Table 2.
Selection of studies investigating the role of infectious factors in NMOSD.
| NMOSD | ||
|---|---|---|
| Infectious Agent | Evidence | References |
| TB | Case report: a patient with NMOSD experienced relapses following episodes of pulmonary TB | [155] |
| There is no association between NMO and pulmonary TB in a Chinese cohort | [156] | |
| There is an association between NMO and pulmonary TB in a South-African cohort | [157] | |
| Two cases of NMOSD with onset temporally related to pulmonary TB | [158] | |
| Antituberculosis treatment reduced relapses in patients with steroid-refractory NMO and led to neurological recovery | [159] | |
| Pulmonary TB was associated with NMOSD in 5 out of 24 Brazilian patients | [160] | |
| H. pylori | High titers of anti H. pylori antibodies are observed only in AQP4-positive patients | [161] |
| High titers of anti H. pylori antibodies are observed in both AQP4-positive and -negative patients, with stronger association with the first group | [162] | |
| A higher prevalence of H. pylori infection was described in AQP4-positive compared to AQP4-negative patients | [163] | |
| There is no difference between AQP4-negative patients and healthy controls in terms of the frequency of H. pylori infection | [164] | |
| EBV | Anti-EA IgG are higher in NMO patients than in MS patients and healthy controls, both in sera and CSF | [165] |
| NMO is associated with the reactivation of EBV | [166] | |
| HERV | Patients with NMOSD have lower levels of anti-HERV antibodies compared to patients with MS and to healthy individuals | [167,168] |
| Gut microbiota | Clostridium perfringens is abundant in individuals with NMO | [169] |
| There is a potential molecular mimicry between Clostridium perfrigens and AQP4 | [170] | |
| Fungi | High in vitro immune reactivity to Escherichia coli is correlated with disability in NMO | [148] |
| HIV | Characterization of six cases of patients with HIV developing NMOSD | [171] |
| HIV is able to activate several cellular lines of the immune system | [172] | |
| Characterization of two cases of patients with HIV developing NMO | [173] | |
NMOSD: neuromyelitis optica spectrum disorder; TB: tuberculosis; EBV: Epstein–Barr virus; EA: early antigen; HERV: human endogenous retrovirus; HIV: human immunodeficiency virus.