Case report: Concurrent MOG antibody-associated disease and latent infections in two patients

• Published in: Frontiers in immunology 2024-09, Vol.15, p.1455355
• Main Authors: Kulsvehagen, Laila, Woelfle, Tim, Ayroza Galvão Ribeiro Gomes, Ana Beatriz, Lipps, Patrick, Neziraj, Tradite, Flammer, Julia, Leuzinger, Karoline, Derfuss, Tobias, Kuhle, Jens, Papadopoulou, Athina, Pröbstel, Anne-Katrin
• Format: Article
• Language: English
• Subjects: Adult; Autoantibodies - blood; Autoantibodies - immunology; B-Lymphocytes - immunology; case report; Female; Humans; Immunology; infection; Latent Infection - diagnosis; Latent Infection - immunology; Male; Middle Aged; molecular mimicry; myelin oligodendrocyte glycoprotein; myelin oligodendrocyte glycoprotein antibody-associated disease; Myelin-Oligodendrocyte Glycoprotein - immunology; syphilis; Syphilis - blood; Syphilis - complications; Syphilis - diagnosis; Syphilis - immunology; Treponema pallidum - immunology
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2024.1455355

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is frequently preceded by infections. The underlying pathomechanism, however, remains poorly understood. Here, we present the clinical data of two MOGAD patients with concurrent syphilis infection and investigate the reactivity of patient-derived antibodies to MOG and ( ). Longitudinal serum samples and soluble immunoglobulins in single B cell supernatants were measured for MOG reactivity by a live cell-based assay. Reactivity against was assessed by enzyme-linked immunosorbent assay. The two patients presented MOGAD and concurrent latent syphilis infection, manifesting as cervical myelitis and unilateral optic neuritis, respectively. The first patient had been living with HIV on antiretroviral therapy, and the second was concomitantly diagnosed with chronic hepatitis B infection. Upon screening of B cell supernatants, we identified reactivity to MOG or Notably, one B cell showed reactivity to both antigens. The coexistence of MOGAD diagnoses and latent syphilis, alongside the identification of antibody reactivity to MOG and , underscores the potential pathomechanistic link between syphilis infection and subsequent autoimmune neuroinflammation. Cross-reactivity between MOG and antibodies remains to be validated on a molecular level, and further characterization of infectious triggers associated with MOGAD is needed.