본문 바로가기
KERD
논문KCI 등재

New Insights into Neuromyelitis Optica

김수현|김호진|김우준
대한신경과학회 (Korean Neurological Association)|2011.09|Journal of Clinical Neurology|제7권 제3호|pp. 115-127

2

조회

0

다운로드

7

인용

0

참고문헌

키워드

diagnosispathogenesisneuromyelitis opticaneuromyelitis optica spectrum disorderDevic’s diseasemanagement.

초록

Neuromyelitis optica (NMO) is an idiopathic inflammatory disorder of the central nervous system (CNS) that preferentially affects the optic nerves and spinal cord. In Asia, NMO has long been considered a subtype of multiple sclerosis (MS). However, recent clinical, pathological, immunological, and imaging studies have suggested that NMO is distinct from MS. This reconsideration of NMO was initially prompted by the discovery of a specific antibody for NMO (NMO-IgG) in 2004. NMO-IgG is an autoantibody that targets aquaporin-4 (AQP4), the most abundant water channel in the CNS; hence, it was named anti-AQP4 antibody. Since it demonstrated reasonable sensitivity and high specificity, anti-AQP4 antibody was incorporated into new diagnostic criteria for NMO.The spectrum of NMO is now known to be wider than was previously recognized and includes a proportion of patients with recurrent, isolated, longitudinally extensive myelitis or optic neuritis, and longitudinally extensive myelitis or optic neuritis associated with systemic autoimmune disease or with brain lesions typical of NMO. In this context, a new concept of “NMO spectrum disorders”was recently introduced. Furthermore, seropositivity for NMO-IgG predicts future relapses and is recognized as a prognostic marker for NMO spectrum disorders. Humoral immune mechanisms, including the activation of B-cells and the complement pathway, are considered to play important roles in NMO pathogenesis. This notion is supported by recent studies showing the potential pathogenic role of NMO-IgG as an initiator of NMO lesions. However, a demonstration of the involvement of NMO-IgG by the development of active immunization and passive transfer in animal models is still needed. This review focuses on the new concepts of NMO based on its pathophysiology and clinical characteristics. Potential management strategies for NMO in light of its pathomechanism are also discussed.

Abstract

Neuromyelitis optica (NMO) is an idiopathic inflammatory disorder of the central nervous system (CNS) that preferentially affects the optic nerves and spinal cord. In Asia, NMO has long been considered a subtype of multiple sclerosis (MS). However, recent clinical, pathological, immunological, and imaging studies have suggested that NMO is distinct from MS. This reconsideration of NMO was initially prompted by the discovery of a specific antibody for NMO (NMO-IgG) in 2004. NMO-IgG is an autoantibody that targets aquaporin-4 (AQP4), the most abundant water channel in the CNS; hence, it was named anti-AQP4 antibody. Since it demonstrated reasonable sensitivity and high specificity, anti-AQP4 antibody was incorporated into new diagnostic criteria for NMO.The spectrum of NMO is now known to be wider than was previously recognized and includes a proportion of patients with recurrent, isolated, longitudinally extensive myelitis or optic neuritis, and longitudinally extensive myelitis or optic neuritis associated with systemic autoimmune disease or with brain lesions typical of NMO. In this context, a new concept of “NMO spectrum disorders”was recently introduced. Furthermore, seropositivity for NMO-IgG predicts future relapses and is recognized as a prognostic marker for NMO spectrum disorders. Humoral immune mechanisms, including the activation of B-cells and the complement pathway, are considered to play important roles in NMO pathogenesis. This notion is supported by recent studies showing the potential pathogenic role of NMO-IgG as an initiator of NMO lesions. However, a demonstration of the involvement of NMO-IgG by the development of active immunization and passive transfer in animal models is still needed. This review focuses on the new concepts of NMO based on its pathophysiology and clinical characteristics. Potential management strategies for NMO in light of its pathomechanism are also discussed.

