Τίτλος:
Anti-Myelin Oligodendrocyte Glycoprotein and Human Leukocyte Antigens as
Markers in Pediatric and Adolescent Multiple Sclerosis: on Diagnosis,
Clinical Phenotypes, and Therapeutic Responses
Περίληψη:
Early-onset (pediatric and adolescent) multiple sclerosis (MS) is a
well-established demyelinating disease that accounts for approximately
3-5% of all MS cases. Thus, identifying potential biomarkers that can
reflect the pathogenic mechanisms, disease course and prognosis, and
therapeutic response in such patients is of paramount importance. Myelin
oligodendrocyte glycoprotein (MOG) has been regarded as a putative
autoantigen and autoantibody target in patientswith demyelinating
diseases for almost three decades. However, recent studies have
suggested that antibodies against MOG represent a distinct clinical
entity of dominantly humoral profile, with a range of clinical
phenotypes closely related to the age of onset, specific patterns of
disease course, and responses to treatment. Furthermore, the major
histocompatibility complex (MHC)-which has been regarded as the “gold
standard” for attributing genetic burden in adult MS since the early
1970s-has also emerged as the primary genetic locus in early-onsetMS,
particularly with regard to the human leukocyte antigen (HLA) alleles
DRB1*1501 and DRB1*0401. Recent studies have investigated the
potential interactions among HLA, MOG, and environmental factors,
demonstrating that early-onset MS is characterized by genetic,
immunogenetic, immunological, and familial trait correlations. In this
paper, we review recent evidence regarding HLA-genotyping and MOG
antibodies-the two most important candidate biomarkers for early-onset
MS-as well as their potential application in the diagnosis and treatment
of MS.
