KEGG   DISEASE: Neuromyelitis optica
Entry
H01491                      Disease                                
Name
Neuromyelitis optica;
Devic disease
Description
Neuromyelitis optica (NMO), also known as Devic's disease is an inflammatory demyelinating disease that selectively affects optic nerves and spinal cord. The etiology of NMO is unknown but it is believed to be an autoimmune disorder triggered by an environmental factor, possibly an infection, in genetically susceptible individuals. The principal effector in NMO is the self-reactive, complement-activating anti-AQP4 antibody. AQP4 water channel is a component of the dystroglycan protein complex located in astrocytic foot processes at the blood-brain barrier. Anti-AQP4 antibody is sensitive and highly specific serum markers of autoimmune NMO. For many decades, NMO was considered to be a subtype of multiple sclerosis (MS), but prognosis and optimal treatments differ. Corticosteroids and plasma exchange (PLEX) are the most commonly used therapeutic modalities in acute settings. Corticosteroids exert global immunosuppressive and anti-inflammatory effects, whereas PLEX removes antibodies, complement, and cytokines from the blood. Besides, immunosuppressant agents interfering with the function of T and B cells have been shown to prevent disease relapses and reduce neurological disability in NMO.
Category
Immune system disease
Brite
Human diseases in ICD-11 classification [BR:br08403]
 08 Diseases of the nervous system
  Multiple sclerosis or other white matter disorders
   8A43  Neuromyelitis optica
    H01491  Neuromyelitis optica
Pathway
hsa04962  Vasopressin-regulated water reabsorption
hsa04976  Bile secretion
Drug
Satralizumab [DR:D11079] (anti-AQP4 antibody positive)
Inebilizumab [DR:D11757] (AQP4 antibody positive)
Eculizumab [DR:D03940] (anti-AQP4 antibody positive)
Comment
Autoantigen: AQP4 [HSA:361]
See also H01490 Multiple sclerosis.
Other DBs
ICD-11: 8A43
ICD-10: G36.0
MeSH: D009471
Reference
  Authors
Jasiak-Zatonska M, Kalinowska-Lyszczarz A, Michalak S, Kozubski W
  Title
The Immunology of Neuromyelitis Optica-Current Knowledge, Clinical Implications, Controversies and Future Perspectives.
  Journal
Int J Mol Sci 17:273 (2016)
DOI:10.3390/ijms17030273
Reference
  Authors
Jarius S, Wildemann B
  Title
AQP4 antibodies in neuromyelitis optica: diagnostic and pathogenetic relevance.
  Journal
Nat Rev Neurol 6:383-92 (2010)
DOI:10.1038/nrneurol.2010.72
Reference
  Authors
Lennon VA, Kryzer TJ, Pittock SJ, Verkman AS, Hinson SR
  Title
IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel.
  Journal
J Exp Med 202:473-7 (2005)
DOI:10.1084/jem.20050304
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