참고문헌 (129)

  1. Wingerchuk DM, "The spectrum of neuromyelitis optica", Lancet Neurol, 6, pp.805~815 (2007)
  2. Allbutt T, "On the ophthalmoscopic signs of spinal disease", Lancet, 1, pp.76~78 (1870)
  3. Devic E, "Myelite subaigue compliquee de nevrite optique", Bull Med (Paris), 8, pp.1033~1034 (1894)
  4. Lennon VA, "A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis", Lancet, 364, pp.2106~2112 (2004)
  5. Lennon VA, "IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel", J Exp Med, 202, pp.473~477 (2005)
  6. Wingerchuk DM, "Revised diagnostic criteria for neuromyelitis optica", Neurology, 66, pp.1485~1489 (2006)
  7. Matiello M, "Neuromyelitis optica", Curr Opin Neurol, 20, pp.255~260 (2007)
  8. Cabrera-Gómez JA, "An epidemiological study of neuromyelitis optica in Cuba", J Neurol, 256, pp.35~44 (2009)
  9. Cabre P, "Environmental changes and epidemiology of multiple sclerosis in the French West Indies", J Neurol Sci, 286, pp.58~61 (2009)
  10. Bizzoco E, "Prevalence of neuromyelitis optica spectrum disorder and phenotype distribution", J Neurol, 256, pp.1891~1898 (2009)
  11. Kira J, "Multiple sclerosis in the Japanese population", Lancet Neurol, 2, pp.117~127 (2003)
  12. Cree BA, "Clinical characteristics of African Americans vs Caucasian Americans with multiple sclerosis", Neurology, 63, pp.2039~2045 (2004)
  13. Papais-Alvarenga RM, "Optic neuromyelitis syndrome in Brazilian patients", J Neurol Neurosurg Psychiatry, 73, pp.429~435 (2002)
  14. Wingerchuk DM, "The clinical course of neuromyelitis optica (Devic’s syndrome)", Neurology, 53, pp.1107~1114 (1999)
  15. de Seze J, "Is Devic’s neuromyelitis optica a separate disease? A comparative study with multiple sclerosis", Mult Scler, 9, pp.521~525 (2003)
  16. Davis R, "Neuromyelitis optica in childhood: case report with sequential MRI findings", J Child Neurol, 11, pp.164~167 (1996)
  17. Banwell B, "Neuromyelitis optica-IgG in childhood inflammatory demyelinating CNS disorders", Neurology, 70, pp.344~352 (2008)
  18. McKeon A, "CNS aquaporin-4 autoimmunity in children", Neurology, 71, pp.93~100 (2008)
  19. Filley CM, "Neuromyelitis optica in the elderly", Arch Neurol, 41, pp.670~672 (1984)
  20. McAlpine D, "Familial neuromyelitis optica: its occurrence in identical twins", Brain, 61, pp.430~438 (1983)
  21. Ch’ien LT, "Neuromyelitis optica (Devic’s syndrome) in two sisters", Clin Electroencephalogr, 13, pp.36~39 (1982)
  22. Yamakawa K, "Familial neuromyelitis optica (Devic’s syndrome) with late onset in Japan", Neurology, 55, pp.318~320 (2000)
  23. Keegan M, "Familial Devic’s disease", Can J Neurol Sci, 27, pp.557~558 (2000)
  24. Cabrera-Gómez JA, "Neuromyelitis optica and mul-tiple sclerosis in sisters", Mult Scler, 15, pp.269~271 (2009)
  25. Matiello M, "Familial neuromyelitis optica", Neurology, 75, pp.310~315 (2010)
  26. Yamasaki K, "HLA-DPB1*0501-associated opticospinal multiple sclerosis: clinical, neuroimaging and immunogenetic studies", Brain, 122, pp.1689~1696 (1999)
  27. Ito H, "HLA-DP-associated susceptibility to the optico-spinal form of multiple sclerosis in the Japanese", Tissue Antigens, 52, pp.179~182 (1998)
  28. Misu T, "Pure optic-spinal form of multiple sclerosis in Japan", Brain, 125, pp.2460~2468 (2002)
  29. Wang H, "HLA-DPB1 0501 is associated with susceptibility to anti-aquaporin-4 antibodies positive neuromyelitis optica in southern Han Chinese", J Neuroimmunol, 233, pp.181~184 (2011)
  30. Lucchinetti CF, "A role for humoral mechanisms in the pathogenesis of Devic’s neuromyelitis optica", Brain, 125, pp.1450~1461 (2002)
