Myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD) is an autoimmune disease that shares symptoms with other demyelinating conditions, such as multiple sclerosis (MS). Like MS, MOGAD can cause inflammation of the optic nerve and spinal cord, potentially resulting in long-term disability. However, despite clinical similarities, MOGAD is driven by a distinct pathophysiology. This difference is thought to underlie the limited effectiveness of current immunomodulatory treatments that are otherwise used successfully in MS. Yet, studies exploring the underlying disease mechanisms have been scarce—until now.
Defining MOGAD as a distinct disease entity
A collaborative team of researchers from the Universities of Zurich, Munich, Toulouse, Lyon, Basel and Bonn has provided important new insights into the rare disease. The researchers performed detailed immune-cell profiling of MOGAD patients, comparing the results with data from individuals with MS and healthy controls. The analysis revealed striking differences across multiple immune-cell subsets, including natural killer (NK-), T-, and B-cells. These findings demonstrate that MOGAD is characterized by a unique immunological signature that sets it apart from MS and other neuroinflammatory diseases. “These findings support MOGAD as its own disease entity, distinct from other neuroinflammatory conditions such as MS,” explains Prof. Dr. Pröbstel, managing director of the Department of Neurology at the University Hospital Bonn (UKB), Member of the ImmunoSensation2 Cluster of Excellence at the University of Bonn and research group leader at the German Center for Neurodegenerative Diseases (DZNE).
Towards disease-specific treatment strategies
While MS therapies have long relied on broad immunomodulation, patients with MOGAD often respond poorly to these established treatments. Prof. Pröbstel and colleagues now provides a detailed map of the immune landscape in MOGAD, offering crucial clues for future therapeutic approaches. “Importantly, this work lays the foundation for hypothesis-driven research aimed at understanding MOGAD’s unique immunopathology and developing targeted therapies,” adds Prof. Pröbstel. By defining how immune cell populations differ between MOGAD and MS, the study paves the way for a more personalized approach to treating neuroinflammatory diseases. Before application in medical practice, the hypotheses developed on the basis of the profile data obtained must be validated in clinical studies.