Participants

Twelve patients with NMOSD from the Oxford specialist clinic were selected with widely-varying serum AQP4-IgG levels [Table 1, 91–26 610 ΔMFI (median fluorescence intensity) units] and durations from disease onset. Clinical datasets, including patient demographics, presenting features, medications and relapses timings, were extracted from case notes. Blood was obtained from these 12 patients and from 12 sex- and age-matched (±5 years) healthy control subjects. Full informed consent was obtained and the work was performed under Research ethics committee approvals 16/YH/0013 and 16/SC/0224.

Clinical characteristics of patients with NMOSD

Serum AQP4-IgG levels determined by flow cytometry as described in Fig. 3 (ΔMFI, as defined in Methods). AZA = azathioprine; IT = immunotherapy; MMF = mycophenolate mofetil; ON = optic neuritis; Pred = prednisolone; TM = transverse myelitis; RTX = rituximab. Only Patients 11 and 12 ever received rituximab. Lymphocyte subsets are presented in Supplementary Table 1.