Myelin Oligodendrocyte Glycoprotein Antibody Disease After COVID-19 Vaccination - Causal or Incidental?

Sehgal, Vineet; Bansal, Priyanshu; Arora, Shaifali; Kapila, Saniya; Bedi, Gaganpreet S

doi:10.7759/cureus.27024

Cited by 7 publications

(9 citation statements)

References 19 publications

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“…MOGAD is an emerging subset of CNS demyelinating disease [61,62], and has also been related to COVID-19 [6]. In our study, one patient evolved with MOGAD during an asymptomatic SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 58%

Molecular Mimicry between SARS-CoV-2 Proteins and Human Self-Antigens Related with Autoimmune Central Nervous System (CNS) Disorders

Gutman,

Fernandes,

Raposo-Vedovi

et al. 2023

Microorganisms

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SARS-CoV-2 can trigger autoimmune central nervous system (CNS) diseases in genetically susceptible individuals, a mechanism poorly understood. Molecular mimicry (MM) has been identified in other viral diseases as potential triggers of autoimmune CNS events. This study investigated if MM is the process through which SARS-CoV-2 induces the breakdown of immune tolerance. The frequency of autoimmune CNS disorders was evaluated in a prospective cohort with patients admitted to the COVID-19 Intense Care Unity (ICU) in Rio de Janeiro. Then, an in silico analysis was performed to identify the conserved regions that share a high identity between SARS-CoV-2 antigens and human proteins. The sequences with significant identity and antigenic properties were then assessed for their binding capacity to HLA subtypes. Of the 112 patients included, 3 were classified as having an autoimmune disorder. A total of eleven combinations had significant linear and three-dimensional overlap. NMDAR1, MOG, and MPO were the self-antigens with more significant combinations, followed by GAD65. All sequences presented at least one epitope with strong or intermediate binding capacity to the HLA subtypes selected. This study underscores the possibility that CNS autoimmune attacks observed in COVID-19 patients, including those in our population, could be driven by MM in genetically predisposed individuals.

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Section: Discussionmentioning

confidence: 58%

Molecular Mimicry between SARS-CoV-2 Proteins and Human Self-Antigens Related with Autoimmune Central Nervous System (CNS) Disorders

Gutman,

Fernandes,

Raposo-Vedovi

et al. 2023

Microorganisms

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show abstract

“…Several reports suggest that conditions belonging to MOGAD also occur after COVID-19 vaccination ( 31–33 ). Among them, cases of post-vaccination encephalitis have been published, such as peduncular and brainstem encephalitis ( 32 ), or encephalomyelitis ( 34 ). However, it should be noted that anti-MOG antibodies may increase the possibility of an immunogenic process in susceptible individuals; these are very rare cases with a low incidence ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

The MOG antibody associated encephalitis preceded by COVID-19 infection; a case study and systematic review of the literature

et al. 2023

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BackgroundNew neurological complications of COVID-19 infection have been reported in recent research. Among them, the spectrum of anti-MOG positive diseases, defined as anti-MOG antibody associated disease (MOGAD), is distinguished, which can manifest as optic neuritis, myelitis, or various forms of encephalitis (MOGAE).Materials and methodsThis study reports a new case of MOGAE following SARS-CoV-2 infection. A literature review of other MOGAE cases associated with COVID-19 infection was conducted and summarized.ResultsA 60-year-old male patient, who had previously been infected with COVID-19, was admitted to the Neurology Department with a rapidly progressive deterioration of his cognitive functions that lasted for about 3 months. On neurological examination, the Mini-Mental State Examination (MMSE) score was 17, which further deteriorated to 13. In addition, central paresis of the right VIIth nerve and pyramidal hemiparesis on the right side were noted. The MRI of the brain showed multiple hyperintense lesions. The CSF examination revealed an elevated total protein level with a normal cell count, and serum showed a positive finding of anti-MOG antibodies. Taking into account all the information, the diagnosis of MOGAE, following COVID-19 infection, was made. A total of 9 similar cases of MOGAE associated with SARS-CoV-2 infection were identified in the available literature. Among them 2 cases presented progressive cognitive dysfunction and another 5 altered mental status. The most frequently described MRI changes were hyperintense lesions located cortically and/or subcortically. Anti-MOG antibodies were positive in all patients. In 5 cases they were detected only in serum, in 2 cases in serum and CSF, and in 2 cases the origin was not reported.ConclusionThe reported cases of MOGAE following COVID-19 infection suggest an increasing new clinical problem, and show an association between COVID-19 and MOGADs.

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“…In total, 79 cases (including our index case of MOGAD) diagnosed with CNS IDDs after COVID-19 vaccination were identified across 45 articles [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ] ( Table 1 ). Among them, the proportion of females (54.4%) was higher than that of males (45.6%), with average ages of 46.2 and 48.5 ( p = 0.524), respectively.…”

Section: Methodsmentioning

confidence: 99%

Clinical Research into Central Nervous System Inflammatory Demyelinating Diseases Related to COVID-19 Vaccines

Cheng,

Ho,

Hsu

et al. 2024

Diseases

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Various vaccines have been developed in response to the SARS-CoV-2 pandemic, and the safety of vaccines has become an important issue. COVID-19 vaccine-related central nervous system inflammatory demyelinating diseases (CNS IDDs) have been reported recently. We present one case of AstraZeneca vaccine-related myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease and a literature review of another 78 patients published from January 2020 to October 2022. Patients were divided into three vaccine types (viral vector, mRNA, and inactivated vaccines) for further analyses. Among 79 patients with COVID-19 vaccine-related CNS IDDs, 49 (62%) cases received viral vector vaccines, 20 (25.3%) received mRNA vaccines, and 10 (12.7%) received inactivated vaccines. Twenty-seven cases (34.2%) were confirmed with autoantibodies, including fifteen patients (19%) with anti-MOG, eleven (13.9%) with anti-aquaporin 4 (AQP4), and one (1.3%) with both antibodies. Significantly, more males developed CNS IDDs post viral vector vaccines compared to mRNA and inactivated vaccines. Patients receiving mRNA vaccines were older than those receiving other types. Furthermore, mRNA and inactivated vaccines correlated more with anti-AQP4 antibodies, while viral vector vaccines showed higher MOG positivity. This research suggests potential associations between COVID-19 vaccine-related CNS IDDs and gender, age, and autoantibodies, contingent on vaccine types. Protein sequence analysis implies similarities between the S protein and AQP4/MOG. Further studies may elucidate the mechanisms of CNS IDDs, aiding vaccine selection for specific types.

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Myelin Oligodendrocyte Glycoprotein Antibody Disease After COVID-19 Vaccination - Causal or Incidental?

Cited by 7 publications

References 19 publications

Molecular Mimicry between SARS-CoV-2 Proteins and Human Self-Antigens Related with Autoimmune Central Nervous System (CNS) Disorders

Molecular Mimicry between SARS-CoV-2 Proteins and Human Self-Antigens Related with Autoimmune Central Nervous System (CNS) Disorders

The MOG antibody associated encephalitis preceded by COVID-19 infection; a case study and systematic review of the literature

Clinical Research into Central Nervous System Inflammatory Demyelinating Diseases Related to COVID-19 Vaccines

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