Cerebrospinal Fluid Aquaporin-4 Antibody Levels in Neuromyelitis Optica Attacks

To elucidate immunopathogenetic roles of aquaporin‐4 antibodies in the cerebrospinal fluid (CSF) of neuromyelitis optica spectrum disorders (NMOSD), we analyzed aquaporin‐4 antibody titers, cellular and inflammatory markers in the CSF collected from 11 aquaporin‐4 antibody seropositive patients. The CSF aquaporin‐4 antibody levels during attacks (but not in sera) closely correlated with pleocytosis, inflammatory cytokines including interleukin‐6 that can regulate antibody‐producing plasmablasts, and glial fibrillary acidic protein levels in the CSF. The amount of aquaporin‐4 antibodies present in the central nervous system may have therapeutic implications, as it is associated with astrocyte injury and inflammatory responses during NMOSD attacks. Ann Neurol 2014;76:305–309

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