Клинический разбор в общей медицине

Миелин-олигодендроцитарный гликопротеин (MOG-IgG)-ассоциированное заболевание – это редкое аутоиммунное воспалительное демиелинизирующее заболевание центральной нервной системы, характеризующееся опосредованным антителами к MOG поражением миелиновой оболочки нейронов головного и спинного мозга и формированием различных клинических фенотипов: от неврита зрительного нерва и поперечного миелита до острого рассеянного энцефаломиелита и коркового энцефалита. Хотя во многом клиническая картина данного заболевания может казаться схожей с заболеванием спектра оптиконейромиелита, большинство экспертов рассматривают MOG-IgG-ассоциированное заболевание как отдельную нозологию с характерным патогенезом. В данной статье рассматриваются история изучения заболевания, основы патофизиологии, основные клинико-радиологические характеристики течения заболевания, а также обновленные критерии диагностики и современные перспективы лечения. Представлен клинический случай пациента с MOG-IgG-ассоциированным заболеванием.

Ключевые слова: MOG-IgG-ассоциированное заболевание, заболевание спектра оптиконейромиелита, антитела к MOG.

1. Andersen J, Brilot F. Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): Insights into pathogenesis and biomarkers of prognosis. Semin Immunol 2025;(78):101944. DOI: 10.1016/j.smim.2025.101944

2. Matsumoto Y, Kaneko K, Takahashi T et al. Diagnostic implications of MOG-IgG detection in sera and cerebrospinal fluids. Brain 2023;146(9):3938-48. DOI: 10.1093/brain/awad122

3. Kerlero de Rosbo N, Mendel I, Ben-Nun A. Chronic relapsing experimental autoimmune encephalomyelitis with a delayed onset and an atypical clinical course, induced in PL/Jmice by myelin oligodendrocyte glycoprotein (MOG)-derived peptide: preliminary analysis of MOG T cell epitopes. Eur J Immunol 1995;25(4):985-93. DOI: 10.1002/eji.1830250419

4. Berger T, Rubner P, Schautzer F et al. Antimyelin antibodies as a predictor of clinically definite multiple sclerosis after a first demyelinating event. N Engl J Med 2003;349(2):139-45. DOI: 10.1056/NEJMoa022328

5. Краснов В.С., Руднева Ю.А., Назаров В.Д. и др. MOG-IgG-ассоциированное демиелинизирующее заболевание: современные представления, вопросы диагностики и лечения. Практическая медицина. 2020;(5):8-15.

Krasnov V.S., Rudneva Yu.A., Nazarov V.D. et al. MOG-IgG-associated demyelinating disorder: modern concepts, issues of diagnosis and treatment. Practical medicine. 2020;18(5):8-15 (in Russian).

6. Moseley CE, Virupakshaiah A, Forsthuber TG et al. MOG CNS Autoimmunity and MOGAD. Neurol Neuroimmunol Neuroinflamm 2024;11(5):e200275. DOI: 10.1212/NXI.0000000000200275

7. Lennon VA, Wingerchuk DM, Kryzer TJ. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet 2004;364(9451):2106-12. DOI: 10.1016/S0140-6736(04)17551-X

8. Wingerchuk DM, Banwell B, Bennett JL. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 2015;85(2):177-89. DOI: 10.1212/WNL.0000000000001729

9. Sechi E, Cacciaguerra L, Chen JJ et al. Myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD): a review of clinical and mri features, diagnosis, and management. Front Neurol 2022;(13):885218. DOI: 10.3389/fneur.2022.885218

10. Von Büdingen HC, Mei F, Greenfield A et al. The myelin oligodendrocyte glycoprotein directly binds nerve growth factor to modulate central axon circuitry. J Cell Biol 2015;210(6):891-8. DOI: 10.1083/jcb.201504106

11. Kohyama K, Nishida H, Kaneko K et al. Complement-dependent cytotoxicity of human autoantibodies against myelin oligodendrocyte glycoprotein. Front Neurosci 2023;(17):1014071. DOI: 10.3389/fnins.2023.1014071

12. Brilot F, Dale RC, Selter RC et al. Antibodies to native myelin oligodendrocyte glycoprotein in children with inflammatory demyelinating central nervous system disease. Ann Neurol 2009;66(6):833-42. DOI: 10.1002/ana.21916

13. Spatola M, Chuquisana O, Jung W et al. Humoral signatures of MOG-antibody-associated disease track with age and disease activity. Cell Rep Med 2023;4(2):100913. DOI: 10.1016/j.xcrm.2022.100913

14. Banwell B, Bennett JL, Marignier R et al. Diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease: International MOGAD Panel proposed criteria. Lancet Neurol 2023;22(3):268-82. DOI: 10.1016/S1474-4422(22)00431-8

