Evidence map›Paper›PMID 41613124›Full record

ArticleFrontiers in immunology2025

Diagnostic biomarkers for differentiating AQP4-IgG- negative NMOSD from other nervous system autoimmune disorders: a retrospective study.

Wencan Jiang, Yang Jiao, Menglue Zhang, Chenxu Wang, Xiaotong Li, Kelin Chen, Yaowei Ding, Haoran Li, Lijuan Wang, Siwen Li and 4 more

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Wencan Jiang *Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yang Jiao *Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Menglue ZhangLaboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Chenxu WangLaboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xiaotong LiLaboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Kelin ChenLaboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yaowei DingLaboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Haoran LiLaboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Lijuan WangLaboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Siwen LiLaboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Ziwei LiuLaboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Chi HuangLaboratory Diagnosis Platform for Nervous System Infectious Diseases, Laboratory for Clinical Medicine, Capital Medical University, Beijing, China.
Lei LiuLaboratory Diagnosis Platform for Nervous System Infectious Diseases, Laboratory for Clinical Medicine, Capital Medical University, Beijing, China.
Guojun ZhangLaboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and objective: The clinical manifestations of neuromyelitis optica spectrum disorders (NMOSD) overlap with those of other central nervous system (CNS) disorders, making differential diagnosis based on symptoms alone difficult. This study aimed to identify distinguishing indicators of aquaporin-4 (AQP4) IgG-negative NMOSD and assess their diagnostic value. Methods: We analyzed four groups: 85 patients with AQP4-IgG-negative NMOSD, 192 with AQP4-IgG-positive NMOSD, 547 with other nervous system autoimmune disorders (e.g., multiple sclerosis, Guillain-Barré syndrome, and viral and autoimmune encephalitis), and 269 healthy controls matched for sex, age, and BMI.A diagnostic model was established using clinical, biochemical, and cerebrospinal fluid (CSF) variables. The dataset was divided into training and internal validation cohorts, and model performance was further assessed through external validation using an independently collected dataset obtained during the same study period. Results: We enrolled 1,093 participants. The AQP4-IgG-negative NMOSD group showed: higher diplopia incidence (35.29% vs. 17.19% in positive NMOSD, 17.18% in controls; P<0.001); lower limb sensory abnormalities (76.47% vs. 89.58%, P = 0.0056) and urinary dysfunction (36.47% vs. 57.29%, P = 0.0017) than positive cases; predominant brainstem involvement (50.59% vs. 31.77% in positive, 28.70% in controls; P<0.001); moderate spinal cord involvement (70.59% vs. 88.02% in positive, 38.57% in controls; P<0.001); and altered thyroxine, apolipoprotein A1, eosinophils, and basophils. After false discovery rate correction (q<0.1), diplopia, brainstem involvement, spinal cord involvement, serum albumin, and CSF albumin remained significant. A combined model incorporating twelve predictors (Ocular symptoms, Gastrointestinal symptoms, Water swallowing and choking difficulties, Cerebral lobes, Centrum semiovale, Brainstem, Cerebral ganglia, Spinal cord, APOA1, Ca, Toxoplasma gondii IgM Antibody, CSF IgG) achieved an AUC of 0.936in the training cohort and 0.929 in external validation. Discussion: AQP4-IgG-negative NMOSD shows distinct clinical, imaging, and laboratory profiles compared to other nervous system autoimmune disorders. A multi-indicator diagnostic approach offers higher accuracy than single-marker diagnostics.

Indexed as

Aquaporin 4Neuromyelitis OpticaAdolescentAdultAgedAged, 80 and overAutoantibodiesBiomarkersCase-Control StudiesChildChild, PreschoolDiagnosis, DifferentialFemaleHumansImmunoglobulin GLipidsAQP4 protein, humanAquaporin 4AutoantibodiesBiomarkersImmunoglobulin GLipidsAQP4-IgGclinical characteristicslaboratory examinationsmagnetic resonance imagingneuromyelitis optica spectrum disorder

Identifiers

PMID41613124
PMCPMC12846999

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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.