{"id":4218,"date":"2024-12-24T13:59:41","date_gmt":"2024-12-24T05:59:41","guid":{"rendered":"https:\/\/uni-pharma.com.tw\/article_column\/%e3%80%90precision-medicine%e3%80%91neuromyelitis-optica-nmosd-blood-test-is-a-two-pronged-approach-to-strengthen-the-basis-for-treatment\/"},"modified":"2025-03-13T17:46:47","modified_gmt":"2025-03-13T09:46:47","slug":"%e3%80%90precision-medicine%e3%80%91neuromyelitis-optica-nmosd-blood-test-is-a-two-pronged-approach-to-strengthen-the-basis-for-treatment","status":"publish","type":"article_column","link":"https:\/\/uni-pharma.com.tw\/en\/article_column\/%e3%80%90precision-medicine%e3%80%91neuromyelitis-optica-nmosd-blood-test-is-a-two-pronged-approach-to-strengthen-the-basis-for-treatment\/","title":{"rendered":"\u3010Precision Medicine\u3011Neuromyelitis Optica NMOSD blood test is a two-pronged approach to strengthen the basis for treatment"},"content":{"rendered":"\n<p class=\"has-medium-font-size\"><strong>What is Neuromyelitis Optica Spectrum Disorder?<\/strong><\/p>\n\n<p>Neuromyelitis generalis NMOSD was published in 1884 by Eug\u00e8ne Devic in 17 cases (one of which was Devic himself) with fatal optic neuritis and myelitis comorbidities, so it is also known as Devic&#8217;s syndrome, which is a rare and severe autoimmune central nervous system inflammatory disease. Due to the imbalance of the immune system, patients produce autoimmune antibodies to attack the central nervous system cells in the body, mainly invading the optic nerve, spinal cord and brain.<\/p>\n\n<p>If NMOSD invades the optic nerve, patients often develop color blindness, deterioration of vision, visual field defects, and eye pain in a short period of time. If it invades the spinal cord, it will cause mobility disorders, sensory disorders, bladder dysfunction, mild limb paralysis, pain, severe incontinence, and even paralysis or loss of self-care ability.<sup>[1]<\/sup><\/p>\n\n<p class=\"has-medium-font-size\"><strong>epidemiology<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>The global incidence rate is approximately 0.039-0.73 per 100,000 person-years per year, and the incidence rate for those under 18 years of age is about 0.01-0.06 per 100,000 person-years per year.<sup>[2]<\/sup><\/li>\n\n\n\n<li>Previous studies have shown that the prevalence rate in Japan is about 3.42 per 100,000 people, Malaysia is 1.94 per 100,000 people, and South Korea is 2.56 per 100,000 people<sup>[3],<\/sup> while another study has shown that the average prevalence rate in East Asia such as Japan, South Korea, and China is about 3.5 per 100,000 people<sup>[4].<\/sup><\/li>\n<\/ul>\n\n<p>In recent years, the number of people suffering from the disease in Taiwan has also increased, but due to the fact that it is a rare disease, the prevalence rate in the 2011-2015 survey was about 1.47 per 100,000 people <sup>[5].<\/sup><\/p>\n\n<ul class=\"wp-block-list\">\n<li>It is more common in women, and four studies conducted in different countries have found that the incidence in women is about 2.27 to 9.8 times that of men <sup>[6].<\/sup><\/li>\n\n\n\n<li>The average age of onset ranges from 35 to 45 years <sup>[6],<\/sup> although studies have suggested that there is still a risk in those over 60 years and under 18 years of age.