Anti-MOG IgG in EAE Models Clinical Aspects of Pediatric MOGAD
Yike Jiang1, Estefany Reyes2, Elliot Lin2, Emily Troutman2, Miranda Lumbreras2, Devon DiPalma2, Heather Van Mater1, Mari Shinohara2
1Pediatric, 2Integrative Immunobiology, Duke University
Objective:

The objective of this study was to establish a pediatric MOGAD model that reproduces key clinical features and enables investigation of anti-MOG IgG-mediated immunopathogenesis.

Background:
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a severe, autoantibody-mediated demyelinating syndrome that disproportionally impacts children. Detection of conformation-specific anti-MOG IgG1 in the serum is central to MOGAD diagnosis, yet the pathogenic role of these antibodies remains unclear. We sought to develop a clinically informed model of pediatric MOGAD to study immunopathogenesis that recapitulated (1) early age of disease onset, (2) anti-MOG IgG1 in the serum, and (3) diffuse inflammatory demyelination in the CNS.
Design/Methods:
We employed two complementary approaches to model anti-MOG IgG1: (1) passive transfer of the murine-derived monoclonal antibody 8‑18C5 into young C57BL/6 mice and (2) young transgenic IgHMOG mice expressing the same clonotype endogenously. Experimental autoimmune encephalomyelitis (EAE) was induced by immunization with MOG35-55 to elicit inflammatory demyelination. Immunophenotyping and neuroinflammation were characterized by flow cytometry, confocal microscopy, magnetic resonance imaging (MRI), and in vitro phagocytosis assays.
Results:
Following MOG35-55  immunization, both exogenous and endogenous anti-MOG IgG1 exacerbated EAE disease in young mice. Young IgHMOG mice exhibited reduced peripheral immune cell counts and increased CNS immune infiltration compared to wild-type littermates. IgHMOG mice developed circumferential longitudinal myelitis, bilateral optic neuritis, and multifocal brain inflammation. CNS innate immune cells, including microglia, showed downregulation of surface CD16/CD32, which corresponded with enhanced microglial phagocytosis of MOG in vitro.
Conclusions:
Anti-MOG IgG in EAE recapitulates key aspects of pediatric MOGAD and enables dissection of the mechanisms underlying antibody-mediated immunopathogenesis. Using these models, we identified antibody-mediated microglial phagocytosis of MOG as a novel activity of anti-MOG IgG.
10.1212/WNL.0000000000213254
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