scholarly journals Can Immune Tolerance Be Re-established in Neuromyelitis Optica?

2021 ◽  
Vol 12 ◽  
Author(s):  
Eileah Loda ◽  
Gabriel Arellano ◽  
Gina Perez-Giraldo ◽  
Stephen D. Miller ◽  
Roumen Balabanov
Keyword(s):  
Immune Responses ◽  
Neuromyelitis Optica ◽  
Immune Tolerance ◽  
Adverse Reactions ◽  
Chronic Inflammatory Disease ◽  
Antigen Specificity ◽  
Disease Modifying Therapies ◽  
Basic Science Knowledge ◽  
The Central Nervous System ◽  
Spectrum Disorders

Neuromyelitis optica (NMO) is a chronic inflammatory disease of the central nervous system that primarily affects the optic nerves and spinal cord of patients, and in some instances their brainstem, diencephalon or cerebrum as spectrum disorders (NMOSD). Clinical and basic science knowledge of NMO has dramatically increased over the last two decades and it has changed the perception of the disease as being inevitably disabling or fatal. Nonetheless, there is still no cure for NMO and all the disease-modifying therapies (DMTs) are only partially effective. Furthermore, DMTs are not disease- or antigen-specific and alter all immune responses including those protective against infections and cancer and are often associated with significant adverse reactions. In this review, we discuss the pathogenic mechanisms of NMO as they pertain to its DMTs and immune tolerance. We also examine novel research therapeutic strategies focused on induction of antigen-specific immune tolerance by administrating tolerogenic immune-modifying nanoparticles (TIMP). Development and implementation of immune tolerance-based therapies in NMO is likely to be an important step toward improving the treatment outcomes of the disease. The antigen-specificity of these therapies will likely ameliorate the disease safely and effectively, and will also eliminate the clinical challenges associated with chronic immunosuppressive therapies.

scholarly journals Immunotherapy of Neuromyelitis Optica

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Benjamin Bienia ◽  
Roumen Balabanov
Keyword(s):  
Spinal Cord ◽  
Neuromyelitis Optica ◽  
Blood Circulation ◽  
Treatment Strategies ◽  
Chronic Inflammatory Disease ◽  
Cell Functions ◽  
Growing Body ◽  
The Central Nervous System ◽  
Proinflammatory Molecules ◽  
Peripheral Blood Circulation

Neuromyelitis optica (NMO) is a chronic inflammatory disease of the central nervous system that affects the optic nerves and spinal cord resulting in visual impairment and myelopathy. There is a growing body of evidence that immunotherapeutic agents targeting T and B cell functions, as well as active elimination of proinflammatory molecules from the peripheral blood circulation, can attenuate disease progression. In this review, we discuss the immunotherapeutic options and the treatment strategies in NMO. We also analyze the pathogenic mechanisms of the disease in order to provide recommendations regarding treatments.

scholarly journals Differential diagnosis of neuromyelitis optica spectrum disorders

2017 ◽  
Vol 10 (7) ◽  
pp. 265-289 ◽  
Author(s):  
Sung-Min Kim ◽  
Seong-Joon Kim ◽  
Haeng Jin Lee ◽  
Hiroshi Kuroda ◽  
Jacqueline Palace ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Neuromyelitis Optica ◽  
Clinical Manifestations ◽  
Inflammatory Disorder ◽  
Test Results ◽  
Early Disease ◽  
The Central Nervous System ◽  
Assay Methods ◽  
Spectrum Disorders ◽  
Disease Stages

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system (CNS) mostly manifesting as optic neuritis and/or myelitis, which are frequently recurrent/bilateral or longitudinally extensive, respectively. As the autoantibody to aquaporin-4 (AQP4-Ab) can mediate the pathogenesis of NMOSD, testing for the AQP4-Ab in serum of patients can play a crucial role in diagnosing NMOSD. Nevertheless, the differential diagnosis of NMOSD in clinical practice is often challenging despite the phenotypical and serological characteristics of the disease because: (1) diverse diseases with autoimmune, vascular, infectious, or neoplastic etiologies can mimic these phenotypes of NMOSD; (2) patients with NMOSD may only have limited clinical manifestations, especially in their early disease stages; (3) test results for AQP4-Ab can be affected by several factors such as assay methods, serologic status, disease stages, or types of treatment; (4) some patients with NMOSD do not have AQP4-Ab; and (5) test results for the AQP4-Ab may not be readily available for the acute management of patients. Despite some similarity in their phenotypes, these NMOSD and NMOSD-mimics are distinct from each other in their pathogenesis, prognosis, and most importantly treatment. Understanding the detailed clinical, serological, radiological, and prognostic differences of these diseases will improve the proper management as well as diagnosis of patients.

