Permeability of the blood-CSF barrier in MOGAD: clinical correlation based on the 2023 diagnostic criteria
Background The pathogenesis of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is associated with damage to the blood-cerebrospinal fluid (CSF) barrier (BCB), but a specific correlation remains unclear. We used the newly proposed diagnostic criteria in 2023 with the aim to ev...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2488181 |
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| author | Yin-Xi Zhang Qi-Lun Lai Wei Fang Bing-Qing Du Chun-Hong Shen Yong-Feng Xu Mei-Ping Ding Meng-Ting Cai |
| author_facet | Yin-Xi Zhang Qi-Lun Lai Wei Fang Bing-Qing Du Chun-Hong Shen Yong-Feng Xu Mei-Ping Ding Meng-Ting Cai |
| author_sort | Yin-Xi Zhang |
| collection | DOAJ |
| description | Background The pathogenesis of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is associated with damage to the blood-cerebrospinal fluid (CSF) barrier (BCB), but a specific correlation remains unclear. We used the newly proposed diagnostic criteria in 2023 with the aim to evaluate the permeability of the BCB in MOGAD.Methods We retrospectively analyzed data from 48 eligible patients with MOGAD. Serum and CSF samples were collected simultaneously prior to initiation of immunotherapies at admission. Elevated CSF/serum albumin quotient (QAlb) and indicators of intrathecal immunoglobulin G (IgG) synthesis were calculated as indicators of BCB damage. The relationship between the parameters and clinical features, disease severity, and prognosis were analyzed.Results Elevated QAlb levels were detected in 50% of patients, but only a small proportion of patients met the corresponding classifications of intrathecal IgG synthesis, namely IgG index >0.7 (10.4%), IgG synthesis rate >10 (6.2%), and local IgG synthesis rate >0 (8.1%). Elevated QAlb was significantly more common in patients with myelitis than in those with optic neuritis (p = 0.049). It was identified as an independent predictor of moderate-severe disease at admission (modified Rankin Scale [mRS]/Expanded Disability Status Scale [EDSS] ≥ 4). Moreover, elevated QAlb emerged as an independent risk factor for a poor long-term prognosis (mRS/EDSS ≥3 at the last follow-up).Conclusions BCB damage was common in MOGAD. Elevated QAlb could serve as a biomarker for evaluating disease severity at admission and predicting long-term prognosis. |
| format | Article |
| id | doaj-art-dfaf855ebe754ec0816f4dd28ac6a0e6 |
| institution | DOAJ |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-dfaf855ebe754ec0816f4dd28ac6a0e62025-08-20T03:06:01ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2488181Permeability of the blood-CSF barrier in MOGAD: clinical correlation based on the 2023 diagnostic criteriaYin-Xi Zhang0Qi-Lun Lai1Wei Fang2Bing-Qing Du3Chun-Hong Shen4Yong-Feng Xu5Mei-Ping Ding6Meng-Ting Cai7Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Neurology, Zhejiang Hospital, Hangzhou, ChinaDepartment of Neurology, Hangzhou TCM Hospital, Affiliated to Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaBackground The pathogenesis of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is associated with damage to the blood-cerebrospinal fluid (CSF) barrier (BCB), but a specific correlation remains unclear. We used the newly proposed diagnostic criteria in 2023 with the aim to evaluate the permeability of the BCB in MOGAD.Methods We retrospectively analyzed data from 48 eligible patients with MOGAD. Serum and CSF samples were collected simultaneously prior to initiation of immunotherapies at admission. Elevated CSF/serum albumin quotient (QAlb) and indicators of intrathecal immunoglobulin G (IgG) synthesis were calculated as indicators of BCB damage. The relationship between the parameters and clinical features, disease severity, and prognosis were analyzed.Results Elevated QAlb levels were detected in 50% of patients, but only a small proportion of patients met the corresponding classifications of intrathecal IgG synthesis, namely IgG index >0.7 (10.4%), IgG synthesis rate >10 (6.2%), and local IgG synthesis rate >0 (8.1%). Elevated QAlb was significantly more common in patients with myelitis than in those with optic neuritis (p = 0.049). It was identified as an independent predictor of moderate-severe disease at admission (modified Rankin Scale [mRS]/Expanded Disability Status Scale [EDSS] ≥ 4). Moreover, elevated QAlb emerged as an independent risk factor for a poor long-term prognosis (mRS/EDSS ≥3 at the last follow-up).Conclusions BCB damage was common in MOGAD. Elevated QAlb could serve as a biomarker for evaluating disease severity at admission and predicting long-term prognosis.https://www.tandfonline.com/doi/10.1080/07853890.2025.2488181Blood-cerebrospinal fluid barriermyelin oligodendrocyte glycoprotein antibody-associated diseasealbumin quotientdisease severityprognosis |
| spellingShingle | Yin-Xi Zhang Qi-Lun Lai Wei Fang Bing-Qing Du Chun-Hong Shen Yong-Feng Xu Mei-Ping Ding Meng-Ting Cai Permeability of the blood-CSF barrier in MOGAD: clinical correlation based on the 2023 diagnostic criteria Annals of Medicine Blood-cerebrospinal fluid barrier myelin oligodendrocyte glycoprotein antibody-associated disease albumin quotient disease severity prognosis |
| title | Permeability of the blood-CSF barrier in MOGAD: clinical correlation based on the 2023 diagnostic criteria |
| title_full | Permeability of the blood-CSF barrier in MOGAD: clinical correlation based on the 2023 diagnostic criteria |
| title_fullStr | Permeability of the blood-CSF barrier in MOGAD: clinical correlation based on the 2023 diagnostic criteria |
| title_full_unstemmed | Permeability of the blood-CSF barrier in MOGAD: clinical correlation based on the 2023 diagnostic criteria |
| title_short | Permeability of the blood-CSF barrier in MOGAD: clinical correlation based on the 2023 diagnostic criteria |
| title_sort | permeability of the blood csf barrier in mogad clinical correlation based on the 2023 diagnostic criteria |
| topic | Blood-cerebrospinal fluid barrier myelin oligodendrocyte glycoprotein antibody-associated disease albumin quotient disease severity prognosis |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2488181 |
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