  31. Itoh T, "Identification of a novel aquaporin, AQP12, expressed in pancreatic acinar cells", Biochem Biophys Res Commun, 330, pp.832~838 (2005)
  32. Pittock SJ, "Neuromyelitis optica brain lesions localized at sites of high aquaporin 4 expression", Arch Neurol, 63, pp.964~968 (2006)
  33. Amiry-Moghaddam M, "The molecular basis of water transport in the brain", Nat Rev Neurosci, 4, pp.991~1001 (2003)
  34. Nielsen S, "Specialized membrane domains for water transport in glial cells: high-resolution immunogold cytochemistry of aquaporin-4 in rat brain", J Neurosci, 17, pp.171~180 (1997)
  35. Crane JM, "Live-cell imaging of aquaporin-4 diffusion and interactions in orthogonal arrays of particles", Neuroscience, 168, pp.892~902 (2010)
  36. Marnetto F, "Western blot analysis for the detection of serum antibodies recognizing linear Aquaporin-4 epitopes in patients with Neuromyelitis Optica", J Neuroimmunol, 217, pp.74~79 (2009)
  37. Mader S, "Patterns of antibody binding to aquaporin-4 isoforms in neuromyelitis optica", PLoS One, 5, pp.10455~ (2010)
  38. Weinshenker BG, "Neuromyelitis optica IgG predicts relapse after longitudinally extensive transverse myelitis", Ann Neurol, 59, pp.566~569 (2006)
  39. Matiello M, "NMO-IgG predicts the outcome of recurrent optic neuritis", Neurology, 70, pp.2197~2200 (2008)
  40. Takahashi T, "Anti-aquaporin-4 antibody is involved in the pathogenesis of NMO: a study on antibody titre", Brain, 130, pp.1235~1243 (2007)
  41. Jarius S, "Antibody to aquaporin-4 in the long-term course of neuromyelitis optica", Brain, 131, pp.3072~3080 (2008)
  42. Kim HJ, "Quantitative measurement of anti-aquaporin-4 antibody by enzyme-linked immunosorbent assay using purified human aquaporin-4", 4th Congress of the Pan-Asian Committee for Treatment and Research in Multiple Sclerosis, pp.1290~ (2010)
  43. Misu T, "Loss of aquaporin 4 in lesions of neuromyelitis optica: distinction from multiple sclerosis", Brain, 130, pp.1224~1234 (2007)
  44. Hinson SR, "Pathogenic potential of IgG binding to water channel extracellular domain in neuromyelitis optica", Neurology, 69, pp.2221~2231 (2007)
  45. Waters P, "Aquaporin-4 antibodies in neuromyelitis optica and longitudinally extensive transverse myelitis", Arch Neurol, 65, pp.913~919 (2008)
  46. Kinoshita M, "Astrocytic necrosis is induced by anti-aquaporin-4 antibody-positive serum", Neuroreport, 20, pp.508~512 (2009)
  47. Vincent T, "Functional consequences of neuromyelitis optica-IgG astrocyte interactions on blood-brain barrier permeability and granulocyte recruitment", J Immunol, 181, pp.5730~5737 (2008)
  48. Takano R, "Astrocytic damage is far more severe than demyelination in NMO: a clinical CSF biomarker study", Neurology, 75, pp.208~216 (2010)
  49. Hinson SR, "Aquaporin-4-binding autoantibodies in patients with neuromyelitis optica impair glutamate transport by down-regulating EAAT2", J Exp Med, 205, pp.2473~2481 (2008)
  50. Marignier R, "Anti- aquaporin-4 antibodies in Devic’s neuromyelitis optica: therapeutic implications", Ther Adv Neurol Disord, 3, pp.311~321 (2010)
  51. Kinoshita M, "Neuromyelitis optica: Passive transfer to rats by human immunoglobulin", Biochem Biophys Res Commun, 386, pp.623~627 (2009)
  52. Saadoun S, "Intra-cerebral injection of neuromyelitis optica immunoglobulin G and human complement produces neuromyelitis optica lesions in mice", Brain, 133, pp.349~361 (2010)
  53. Bradl M, "Neuromyelitis optica: pathogenicity of patient immunoglobulin in vivo", Ann Neurol, 66, pp.630~643 (2009)
  54. Bennett JL, "Intrathecal pathogenic anti-aquaporin-4 antibodies in early neuromyelitis optica", Ann Neurol, 66, pp.617~629 (2009)