<\/li>\n<\/ul>\n\n<p class=\"has-medium-font-size\"><strong>Core clinical features<\/strong><\/p>\n\n<p>Because the disease occurs in the central nervous system and does not necessarily target a specific part of the disease, the following symptoms are common:<\/p>\n\n<ul class=\"wp-block-list\">\n<li>Optic neuritis: vision loss in one or both eyes at the same time in a short period of time, eye pain<\/li>\n\n\n\n<li>Acute myelitis: weakness of the limbs, bladder dysfunction, incontinence<\/li>\n\n\n\n<li>Acute brainstem syndrome: unexplained hiccups, nausea, or vomiting<\/li>\n\n\n\n<li>Symptomatic narcolepsy, acute diencephaly clinical syndrome, and typical NMOSD diencephaly lesions<\/li>\n\n\n\n<li>Symptomatic cerebral syndrome with typical NMOSD brain lesions<\/li>\n<\/ul>\n\n<p>The symptoms of NMOSD are usually severe, the recovery period is long, and the recurrence rate is very high, and in severe cases, it is easy to lead to permanent disability or neurorespiratory failure and death.<\/p>\n\n<p class=\"has-medium-font-size\"><strong>Irreversible, highly recurrent! Early detection is the key to proper treatment<\/strong><\/p>\n\n<p>NMOSD is easily confused with multiple sclerosis, but the two are completely different diseases, with different pathogenic mechanisms and different treatments, and if the wrong treatment is used, it may not only be ineffective but may increase the number of acute attacks.<\/p>\n\n<p>It is important to show an accurate diagnosis.<\/p>\n\n<p>Clinical Standard Diagnostic Procedures:<\/p>\n\n<ol class=\"wp-block-list\">\n<li>Core clinical features<\/li>\n\n\n\n<li>Serological test results of AQP-4 antibody<\/li>\n\n\n\n<li>MRI imaging features and observation of neuropathy can be used to make a correct diagnosis<\/li>\n<\/ol>\n\n<p class=\"has-medium-font-size\"><strong>The two-stage serological test greatly improves the accuracy of disease diagnosis<\/strong><br\/><strong>Give out-of-pocket patients an option to ease their burden<\/strong><\/p>\n\n<p>Because the clinical features may be confused with multiple sclerosis (MS), serologic testing for AQP-4 antibodies is added clinically.<\/p>\n\n<p>However, there is a possibility of false negatives due to serologic test results.<\/p>\n\n<p>Clinically, it will enter the third step, allowing patients to use MRI testing at their own expense, but the high cost and the need for part-by-site testing may make some patients hesitate and cause a delay in the timing of treatment.<\/p>\n\n<p>At present, the second test option for patients is to use a second serological test for MOG antibodies, if the AQP-4 antibody is negative but the MOG antibody is positive, it can also help the doctor to confirm the diagnosis and provide accurate treatment in the future.<\/p>\n\n<p>Compared with MRI testing, the two-pronged testing of AOP-4 antibody and MOG antibody can improve the accuracy of the disease at a more affordable cost for patients.<\/p>\n\n<p>The earlier the treatment of NMOSD, the more it can not only reduce the damage to the organs, but also greatly reduce the risk of disease progression, which has a positive impact on the prognosis and quality of life. Therefore, early symptom detection and double serological testing procedures are essential, and the financial burden is relatively easy for patients.<\/p>\n\n<p><\/p>\n\n<p>This article cites information:<\/p>\n\n<p>[1] Taiwan Neuroimmunological Medical Association. September 2022. Panoptic neuromyelitis. Published by Taiwan Neuroimmunology Association.