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Autoimmune Gliopathies and CNS Demyelinating Disease

March 1, 2020

Overview

This webinar will provide an overview of novel biomarker discoveries and advances being made in the study of autoimmune gliopathies. Neuromyelitis optica (NMO) spectrum disorders, considered under the umbrella term, “autoimmune aquaporin-4 channelopathy,” represent an evolving spectrum of central nervous system (CNS) inflammatory autoimmune demyelinating diseases for which a specific antigen has been identified—the astrocytic water channel protein called aquaporin-4 (AQP4). The discovery of AQP4-IgG represents a significant shift from emphasis on the oligodendrocyte and myelin to the astrocyte, and it was the first proven autoimmune gliopathy biomarker.

Continued progress in our understanding of the immunobiology of AQP4 autoimmunity necessitates continuing revision of the clinical diagnostic criteria for NMO spectrum disorders. As the clinical spectrum broadens, the importance of highly specific assays that detect pathogenic AQP4-IgG-targeting extracellular epitopes of AQP4 cannot be overemphasized. IgG-targeting myelin oligodendrocyte glycoprotein (MOG), when detected using cell-based assays expressing recombinant MOG, is now recognized as a biomarker of an autoimmune oligodendrogliopathy (distinct from multiple sclerosis) considered an autoimmune “MOG-opathy.” Also, recently, our group reported a novel immunopathological biomarker, the GFAP antibody, which when detected in CSF, unifies a spectrum of immunotherapy-responsive autoimmune inflammatory CNS disorders termed, “autoimmune GFAP astrocytopathy” distinct from infectious meningoencephalitis and idiopathic inflammatory CNS disorders, such as multiple sclerosis, vasculitis, and sarcoidosis.
 

View the Archived Webinar

  Video length: 1 hour 3 min

 

Presenter

Photo of Sean Pittock, M.D.Sean Pittock, M.D.
Consultant, Neurology
Professor of Neurology, College of Medicine
Mayo Clinic
Rochester, Minnesota
 
 
 

Learning Objectives

  • Describe the evolving spectrum of biomarker-defined inflammatory CNS demyelinating diseases.
  • Recognize the clinical utility of AQP4 and MOG antibody testing and the diagnostic and treatment implications of a positive test.
  • Discuss how improved knowledge of the immunopathologic mechanisms of disease has led to novel therapeutic approaches.

 

Intended Audience

This webinar is designed for any provider who sees patients with a neurologic disease (e.g., neurologists, psychiatrists, and primary care physicians, including internists and family care practitioners) as well as pathologists, laboratory directors, and laboratory sendout coordinators.

 

Level of instruction

Intermediate

 

Faculty Disclosure

Course director(s), planning committee, faculty, and all others who are in a position to control the content of this educational activity are required to disclose all relevant financial relationships with any commercial interest related to the subject matter of the educational activity. Safeguards against commercial bias have been put in place. Faculty members also will disclose any off-label and/or investigational use of pharmaceuticals or instruments discussed in their presentations. Disclosure of this information will be published in course materials so those participants in the activity may formulate their own judgments regarding the presentations.

 
Note: No credit is offered for this neurology presentation.

MCL Education

MCL Education

This post was developed by our Education and Technical Publications Team.