  55. Sharma R, "Inflammation induced by innate immunity in the central nervous system leads to primary astrocyte dysfunction followed by demyelination", Acta Neuropathol, 120, pp.223~236 (2010)
  56. Kalluri SR, "Functional characterization of aquaporin-4 specific T cells: towards a model for neuromyelitis optica", PLoS One, 6, pp.16083~ (2011)
  57. Jarius S, "Immunoglobulin M antibodies to aquaporin-4 in neuromyelitis optica and related disorders", Clin Chem Lab Med, 48, pp.659~663 (2010)
  58. Pittock SJ, "Neuromyelitis optica and non organ-specific autoimmunity", Arch Neurol, 65, pp.78~83 (2008)
  59. Pittock SJ, "Autoimmune neurological accompaniments of neuromyelitis optica (NMO)", Ann Neurol, 60, pp.41~ (2006)
  60. Furukawa Y, "Neuromyelitis optica associated with myasthenia gravis: characteristic phenotype in Japanese population", Eur J Neurol, 13, pp.655~658 (2006)
  61. Kister I, "Ne-uromyelitis optica in patients with myasthenia gravis who underwent thymectomy", Arch Neurol, 63, pp.851~856 (2006)
  62. Antoine JC, "De-vic disease and thymoma with anti-central nervous system and antithymus antibodies", Neurology, 62, pp.978~980 (2004)
  63. Magaña SM, "NMO-IgG status in fulminant CNS inflammatory de-myelinating disorders (IDD)", Neurology, 68, pp.160~ (2007)
  64. Mandler RN, "Neuromyelitis optica Devic’s syndrome, update", Autoimmun Rev, 5, pp.537~543 (2006)
  65. Wingerchuk DM, "Neuromyelitis optica: clinical predictors of a relapsing course and survival", Neurology, 60, pp.848~853 (2003)
  66. 김수현, "Brain abnormalities as an initial manifestation of neuromyelitis optica spectrum disorder", MULTIPLE SCLEROSIS JOURNAL, 17(9), pp.1107~1112, SAGE PUBLICATIONS LTD
  67. Lotze TE, "Spectrum of pediatric neuromyelitis optica", Pediatrics, 122, pp.1039~1047 (2008)
  68. Misu T, "Intractable hiccup and nausea with periaqueductal lesions in neuromyelitis optica", Neurology, 65, pp.1479~1482 (2005)
  69. Riphagen J, "Hiccups, nausea, and vomiting: water channels under attack!", Lancet, 375, pp.954~ (2010)
  70. Pittock SJ, "Brain abnormalities in neuromyelitis optica", Arch Neurol, 63, pp.390~396 (2006)
  71. Li Y, "Brain magnetic reson-ance imaging abnormalities in neuromyelitis optica", Acta Neurol Sc-and, 118, pp.218~225 (2008)
  72. Cabrera-Gómez J, "Brain magnetic re-sonance imaging findings in acute relapses of neuromyelitis optica spectrum disorders", Mult Scler, 14, pp.248~251 (2008)
  73. Kim W, "Ch-aracteristic brain magnetic resonance imaging abnormalities in central nervous system aquaporin-4 autoimmunity", Mult Scler, 16, pp.1229~1236 (2010)
  74. Ito S, "“Cloud-like enhancement” is a magnetic resonance imaging abnormality specific to neuromyelitis optica", Ann Neurol, 66, pp.425~428 (2009)
  75. Kim JE, "Br-ain abnormalities in neuromyelitis optica", J Neurol Sci, 302, pp.43~48 (2011)
  76. Saiki S, "Exten-sive hemispheric lesions with radiological evidence of blood-brain barrier integrity in a patient with neuromyelitis optica", J Neurol Sci, 284, pp.217~219 (2009)
  77. Magaña SM, "Posterior reversible encephalopathy syndrome in neu-romyelitis optica spectrum disorders", Neurology, 72, pp.712~717 (2009)
  78. Takahashi T, "Establishment of a new sensitive assay for anti-human aq-uaporin-4 antibody in neuromyelitis optica", Tohoku J Exp Med, 210, pp.307~313 (2006)
  79. Tanaka Y, "No relapse of neuromyelitis optica during drug-induced B-lymphopenia with hypogammaglo-bulinemia", Neurology, 75, pp.1745~1747 (2010)
  80. Matsuoka T, "Heterogeneity of aquaporin-4 autoimmunity and spinal cord le-sions in multiple sclerosis in Japanese", Brain, 130, pp.1206~1223 (2007)
