B cell-activating factor (BAFF) and aquaporin-4 antibody (AQP4-Ab) concentrations in the cerebrospinal fluid (CSF) are correlated with the severity of neuromyelitis optica spectrum disorder (NMOSD), according to a new study published in the Turkish Journal of Biochemistry. These concentrations can also predict the progression of the disease.

To evaluate the correlation between the severity of NMOSD and BAFF and AQP4-Ab as well as brain-derived neurotrophic factor (BDNF), a team of researchers from China analyzed 68 patients with NMOSD and 65 patients with noninflammatory neurological diseases as a control.

They found no difference between patients with NMOSD and noninflammatory neurological diseases in terms of BAFF and BDNF concentration in the serum. The concentration of AQP4-Ab was high in the serum of patients with NMOSD, as expected. 

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However, when they looked at the CSF, the researchers found that patients with NMOSD had significantly lower levels of BAFF compared to patients with noninflammatory neurological diseases. The levels of BDNF were not significantly different in the CSF of the 2 groups of patients. 

The researchers reported that patients who had more severe disease, as indicated by a score of 7 or higher in the Expanded Disability Status Scale (EDSS), 5 or more spinal segments involved, and those whose disease recurred 3 times or more had lower BAFF concentrations in the CSF.

“BAFF concentration was negatively correlated with disease duration, EDSS score, number of involved spinal segments, and recurrence status,” the researchers wrote.

They also reported that, on the contrary, the concentration of AQP4-Ab was positively correlated with the duration of the disease, EDSS score, the number of involved spinal segments, and recurrence status.

“In conclusion, the concentrations of BAFF and AQP4-Ab in the CSF can well predict the progression of NMOSD, being associated with the severity of the disease,” the researchers wrote.


Li S, Fu J, Xu F, Yu L, Yu Q, Yu N. Concentrations of B cell-activating factor, aquaporin-4 antibody and brain-derived neurotrophic factor in neuromyelitis optica spectrum disorder. Turkish J Biochem. Published online September 19, 2022. doi:10.1515/tjb-2022-0061