15. Trewin BP, Brilot F, Reddel SW et al. MOGAD: A comprehensive review of clinicoradiological features, therapy and outcomes in 4699 patients globally. Autoimmun Rev 2025;24(1):103693. DOI: 10.1016/j.autrev.2024.103693

16. O'Connell K, Hamilton-Shield A, Woodhall M et al. Prevalence and incidence of neuromyelitis optica spectrum disorder, aquaporin-4 antibody-positive NMOSD and MOG antibody-positive disease in Oxfordshire, UK. J Neurol Neurosurg Psychiatry 2020;91(10):1126-8. DOI: 10.1136/jnnp-2020-323158

17. Nagireddy RBR, Kumar A, Singh VK et al. Clinicoradiological comparative study of Aquaporin-4-IgG seropositive neuromyelitis optica spectrum disorder (NMOSD) and MOG antibody associated disease (MOGAD): A prospective observational study and review of literature. J Neuroimmunol 2021;(361):577742. DOI: 10.1016/j.jneuroim.2021.577742

18. Ciotti JR, Eby NS, Wu GF et al. Clinical and laboratory features distinguishing MOG antibody disease from multiple sclerosis and AQP4 antibody-positive neuromyelitis optica. Mult Scler Relat Disord 2020;(45):102399. DOI: 10.1016/j.msard.2020.102399

19. Armangue T, Olivé-Cirera G, Martínez-Hernandez E et al. Associations of paediatric demyelinating and encephalitic syndromes with myelin oligodendrocyte glycoprotein antibodies: a multicentre observational study. Lancet Neurol 2020;19(3):234-46. DOI: 10.1016/S1474-4422(19)30488-0

20. Cobo-Calvo A, Ruiz A, Maillart E et al. Clinical spectrum and prognostic value of CNS MOG autoimmunity in adults: The MOGADOR study. Neurology 2018;90(21):e1858-e1869. DOI: 10.1212/WNL.0000000000005560

21. Jurynczyk M, Messina S, Woodhall MR et al. Clinical presentation and prognosis in MOG-antibody disease: a UK study. Brain 2017;140(12):3128-38. DOI: 10.1093/brain/awx276

22. Jarius S, Ruprecht K, Kleiter I et al. MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 2: Epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome. J Neuroinflammation 2016;13(1):280. DOI: 10.1186/s12974-016-0717-1

23. Petzold A, Plant GT. Chronic relapsing inflammatory optic neuropathy: a systematic review of 122 cases reported. J Neurol 2014;261(1):17-26. DOI: 10.1007/s00415-013-6957-4

24. Chen JJ, Flanagan EP, Pittock SJ et al. Visual outcomes following plasma exchange for optic neuritis: an international multicenter retrospective analysis of 395 optic neuritis attacks. Am J Ophthalmol 2023;(252):213-24. DOI: 10.1016/j.ajo.2023.02.013

25. Netravathi M, Holla VV, Nalini A et al. Myelin oligodendrocyte glycoprotein-antibody-associated disorder: a new inflammatory CNS demyelinating disorder. J Neurol 2021;268(4):1419-33. DOI: 10.1007/s00415-020-10300-z

26. Ambrosius W, Michalak S, Kozubski W et al. Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Current Insights into the Disease Pathophysiology, Diagnosis and Management. Int J Mol Sci 2020;22(1):100. DOI: 10.3390/ijms22010100

27. Nosadini M, Eyre M, Giacomini T et al. Early Immunotherapy and Longer Corticosteroid Treatment Are Associated With Lower Risk of Relapsing Disease Course in Pediatric MOGAD. Neurol Neuroimmunol Neuroinflamm 2022;10(1):e200065. DOI: 10.1212/NXI.0000000000200065

28. Chen B, Gomez-Figueroa E, Redenbaugh V et al. Do early relapses predict the risk of long-term relapsing disease in an adult and paediatric cohort with MOGAD? Ann Neurol 2023;94(3):508-17. DOI: 10.1002/ana.26731

29. Chen JJ, Flanagan EP, Jitprapaikulsan J. Myelin oligodendrocyte glycoprotein antibody-positive optic neuritis: clinical characteristics, radiologic clues, and outcome. Am J Ophthalmol 2018;(195):8-15. DOI: 10.1016/j.ajo.2018.07.020

30. Lotan I, Chen JJ, Hacohen Y et al. Intravenous immunoglobulin treatment for acute attacks in myelin oligodendrocyte glycoprotein antibody disease. Mult Scler 2023;29(9):1080-9. DOI: 10.1177/13524585231184738

31. Chwalisz BK, Levy M. The treatment of myelin oligodendrocyte glycoprotein antibody disease: a state-of-the-art review. J Neuroophthalmol 2022;42(3):292-6. DOI: 10.1097/WNO.0000000000001684