  81. Paul F, "An-tibody to aquaporin 4 in the diagnosis of neuromyelitis optica", PLoS Med, 4, pp.133~ (2007)
  82. Hayakawa S, "Neuromyelitis optica and anti-aquaporin-4 antibodies mea-sured by an enzyme-linked immunosorbent assay", J Neuroimmunol, 196, pp.181~187 (2008)
  83. Fazio R, "Antiacquaporin 4 antibodies detection by different techni-ques in neuromyelitis optica patients", Mult Scler, 15, pp.1153~1163 (2009)
  84. Bergamaschi R, "Oligoclonal bands in Devic’s neuromyelitis optica and multiple sclerosis: differences in repeated cerebrospinal fluid examin-ations", Mult Scler, 10, pp.2~4 (2004)
  85. Zaffaroni M, "Italian Devic’s Study Group. Cerebrospinal fluid findings in Devic’s neuromyelitis optica", Neurol Sci, 25, pp.368~370 (2004)
  86. Argyriou AA, "Neuromyelitis optica: a distinct demyelinat-ing disease of the central nervous system", Acta Neurol Scand, 118, pp.209~217 (2008)
  87. Miller DH, "Differential diagnosis of suspected multiple sclero-sis: a consensus approach", Mult Scler, 14, pp.1157~1174 (2008)
  88. Chan KH, "Idiopathic severe recurrent transverse myelitis: a restricted variant of neuromyelitis optica", Clin Neurol Neurosurg, 107, pp.132~135 (2005)
  89. Kidd D, "Chronic relapsing inflammatory optic neuropathy (CRION)", Brain, 126, pp.276~284 (2003)
  90. Sellner J, "EFNS guidelines on diagnosis and management of neuromyelitis optica", Eur J Neurol, 17, pp.1019~1032 (2010)
  91. Bennetto L, "Plasma exchange in episodes of severe inflammatory demyelination of the cen-tral nervous system. A report of six cases", J Neurol, 251, pp.1515~1521 (2004)
  92. Lehmann HC, "Plasma exchange in neuroimmunological disorders: Part 1: Rationale and treatment of inflammatory central nervous system disorders", Arch Neurol, 63, pp.930~935 (2006)
  93. Narita YM, "Efficacy of plasmapheresis for the treatment of severe toxic epidermal necrolysis: is cytokine expression analysis useful in predicting its therapeutic efficacy", J Dermatol, 38, pp.236~245 (2011)
  94. Weinshenker BG, "A randomized trial of plasma exch-ange in acute central nervous system inflammatory demyelinating disease", Ann Neurol, 46, pp.878~886 (1999)
  95. Keegan M, "Plasma exchange for severe attacks of CNS demyelination: predictors of response", Neurology, 58, pp.143~146 (2002)
  96. Ruprecht K, "Plasma exchange for severe optic neuritis: treatment of 10 patients", Neurology, 63, pp.1081~1083 (2004)
  97. Watanabe S, "Therapeutic efficacy of plasma exchange in NMO-IgG-positive patients with neuromyelitis optica", Mult Scler, 13, pp.128~132 (2007)
  98. Bonnan M, "Plasma exchange in severe spinal attacks associated with neuromyelitis optica spectrum disorder", Mult Scler, 15, pp.487~492 (2009)
  99. Llufriu S, "Plasma exchange for acute attacks of CNS demyelination: Predictors of improvement at 6 months", Neurology, 73, pp.949~953 (2009)
  100. Wang KC, "The rescue effect of plasma exchange for neuromyelitis optica", J Clin Neurosci, 18, pp.43~46 (2011)
  101. Munemoto M, "Therapeutic efficacy of double filtration plasmapheresis in pa-tients with anti-aquaporin-4 antibody-positive multiple sclerosis", J Clin Neurosci, 18, pp.478~480 (2011)
  102. Intravenous immunoglobulin for Guillain-Barré syndrome, "Hughes RA", Cochrane Database Syst Rev, ~, pp.CD002063. (2010)
  103. Dalakas MC, "The use of intravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases: evidence-based indications and safety profile", Pharmacol Ther, 102, pp.177~193 (2004)
  104. Wingerchuk DM, "Neuromyelitis optica", Curr Treat Options Neurol, 10, pp.55~66 (2008)
  105. Warabi Y, "Interferon beta-1b exacerbates multiple sclerosis with severe optic nerve and spinal cord demyelinat-ion", J Neurol Sci, 252, pp.57~61 (2007)
