 93.3% (CI:88.0–96.7) for LCBA-IgG
H+L, and 74.6% (CI:61.0–85.3) and 100% (CI:97.6–100) for LCBA-IgG
1. Eighteen of 57 (31%) samples showed discrepant results (all negative on LCBA-IgG
1); of these, three with ‘possible MOGAD’ showed high-titer MOG-IgG (≥ 1:640), and positivity for MOG-IgG
2, whereas 15/18 had low-titer MOG-IgG (1:160/1:320) and mixed diagnoses (5 ‘possible MOGAD’, 6 MS, 4 OND). In the subgroup analysis, sensitivity was 92.3% (CI:79.1–98.4) and specificity 97.0% (CI:83.8–99.9) for LCBA-IgG
Fcγ, and 87.2% (CI:72.6–95.7) and 97.0% (CI:83.8–99.9) for FCBA-IgG
Fcγ. Conclusions: LCBA-IgG
1 showed the highest specificity but can miss MOG-IgG
2 reactivities, whose meaning warrants further investigations. Titration of samples tested with LCBA-IgG
H+L/ IgG
Fcγ is important for meaningful interpretation of the results. In the subgroup analysis, LCBA-IgG
Fcγ yielded the highest accuracy, and FCBA-IgG
Fcγ good specificity, but it was at risk of false-negative results.
AB - Background: The detection of antibodies to myelin oligodendrocyte glycoprotein (MOG) is fundamental for the identification of MOG antibody-associated disorders (MOGAD), and the differential diagnosis of acquired demyelinating syndromes of the CNS, among which multiple sclerosis (MS). We compared the diagnostic performance of four cell-based assays (CBAs) for their detection. Methods: Consecutive sera from 204 patients with ‘possible MOGAD’ (55), MS (112), and other neurological disorders (OND, 37) were tested for MOG-IgG with a live-CBA with anti-heavy-and-light chain secondary-antibody (LCBA-IgG
H+L), and a live-CBA for IgG
1 (LCBA-IgG
1). A subgroup of 71 patients was additionally tested with a live-CBA with anti-Fcγ secondary-antibody (LCBA-IgG
Fcγ), and a commercial fixed-CBA with anti-Fcγ secondary-antibody (FCBA-IgG
Fcγ)
. Results: Fifty-seven/204 patients (27.9%) were MOG-IgG-positive. Sensitivity was 89.1% (CI:77.8–95.9) and specificity 93.3% (CI:88.0–96.7) for LCBA-IgG
H+L, and 74.6% (CI:61.0–85.3) and 100% (CI:97.6–100) for LCBA-IgG
1. Eighteen of 57 (31%) samples showed discrepant results (all negative on LCBA-IgG
1); of these, three with ‘possible MOGAD’ showed high-titer MOG-IgG (≥ 1:640), and positivity for MOG-IgG
2, whereas 15/18 had low-titer MOG-IgG (1:160/1:320) and mixed diagnoses (5 ‘possible MOGAD’, 6 MS, 4 OND). In the subgroup analysis, sensitivity was 92.3% (CI:79.1–98.4) and specificity 97.0% (CI:83.8–99.9) for LCBA-IgG
Fcγ, and 87.2% (CI:72.6–95.7) and 97.0% (CI:83.8–99.9) for FCBA-IgG
Fcγ. Conclusions: LCBA-IgG
1 showed the highest specificity but can miss MOG-IgG
2 reactivities, whose meaning warrants further investigations. Titration of samples tested with LCBA-IgG
H+L/ IgG
Fcγ is important for meaningful interpretation of the results. In the subgroup analysis, LCBA-IgG
Fcγ yielded the highest accuracy, and FCBA-IgG
Fcγ good specificity, but it was at risk of false-negative results.
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U2 - 10.1007/s00415-020-10024-0
DO - 10.1007/s00415-020-10024-0
M3 - Article
VL - 267
SP - 3555
EP - 3564
JO - J. Neurol.
JF - J. Neurol.
SN - 0340-5354
IS - 12
ER -