Myelin Oligodendrocyte Glycoprotein Antibody-Associated Neuroinflammatory Disorders

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disorders encompass a spectrum of central nervous system inflammatory demyelinating conditions characterised by the presence of serum IgG autoantibodies directed against MOG, a glycoprotein expressed on the outer surface of myelin sheaths and oligodendrocyte membranes. Clinically, these disorders most often present as acute disseminated encephalomyelitis (ADEM), optic neuritis (ON) or transverse myelitis (TM), and may follow either a monophasic or relapsing course. Pathogenic mechanisms involve complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity and phagocytosis, alongside T-cell recruitment and activation. Neuroimaging typically reveals perivenous and confluent white matter lesions, while cerebrospinal fluid studies often show mild pleocytosis with infrequent oligoclonal bands. Distinct from multiple sclerosis and aquaporin-4-IgG-positive neuromyelitis optica spectrum disorders, MOG antibody-associated disease demands specific high-sensitivity cell-based assays for accurate diagnosis. Global efforts now focus on establishing prognostic biomarkers to predict relapse risk, guiding tailored immunotherapies and avoiding overtreatment in monophasic cases. Advances in understanding immune effector pathways and lesion pathology are reshaping diagnostic criteria and informing novel therapeutic strategies, underscoring the international significance of this emerging neuroimmunological entity.

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Myelin Oligodendrocyte Glycoprotein Antibody-Associated Neuroinflammatory Disorders publication trend

The graph below shows the total number of articles in myelin oligodendrocyte glycoprotein antibody-associated neuroinflammatory disorders across all publications each year (not limited to Nature Index journals).

Technical terms

Myelin oligodendrocyte glycoprotein (MOG): A surface-expressed protein on myelin sheaths and oligodendrocyte membranes targeted by specific autoantibodies in MOG antibody-associated disorders.

MOG-IgG: Immunoglobulin G autoantibodies recognising conformational epitopes on full-length MOG, detected by cell-based assays and used diagnostically.

Complement-dependent cytotoxicity (CDC): An effector mechanism in which antibody binding activates the complement cascade, leading to target cell lysis.

Antibody-dependent cellular cytotoxicity (ADCC): A process in which natural killer cells or other effector leukocytes recognise antibody-coated targets via Fc receptors and induce cell death.

Acute disseminated encephalomyelitis (ADEM): A monophasic inflammatory demyelinating event often characterised by widespread encephalopathy and multifocal white matter lesions.

Optic neuritis (ON): Inflammation of the optic nerve presenting with acute visual loss and pain on eye movement.

Transverse myelitis (TM): Inflammatory demyelination of the spinal cord resulting in motor, sensory and autonomic dysfunction below the level of the lesion.

References

1. Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): Insights into pathogenesis and biomarkers of prognosis. Seminars in Immunology (2025).
2. MOGAD patient autoantibodies induce complement, phagocytosis, and cellular cytotoxicity. JCI Insight (2023).
3. MOG encephalomyelitis: international recommendations on diagnosis and antibody testing. Journal of Neuroinflammation (2018).
4. The pathology of central nervous system inflammatory demyelinating disease accompanying myelin oligodendrocyte glycoprotein autoantibody. Acta Neuropathologica (2020).