Incidence of neuromyelitis optica spectrum disorders in China: a large cohort study using claim data

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Abstract

Objectives

Population-based studies estimating the incidence of neuromyelitis optica spectrum disorders (NMOSDs) in Asia are limited, and the relationship between latitude and incidence has been scarcely investigated. We aimed to estimate the incidence of NMOSDs in Chinese adults and explore their relationship to latitude.

Design

Cohort study based on data from the Urban Employee Basic Medical Insurance in China.

Participants

177 million people were followed from 2016 to 2017 in 20 provinces.

Primary outcome measures

The incidence rate was estimated by Poisson distribution and reported as age-adjusted and sex-adjusted rates using the standard population.

Results

There were 1313 incident NMOSD cases, with an overall incidence of 0.41 (95% CIs: 0.39 to 0.43) per 100 000 person-years. The incidence in females was higher, with a female-to-male IRR of 4.52. The incidence increased with age, peaking at 55–64 years in females and 65–74 years in males and then decreasing thereafter. The female-to-male IRRs were higher in those <55 years. The association between latitude and incidence was not statistically significant.

Conclusions

The incidence of NMOSD in Chinese adults was 0.41 per 100 000 person-years. There is no latitude gradient observed. Sex and age influence the risk of NMOSD, suggesting the role of genetic, hormonal and other related factors in the pathophysiology.

Related collections

Most cited references 33

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International consensus diagnostic criteria for neuromyelitis optica spectrum disorders

Dean Wingerchuk, Brenda Banwell, Jeffrey L. Bennett … (2016)

Neuromyelitis optica (NMO) is an inflammatory CNS syndrome distinct from multiple sclerosis (MS) that is associated with serum aquaporin-4 immunoglobulin G antibodies (AQP4-IgG). Prior NMO diagnostic criteria required optic nerve and spinal cord involvement but more restricted or more extensive CNS involvement may occur. The International Panel for NMO Diagnosis (IPND) was convened to develop revised diagnostic criteria using systematic literature reviews and electronic surveys to facilitate consensus. The new nomenclature defines the unifying term NMO spectrum disorders (NMOSD), which is stratified further by serologic testing (NMOSD with or without AQP4-IgG). The core clinical characteristics required for patients with NMOSD with AQP4-IgG include clinical syndromes or MRI findings related to optic nerve, spinal cord, area postrema, other brainstem, diencephalic, or cerebral presentations. More stringent clinical criteria, with additional neuroimaging findings, are required for diagnosis of NMOSD without AQP4-IgG or when serologic testing is unavailable. The IPND also proposed validation strategies and achieved consensus on pediatric NMOSD diagnosis and the concepts of monophasic NMOSD and opticospinal MS.

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Gender differences in autoimmune disease.

S T Ngo, F J Steyn, P A McCombe (2014)

Autoimmune diseases are a range of diseases in which the immune response to self-antigens results in damage or dysfunction of tissues. Autoimmune diseases can be systemic or can affect specific organs or body systems. For most autoimmune diseases there is a clear sex difference in prevalence, whereby females are generally more frequently affected than males. In this review, we consider gender differences in systemic and organ-specific autoimmune diseases, and we summarize human data that outlines the prevalence of common autoimmune diseases specific to adult males and females in countries commonly surveyed. We discuss possible mechanisms for sex specific differences including gender differences in immune response and organ vulnerability, reproductive capacity including pregnancy, sex hormones, genetic predisposition, parental inheritance, and epigenetics. Evidence demonstrates that gender has a significant influence on the development of autoimmune disease. Thus, considerations of gender should be at the forefront of all studies that attempt to define mechanisms that underpin autoimmune disease. Copyright © 2014. Published by Elsevier Inc.

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Is Open Access

Estrogen receptors regulate innate immune cells and signaling pathways

Susan Kovats (2015)

Humans show strong sex differences in immunity to infection and autoimmunity, suggesting sex hormones modulate immune responses. Indeed, receptors for estrogens (ER) regulate cells and pathways in the innate and adaptive immune system, as well as immune cell development. ERs are ligand-dependent transcription factors that mediate long-range chromatin interactions and form complexes at gene regulatory elements, thus promoting epigenetic changes and transcription. ERs also participate in membrane-initiated steroid signaling to generate rapid responses. Estradiol and ER activity show profound dose- and context-dependent effects on innate immune signaling pathways and myeloid cell development. While estradiol most often promotes the production of type I interferon, innate pathways leading to pro-inflammatory cytokine production may be enhanced or dampened by ER activity. Regulation of innate immune cells and signaling by ERs may contribute to the reported sex differences in innate immune pathways. Here we review the recent literature and highlight several molecular mechanisms by which ERs regulate the development or functional responses of innate immune cells.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2022

Publication date (Electronic): 25 January 2022

Volume: 12

Issue: 1

Electronic Location Identifier: e048942

Affiliations

[1 ]departmentDepartment of Epidemiology and Biostatistics, School of Public Health , Peking University Health Science Center , Beijing, China

[2 ]departmentDepartment of Ophthalmology, The First Medical Center , Chinese PLA General Hospital , Beijing, China

[3 ]departmentDepartment of Neuro-ophthalmology, Eye Hospital , China Academy of Chinese Medical Sciences , Beijing, China

Author notes

[Correspondence to ] Professor Yong-Hua Hu; yhhu@ 123456bjmu.edu.cn ; Professor Shihui Wei; weishihui706@ 123456hotmail.com

Author information

Yiqun Wu http://orcid.org/0000-0002-5554-1678

Pei Gao http://orcid.org/0000-0001-8649-1290

Yong-Hua Hu http://orcid.org/0000-0003-1631-3952

Article

Publisher ID: bmjopen-2021-048942

DOI: 10.1136/bmjopen-2021-048942

PMC ID: 8804634

PubMed ID: 35105613

SO-VID: 89ebfffb-3807-4a9e-becc-7af641e60af6

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 26 August 2021

Date accepted : 13 January 2022

Custom metadata

special-feature unlocked

ScienceOpen disciplines: Medicine

Keywords: epidemiology,neuro-ophthalmology,neurology

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