  106. Shimizu J, "IFNβ-1b may severely exacerbate Japanese optic-spinal MS in neuromyelitis optica spectrum", Neurology, 75, pp.1423~1427 (2010)
  107. Palace J, "Interferon Beta treatment in neuromyelitis optica: increase in relapses and aquaporin 4 antibody titers", Arch Neurol, 67, pp.1016~1017 (2010)
  108. Invernizzi P, "Azathioprine in multiple sclerosis", Mini Rev Med Chem, 8, pp.919~926 (2008)
  109. Hommes OR, "Clinical practice of immunosuppressive treatments in multiple sclerosis: results of a second international qu-estionnaire", J Neurol Sci, 223, pp.65~67 (2004)
  110. Mandler RN, "Devic’s neuromyelitis optica: a prospective study of seven patients treated with prednisone and azathioprine", Neurology, 51, pp.1219~1220 (1998)
  111. La Mantia L, "Azathioprine. Safety profile in multiple sclerosis patients", Neurol Sci, 28, pp.299~303 (2007)
  112. Watanabe S, "Low-dose corticosteroids reduce relapses in neuromyelitis optica: a retrospective analysis", Mult Scler, 13, pp.968~974 (2007)
  113. Ginzler EM, "Toxicity and to-lerability of mycophenolate mofetil (MMF) vs intravenous cycloph-osphamide (IVC) in a multicenter trial as induction therapy for lupus nephritis (LN)", Arthritis Rheum, 48, pp.647~ (2003)
  114. Falcini F, "Sus-tained improvement of a girl affected with Devic’s disease over 2 years of mycophenolate mofetil treatment", Rheumatology (Oxford), 45, pp.913~915 (2006)
  115. Jacob A, "Treatment of neuromyelitis optica with mycophenolate mofetil: retrospective analysis of 24 patients", Arch Neurol, 66, pp.1128~1133 (2009)
  116. Zwerner J, "Mycophenolate mofetil", Dermatol Ther, 20, pp.229~238 (2007)
  117. Fidler JM, "Selective immunomodulation by the antineoplastic agent mitoxantrone. II. Nonspecific adherent suppressor cells derived from mitoxantrone-treated mice", J Immunol, 136, pp.2747~2754 (1986)
  118. Weinstock-Guttman B, "Study of mitoxantrone for the treatment of recurrent neuromyelitis optica (Devic disease)", Arch Neurol, 63, pp.957~963 (2006)
  119. 김수현, "Efficacy and Safety of Mitoxantrone in Patients With Highly Relapsing Neuromyelitis Optica", ARCHIVES OF NEUROLOGY, 68(4), pp.473~479, AMER MEDICAL ASSOC
  120. Cohen BA, "Mitoxantrone treatment of multiple sclerosis: safety considerations", Neurology, 63, pp.28~32 (2004)
  121. Ellis R, "Therapy-related acute leukaemia with Mitoxantrone: what is the risk and can we minimise it", Mult Scler, 15, pp.505~508 (2009)
  122. Bakker J, "Devic’s neuromyelitis optica treated with intravenous gamma globulin (IVIG)", Can J Neurol Sci, 31, pp.265~267 (2004)
  123. Okada K, "Intermittent intravenous immunoglobulin successfully prevents relapses of neuromyelitis optica", Intern Med, 46, pp.1671~1672 (2007)
  124. Cree BA, "An open label study of the effects of rituximab in neuromyelitis optica", Neurology, 64, pp.1270~1272 (2005)
  125. Jacob A, "Treatment of neuromyelitis optica with rituximab: retrospective analysis of 25 patients", Arch Neurol, 65, pp.1443~1448 (2008)
  126. Repeated treatment with rituximab based on the assessment of peripheral circulating memory B cells in patients with relapsing neuromyelitis optica over 2 years, "Kim SH", Arch Neurol, ~ (2011)
  127. Ibrahim H, "A review: the use of rituximab in neuromuscular diseases", J Clin Neuromuscul Dis, 12, pp.91~102 (2010)
  128. Tyler KL, "Progressive multifocal leukoencephalopathy: can we reduce risk in patients receiving biological immunomodulatory therapies", Ann Neurol, 68, pp.271~274 (2010)
  129. Miyamoto K, "Intermittent plasmapheresis prevents recurrence in neuromyelitis optica", Ther Apher Dial, 13, pp.505~508 (2009)

