Evidence map›Paper›PMID 40380029›Full record

ArticleJournal of neurology2025

Fluctuations in serum aquaporin-4 antibody titers: the clinical significance in neuromyelitis optica spectrum disorder.

Zhouzhou Wang, Hongmei Tan, Wenjuan Huang, Yuxin Fan, Liang Wang, Lei Zhou, Jingzi ZhangBao, Chao Quan

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Use of Fluid Biomarkers in NMOSD and MOGAD: Clinical and Research Applications.Neurology(R) neuroimmunology & neuroinflammation · 2026
    Review
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Zhouzhou Wang *Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.ORCID http://orcid.org/0009-0003-9281-1571
Hongmei Tan *Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Wenjuan HuangDepartment of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.ORCID http://orcid.org/0000-0002-8056-373X
Yuxin FanDepartment of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.ORCID http://orcid.org/0009-0006-7784-7340
Liang WangDepartment of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Lei ZhouDepartment of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Jingzi ZhangBaoDepartment of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. zhangbaojingzi@126.com.ORCID http://orcid.org/0000-0002-5308-6325
Chao QuanDepartment of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. chao_quan@fudan.edu.cn.ORCID http://orcid.org/0000-0003-1040-3930

Funding

Innovative Research Group Project of the National Natural Science Foundation of China 82171341
6 · The paper itself

Abstract

objectivesTo evaluate the relationship between aquaporin-4 immunoglobulin G (AQP4-IgG) titer dynamics and relapse in neuromyelitis optica spectrum disorder (NMOSD), compare AQP4-IgG dynamics across different maintenance therapy strategies, and identify factors associated with AQP4-IgG titer seroreversion to negativity.

methodsAltogether 171 patients with ≥ 2 serum AQP4-IgG tests by fixed cell-based assay 30 days apart and at least once positive were included. Their clinical and treatment data were reviewed.

resultsAmong the 171 NMOSD patients with a median disease duration of 81.3 months, 44 (25.7%) became AQP4-IgG seronegative, accompanied by a reduction in annualized relapse rate (0.16 vs. 0.00, P < 0.001). Decline in serum AQP4-IgG titers emerged as the protective factor against relapse (HR 0.53, 95% CI 0.36-0.79, P = 0.002). Patients receiving monoclonal antibodies (mostly B cell-depleting therapies) as their initial and sole therapy throughout disease demonstrated higher likelihood of AQP4-IgG seroreversion compared to those treated with non-specific immunosuppressants (HR 3.01, 95% CI 1.23-7.34, P = 0.016) or those started with immunosuppressants and later switched to monoclonal antibodies (HR 6.17, 95% CI 2.13-17.54, P < 0.001). Male (OR 3.95, 95% CI 1.35-11.63, P = 0.012), baseline AQP4-IgG titer (OR 0.71, 95% CI 0.55-0.92, P = 0.008) and monoclonal antibody treatment throughout disease (OR 4.07, 95% CI 1.45-11.40, P = 0.008) were independently associated with AQP4-IgG seroreversion.

interpretationSerum AQP4-IgG titer is related with relapse risk. Early initiation of monoclonal antibodies shows a superior suppressive effect on AQP4 autoimmunity.

Indexed as

Aquaporin 4AutoantibodiesImmunoglobulin GNeuromyelitis OpticaAdultAgedClinical RelevanceFemaleHumansImmunosuppressive AgentsMaleMiddle AgedRecurrenceRetrospective StudiesYoung AdultAQP4 protein, humanAquaporin 4AutoantibodiesImmunoglobulin GImmunosuppressive AgentsAquaporin-4BiomarkerImmunoglobulin GNeuromyelitis optica spectrum disorder

Identifiers

PMID40380029

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.