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Investigating the Association between Aquaporin-4 and Osteoporosis in Patients with Neuromyelitis Optica Spectrum Disorders
Zhila Maghbooli, Solaleh Emamgholipour, Majid Ramezani, Mohammad Ali Sahraian,
Volume 19, Issue 1 (4-2025)
Abstract
Background and Aim: Neuromyelitis Optica Spectrum Disorders (NMOSD) is an uncommon disorder of the central nervous system mainly affecting the optic nerves and spinal cord. NMOSD is associated with IgG antibody binding to aquaporin-4 (AQP4) that triggers astrocyte and axon loss. Aquaporin 4 is also expressed skeletally and affects bioenergetic regulation pathways and calcium (Ca²⁺) translocations.
The aim of this study was the association between AQP4 and bone loss in NMOSD patients.
Material and Methods: In this study, 32 NMOSD patients were enrolled as the case group, and 37 age-matched individuals without a history of neurological disorders or other acute or chronic conditions served as the control group. Patients with NMOSD were diagnosed based on the criteria established by Wingerchuk et al. Dual x-ray absorptiometry (DEXA) was used to assess bone mineral density (BMD) at three bone sites: the total hip, femoral neck, and spinal lumbar vertebrae (L1-L4). Bone status was defined based on the Z-score in these regions, with a Z-score less than -2 classified as severe bone loss.
Results: Among patients with NMOSD, 15.6% exhibited severe bone densitometry loss in at least one area (total hip, femoral neck, or spine), compared to 5.4% in the control group (P=0.01). Bone densitometry results showed that the Z-score in the femoral neck and hip regions was significantly lower in individuals with NMOSD compared to the control group (P<0.05). In NMOSD patients, the Z-score in the femoral neck and hip regions was considerably lower in aquaporin-4 positive patients compared to the control group (P<0.05). In the regression model, after adjusting for age, sex, body mass index, and history of vitamin D supplementation, patients with aquaporin-4 had lower bone mass (P=0.02).
Conclusion: The study results indicate that aquaporin-4 may play a mediating role in the bone status of patients with NMOSD.

 
Investigating Occupational Conditions and Socioeconomic Support of Patients with Neuromyelitis Optica in Iran
Saeideh Ayoubi, Saman Salemi, Mohammad Ali Sahraian, Termeh Tarjoman, Sharareh Eskandarieh,
Volume 19, Issue 6 (3-2026)
Abstract
Background and Aim: Noncommunicable diseases are one of the most important public health challenges in the 21st century. Neuromyelitis optica (NMO) is a rare autoimmune disease that affects the central nervous system and can lead to permanent disability in young people. This disease is important due to its economic impact and reduced quality of life, and it is essential to understand its economic and social factors on these subjects.
Materials and Methods: This study is a cross-sectional study based on the population of Iranian NMO patients. The instrument of this study was a researcher-made questionnaire in English from Harvard University, USA, which was translated into Persian and re-translated into English (translate- retranslate technique). The samples included NMO patients registered in the Iranian National NMO Registry System at Sina Hospital in Tehran, who completed information about their employment, income, and socioeconomic status via telephone interviews. The data were analyzed by SPSS software.
Results: The total number of samples was 70, with a mean age of 41.40 years with a standard deviation of 10.91 years. The majority of patients were women, with 71.4% (50 of 70) of patients being female and 28.6% (20 of 70) being male. Sixty-one-point four percent of patients (43 of 70) had lost their jobs due to NMO and 70% (49 of 70) had reduced their working hours. Also, 47.1% of patients (33 of 70) reported a decrease in their annual income. Thirty-two-point eight percent (23 of 70) had lost between 51% and 100% of their annual income due to this disease and 10% (7 of 70) of patients had no annual income. Eighteen point five percent (13 of 70) of patients no longer work outside home due to the occurrence of NMO disease. Overall, the effects of NMO on the reduction of employment, working hours and income of patients were significantly high.
Conclusion: The results showed that NMO has serious effects on the employment and income status of these patients in Iran and they need more economic and social support. Considering the physical disabilities caused by this disease and the reduced ability to work, NMO patients should receive special social and economic support from government.

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