<\/p>\n\n<p>[2] Papp V, et al. Neurology. 2021; 96:59-77.  <\/p>\n\n<p>[3] Tian DC, et al. Lancet Reg Health West Pac. 2020; 2:100021.  <\/p>\n\n<p>[4] Hor JY, et al. <em>Front Neurol<\/em>. 2020; 11:501. <\/p>\n\n<p>[5] Fang CW, et al. <em>Mult Scler Relat Disord<\/em>. 2020; 45:102425. <\/p>\n\n<p>[6] Etemadifar M, et al. <em>Mult Scler Int<\/em>. 2015; 2015:1-8. <\/p>\n\n<div class=\"wp-block-stackable-team-member stk-block-team-member stk-block stk-99b50bb is-style-horizontal\" data-v=\"2\" data-block-id=\"99b50bb\"><div class=\"stk-block-team-member__content stk-content-align stk-99b50bb-column stk-container stk-99b50bb-container stk-hover-parent\"><div class=\"stk-block-content stk-inner-blocks has-text-align-right stk-99b50bb-inner-blocks\">\n<div class=\"wp-block-stackable-columns stk-block-columns stk-block stk-e4a0c77\" data-block-id=\"e4a0c77\"><div class=\"stk-row stk-inner-blocks stk-block-content stk-content-align stk-e4a0c77-column\">\n<div class=\"wp-block-stackable-column stk-block-column stk-column stk-block stk-9cc48ea\" data-v=\"4\" data-block-id=\"9cc48ea\"><style>@media screen and (min-width:690px){.stk-9cc48ea{flex:var(--stk-flex-grow,1) 1 calc(20% - var(--stk-column-gap,0px) * 1 \/ 2 ) !important}}<\/style><div class=\"stk-column-wrapper stk-block-column__content stk-container stk-9cc48ea-container stk--no-background stk--no-padding\"><div class=\"stk-block-content stk-inner-blocks stk-9cc48ea-inner-blocks\">\n<div class=\"wp-block-stackable-image stk-block-image has-text-align-center stk-block stk-791a4fd\" data-block-id=\"791a4fd\"><style>.stk-791a4fd .stk-img-wrapper{width:150px !important;height:150px !important}.stk-791a4fd .stk-img-wrapper img,.stk-791a4fd .stk-img-wrapper::after,.stk-791a4fd .stk-img-wrapper::before{mask-image:url('data:image\/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHZpZXdCb3g9IjAgMCAxMDAgMTAwIiBwcmVzZXJ2ZUFzcGVjdFJhdGlvPSJub25lIj48Y2lyY2xlIGN4PSI1MCIgY3k9IjUwIiByPSI1MCI+PC9jaXJjbGU+PC9zdmc+') !important;-webkit-mask-image:url('data:image\/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHZpZXdCb3g9IjAgMCAxMDAgMTAwIiBwcmVzZXJ2ZUFzcGVjdFJhdGlvPSJub25lIj48Y2lyY2xlIGN4PSI1MCIgY3k9IjUwIiByPSI1MCI+PC9jaXJjbGU+PC9zdmc+') !important}<\/style><figure><span class=\"stk-img-wrapper stk-img--shape stk-image--shape-stretch\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" class=\"stk-img wp-image-1740\" src=\"https:\/\/i0.wp.com\/uni-pharma.com.tw\/wp-content\/uploads\/2024\/08\/%E5%BB%96%E5%BB%B7%E6%81%A9-%E7%A0%94%E7%99%BC%E9%86%AB%E6%AA%A2%E5%B8%AB.jpg?resize=800%2C800&#038;ssl=1\" width=\"800\" height=\"800\" alt=\"Fav Icon\" srcset=\"https:\/\/i0.wp.com\/uni-pharma.com.tw\/wp-content\/uploads\/2024\/08\/%E5%BB%96%E5%BB%B7%E6%81%A9-%E7%A0%94%E7%99%BC%E9%86%AB%E6%AA%A2%E5%B8%AB.jpg?w=800&amp;ssl=1 800w, https:\/\/i0.wp.com\/uni-pharma.com.tw\/wp-content\/uploads\/2024\/08\/%E5%BB%96%E5%BB%B7%E6%81%A9-%E7%A0%94%E7%99%BC%E9%86%AB%E6%AA%A2%E5%B8%AB.jpg?