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Clinical Significance of AQP4 Antibody Detection in Chinese Patients with Neuromyelitis Optica (NMO) and High-Risk NMO: A Meta-Analysis

Nagam Varshithreddy, Department of Neurology, First Affiliated Hospital of Soochow University, Suzhou Jiangsu Province, 215006, P.R. China. , Nagam Varshithreddy* , Yin Zhou* , Gu Yanzheng** , Dong Wan-Li* , Fang Qi* , Xue Qun* , **

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International Journal of Neurology and Neurosurgery 9(2):p 149-156, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.9217.12

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Abstract

Aim: To determine the prognostic value of AQP4 (aqua protein 4) antibody in the cohort of Chinese patients, and evaluate the diagnosis of AQP4 antibody detection inneuromyelitisoptica (NMO) and HRNMO (highrisk NMO), and explore the treatment. Methods: China national Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, Chinesescience and technology journal database, PubMed, Embase and the Cochrane Library weresearched up to November 2014 for randomized control trails of related key words. The quality ofstudies was assessed according to the inclusion and exclusion criteria as recommended by the Cochrane Handbook for Systematic Reviews. Metaanalysis was conducted using STATA V.12. Results: Total 13 trials of 11 studies having 472 and 362 cases in NMO and HRNMO groups were included and the numbers of AQP4 antibody positive were 350 and 168 casesrespectively. The metaanalysis showed: The total AQP4 antibody positive ratein NMO group was higher than HRNMO group (RR=0.66y95%Cl (0.53, 0.83); after stratification, inthe cell based assay group (RR = 0.636, 95%CI (0.461, 0.878), the AQP4IgG positive rate in NMOgroup was higher than HRNMO. In indirect immunofluorescence assay method group (RR =0.681, 95%CI (0.460, 1.009), there were no significant differences in AQP4 antibody positive rate between two groups. The Egger linear regression and sensitivity analysis of these studies suggested no evidence of publication bias. Conclusion: The AQP4 antibody positive rate in NMO group was higher than in HRNMO group of Chinese population; with a significant difference between the two groups.

Keywords: Demyelinating Disease; Neuromyelitisoptica; HighRisk NMO; Aquaporin4 Antibody; MetaAnalysis. 

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DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.9217.12

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