Neuromyelitis Optica Spectrum Disorders

2019 ◽  
pp. 109-129
Author(s):  
A. Sebastian López-Chiriboga ◽  
Brian G. Weinshenker
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Neuromyelitis Optica ◽  
Inflammatory Diseases ◽  
Treatment Options ◽  
Neuromyelitis Optica Spectrum Disorders ◽  
Future Prospects ◽  
Mortality And Morbidity ◽  
The Central Nervous System ◽  
Spectrum Disorders

Neuromyelitis optica spectrum disorders (NMOSD) are inflammatory diseases of the central nervous system, traditionally diagnosed in patients with inflammatory attacks restricted to the optic nerves and spinal cord. The chapter considers the epidemiology, pathophysiology and immunopathogenesis of NMOSD. The clinical presentation and radiographic features are reviewed and the prognosis of patients with NMOSD is considered. The mortality and morbidity of untreated NMOSD is much greater than those of MS. Treatment options are summarized and finally future prospects of research are considered.

Neuromyelitis Optica

2013 ◽  
Author(s):  
Aaron E. Miller ◽  
Teresa M. DeAngelis
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Neuromyelitis Optica ◽  
Autoimmune Disorder ◽  
Therapeutic Approaches ◽  
New Concepts ◽  
The Central Nervous System ◽  
Spectrum Disorders

Neuromyelitis optica (NMO), a chronic inflammatory, demyelinating autoimmune disorder of the central nervous system with a predilection for the optic nerves and spinal cord, has long been confused with classical multiple sclerosis. In this chapter, we review the important clinical and radiographic distinctions of NMO and NMO spectrum disorders, and summarize promising new concepts in pathophysiology and therapeutic approaches.

scholarly journals A comparative evaluation of different NeuroMyelitis Optica Spectrum Disorder sets criteria

2020 ◽  
Author(s):  
Caroline Papeix ◽  
Ysoline Beigneux ◽  
Elisabeth Maillart ◽  
Jérôme de Seze ◽  
Catherine Lubetzki ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Comparative Evaluation ◽  
Clinical Presentation ◽  
Transverse Myelitis ◽  
Final Diagnosis ◽  
International Panel ◽  
The Central Nervous System ◽  
Spinal Form ◽  
Spectrum Disorders ◽  
Diagnosis Criteria

Abstract Background Three different sets of criteria have been proposed for the diagnosis of neuromyelitis optica spectrum disorders (NMOSD). OBJECTIVE To compare the specificity, sensitivity and diagnostic accuracy of the three different sets of NMOSD criteria, in patients presenting with inflammatory disorders of the central nervous system suggestive of NMOSD. Methods From 236 suspected NMOSD referred for serum AQP4-IgG testing between 2012 and 2014, the three sets of NMOSD criteria (1999, 2006 NMO criteria and 2015 International Panel for NMO Diagnosis criteria) were applied and compared to the final diagnosis. Results Seventy-six patients fulfilled at least one set of criteria and 28 patients fulfilled all NMOSD set of criteria. The final diagnosis was NMOSD in 66 cases, MS according to the MacDonald 2010 in 85 cases and another diagnosis in 85 cases. 2006 NMO criteria has the highest specificity (99%) and 2015 IPND NMOSD criteria, the highest sensitivity (97%). For the 1999, 2006 and 2015 IPND NMOSD criteria, the accuracy was respectively 82%, 87% and 97%. Conclusions Our study highlights the limitations of the first set of criteria, that include optico-spinal form of MS. The accuracy of NMO/SD diagnostic criteria improved from 1999 to 2015. It confirms the increased performance of the last set of criteria which covers a larger spectrum of clinical presentation. This study raises some the concern to classify patients with seronegative transverse myelitis or optic neuritis, and MOG-antibody associated disease.

scholarly journals NEUROMYELITIS OPTICA SPECTRUM DISORDERS: DIAGNOSIS AND TREATMENT, THE EXPERIENCE OF CLINICAL OBSERVATIONS

2018 ◽  
Vol 25 (3) ◽  
pp. 7-13 ◽  
Author(s):  
V. D. Piven ◽  
V. S. Krasnov ◽  
A. S. Novikova ◽  
F. M. Piven ◽  
Ya. B. Kushnir ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Neuromyelitis Optica ◽  
Clinical Observation ◽  
Clinical Course ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Neuromyelitis Optica Spectrum Disorders ◽  
Clinical Observations ◽  
The Central Nervous System ◽  
Spectrum Disorders

Neuromyelitis optica spectrum disorder (NMOSD) is an aggregate of inflammatory and autoimmune disorders of the central nervous system characterized by recurrent, disabling clinical course and damages predominantly targeting optic nerves, brain stem and spinal cord. NMOSD is stratified into two types: seropositive for aquaporin-4 antibodies (AQP4-IgG) and seronegative, which is reported in 25 % of cases. This article presents modern conceptualizations of NMOSD and describes authors’ own experience of clinical observation of patients.

P 855. Epidemiology of Neuromyelitis Optica Spectrum Disorders in Children and Adolescents

2018 ◽  
Author(s):  
Christian Lechner ◽  
Matthias Baumann ◽  
Eva-Maria Hennes ◽  
Kathrin Schanda ◽  
Markus Reindl ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Neuromyelitis Optica ◽  
Neuromyelitis Optica Spectrum Disorders ◽  
Spectrum Disorders
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