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/uni-pharma.com.tw\/wp-content\/uploads\/2024\/08\/%E5%BB%96%E5%BB%B7%E6%81%A9-%E7%A0%94%E7%99%BC%E9%86%AB%E6%AA%A2%E5%B8%AB.jpg?resize=90%2C90&amp;ssl=1 90w, https:\/\/i0.wp.com\/uni-pharma.com.tw\/wp-content\/uploads\/2024\/08\/%E5%BB%96%E5%BB%B7%E6%81%A9-%E7%A0%94%E7%99%BC%E9%86%AB%E6%AA%A2%E5%B8%AB.jpg?resize=600%2C600&amp;ssl=1 600w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/span><\/figure><\/div>\n<\/div><\/div><\/div>\n\n\n\n<div class=\"wp-block-stackable-column stk-block-column stk-column stk-block stk-6c62ccf\" data-v=\"4\" data-block-id=\"6c62ccf\"><style>@media screen and (min-width:690px){.stk-6c62ccf{flex:var(--stk-flex-grow,1) 1 calc(80% - var(--stk-column-gap,0px) * 1 \/ 2 ) !important}}<\/style><div class=\"stk-column-wrapper stk-block-column__content stk-container stk-6c62ccf-container stk--no-background stk--no-padding\"><div class=\"has-text-align-left stk-block-content stk-inner-blocks stk-6c62ccf-inner-blocks\">\n<div class=\"wp-block-stackable-heading stk-block-heading stk-block-heading--v2 stk-block stk-21a0b7e\" id=\"\u5ed6\u5ef7\u6069-\u91ab\u6aa2\u5e2b\" data-block-id=\"21a0b7e\"><style>.stk-21a0b7e{margin-bottom:0px !important}<\/style><h3 class=\"stk-block-heading__text\">\u5ed6\u5ef7\u6069 \u91ab\u6aa2\u5e2b<\/h3><\/div>\n\n\n\n<div class=\"wp-block-stackable-subtitle stk-block-subtitle stk-block stk-9fff5e7\" data-block-id=\"9fff5e7\"><style>.stk-9fff5e7{margin-bottom:0px !important}<\/style><p class=\"stk-block-subtitle__text stk-subtitle\">\u83ef\u5b87\u85e5\u54c1\u80a1\u4efd\u6709\u9650\u516c\u53f8 \u7814\u767c\u91ab\u6aa2\u5e2b<\/p><\/div>\n\n\n\n<div class=\"wp-block-stackable-text stk-block-text stk-block stk-0303e1f\" data-block-id=\"0303e1f\"><p class=\"stk-block-text__text\">_<\/p><\/div>\n<\/div><\/div><\/div>\n<\/div><\/div>\n<\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>What is Neuromyelitis Optica Spectrum Disorder? Neuromyelitis generalis NMOSD was published in 1884 by Eug\u00e8ne Devic in 17 cases (one of which was Devic himself) with fatal optic neuritis and myelitis comorbidities, so it is also known as Devic&#8217;s syndrome, which is a rare and severe autoimmune central nervous system inflammatory disease. Due to the [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":3705,"parent":0,"template":"","tags":[219,220,231,239,240],"article_column_cat":[216,217],"class_list":["post-4218","article_column","type-article_column","status-publish","has-post-thumbnail","hentry","tag-medical-testing","tag-mayo-clinic-en","tag-autoimmune-antibody-test","tag-nmosd-en","tag-mogad-en","article_column_cat-medical-column-en","article_column_cat-medical-testing"],"blocksy_meta":[],"acf":[],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/uni-pharma.com.tw\/en\/wp-json\/wp\/v2\/article_column\/4218","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/uni-pharma.com.tw\/en\/wp-json\/wp\/v2\/article_column"}],"about":[{"href":"https:\/\/uni-pharma.com.tw\/en\/wp-json\/wp\/v2\/types\/article_column"}],"author":[{"embeddable":true,"href":"https:\/\/uni-pharma.com.tw\/en\/wp-json\/wp\/v2\/users\/8"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/uni-pharma.com.tw\/en\/wp-json\/wp\/v2\/media\/3705"}],"wp:attachment":[{"href":"https:\/\/uni-pharma.com.tw\/en\/wp-json\/wp\/v2\/media?parent=4218"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/uni-pharma.com.tw\/en\/wp-json\/wp\/v2\/tags?post=4218"},{"taxonomy":"article_column_cat","embeddable":true,"href":"https:\/\/uni-pharma.com.tw\/en\/wp-json\/wp\/v2\/article_column_cat?post=4218"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}