관련 논문AI추천

An Update on the Laboratory Diagnosis of Neuromyelitis Optica Spectrum DisordersAppakkudal Ramaswamy Anand, Kulandai Lily Therese, Mani Vimalin Jeyalatha대한신경과학회 · Journal of Clinical Neurology2022 · 제18권 제2호Clinical Usefulness of Cell-based Indirect Immunofluorescence Assay for the Detection of Aquaporin-4 Antibodies in Neuromyelitis Optica Spectrum Disorder강은숙, 김병준, 민주홍, 이광호대한진단검사의학회 · Annals of Laboratory Medicine2012 · 제32권 제5호다발경화증과 시신경척수염범주질환의 감별진단김남희대한신경과학회 · 대한신경과학회지2016 · 제34권 제4호Cerebral Cortex Involvement in Neuromyelitis Optica Spectrum Disorder김수현, 김우준, 김호진, 박민수, 이광수, 이상현, 이지은, 정인혜, 조중양, 허소영, 현재원대한신경과학회 · Journal of Clinical Neurology2016 · 제12권 제2호Disease Course and Outcomes in Patients With the Limited Form of Neuromyelitis Optica Spectrum Disorders and Negative AQP4-IgG Serology at Disease Onset: A Prospective Cohort StudyBingjun Zhang, Jing Zhou, Rui Li, Wei Qiu, Xiao-Dong Li, Xiaonan Zhong, Yanyu Chang, Yaqing Shu, Yuge Wang대한신경과학회 · Journal of Clinical Neurology2022 · 제18권 제4호Clinical Efficacy of Plasmapheresis in Patients with Neuromyelitis Optica Spectrum Disorder and Effects on Circulating Anti-Aquaporin-4 Antibody Levels김수현, 김우준, 김호진, 이규임, 정인자, 허소영대한신경과학회 · Journal of Clinical Neurology2013 · 제9권 제1호

이 간행물의 다른 논문 (9건)

Disability-Adjusted Life Years Analysis: Implications for Stroke Research홍근식pp. 109-114Psychiatric Symptoms and Quality of Life in Patients with Drug- Refractory Epilepsy Receiving Adjunctive Levetiracetam Therapy서정규, 황양하, 이장준, 이호원, 송현석, 박성파pp. 128-136Efficacy and Safety of Switching from Oral Cholinesterase Inhibitors to the Rivastigmine Transdermal Patch in Patients with Probable Alzheimer’s Disease최성혜, 박선아, 윤수진, 박현영, 김정은, 김은주, 이정주, 심동석, 심용수, 한현정pp. 137-142Polymorphism of the Glutamate Transporter Protein EAAT2 and Migraine Transformation into Chronic Daily Headache신혜은, 박정욱, 한수정, 이광수pp. 143-147Changes in Length of Stay for Neurological Geriatric Diseases in Korea between 2003 and 2007임도희, 이건세, 장성훈, 김형수, 배희준, 고임석pp. 148-155
원문 보기