Distinct Inflammatory Profiles and Clinical Characteristics of NMOSD: A Comparative Analysis with NMOSD-like and Encephalitis-like MOG-AD

To better differentiate neuromyelitis optica spectrum disorder (NMOSD) from myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), it is crucial to systematically explore the correlation between their clinical and immunological characteristics. Utilizing high-throughput protein detection technologies, we analyzed 92 inflammation-related proteins in plasma samples from NMOSD (n = 50), NMOSD-like MOGAD (n = 12), and encephalitis-like MOGAD (n = 8) groups. In this study, we found that seizures (2% vs 30%, p < 0.001) and acute disseminated encephalomyelitis (0% vs 30%, p < 0.001) were more common in MOGAD, while transverse myelitis (52% vs 5%, p < 0.001) was more common in NMOSD. The signs and symptoms of NMOSD-like and encephalitis-like MOGAD were largely similar. There were no significant differentially expressed proteins identified between the NMOSD group and the NMOSD-like MOGAD group, while the elevated IL-24 and TRANCE were in the encephalitis-like MOGAD group rather than in the NMOSD group. There was a positive correlation of CCL20 expression with EDSS scores in the NMOSD group, while this association was not found in the other groups. In conclusion, encephalitis-like MOGAD has distinct clinical and peripheral inflammatory protein characteristics compared to NMOSD and NMOSD-like MOGAD. Some differential IRPs are closely associated with specific clinical parameters.