Altered lipidomic and metabolomic status in cerebrospinal fluid of children with myelin oligodendrocyte glycoprotein antibody-associated disorder

Myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD) is a group of acquired demyelinating syndromes affecting the central nervous system. MOGAD-associated bioactive molecules remain elusive. A retrospective case-control study was performed to characterize the biochemical and immunological profiles of cerebrospinal fluid (CSF) in MOGAD. Thirteen patients with MOGAD (onset age: 2-14 years, 6 females) and five patients with epilepsy, serving as controls, were enrolled. Liquid chromatography with tandem mass spectrometry was used for lipidomic and metabolomic analyses using CSF samples collected at disease onset (n = 5). The MS/MS system detected a total of 7527 molecules in lipidomic and 17,526 molecules in metabolomic analyses of CSF. Among them, 162 (0.02 %) lipophilic molecules were detected at levels that differed from those of controls. Among the 549 (0.03 %) hydrophilic molecules that were differentially presented, pyridoxine, ribitol, and isethionate levels were significantly lower in patients with MOGAD. Both lipidomic and metabolomic analyses, discriminated CSF samples of patients with MOGAD from controls using Uniform Manifold Approximation and Projection. In summary, CSF samples from children with MOGAD exhibit distinctive lipidomic and metabolomic profiles. These findings provide evidence for the diagnostic potential of CSF-based lipidomic and metabolomic analyses for childhood-onset MOGAD.