Pattern-specific loss of aquaporin-4 immunoreactivity distinguishes neuromyelitis optica from multiple sclerosis.
Multiple sclerosis (MS) and neuromyelitis optica (NMO) are inflammatory demyelinating disorders that affect the central nervous system, and their clinical presentations are often difficult to differentiate. Identification of an autoantibody, NMO-IgG (anti-aquaporin 4, AQP4), has made a major step in diagnosing NMO. However, the issue still remains for NMO-IgG negative spectrum of disorders and MS cases that primarily affect the optic nerve and spinal cord. Work by Dr. Lucchinetti's group at the Mayo Clinic distinguishes the pathological features that clearly distinguish MS from NMO. Moreover, pathogenesis of NMO was elaborated by careful analysis of the postmortem NMO tissue. This article teaches us how much we can learn about complex disorders from analysis of the diseased tissue.