E.U. paediatric MOG consortium consensus: Part 3 - Biomarkers of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders.

A first episode of acquired demyelinating disorder (ADS) in children is a diagnostic challenge as different diseases can express similar clinical features. Recently, antibodies against myelin oligodendrocyte glycoprotein (MOG) have emerged as a new ADS biomarker, which clearly allow the identification of monophasic and relapsing ADS forms different from MS predominantly in children. Due to the novelty of this antibody there are still challenges and controversies about its pathogenicity and best technique to detect it. In this manuscript we will discuss the recommendations and caveats on MOG antibody assays, role in the pathogenesis, and additionally discuss the usefulness of other potential new biomarkers in MOG-antibody associated disorders (MOGAD)

E.U. paediatric MOG consortium consensus: Part 5 – Treatment of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders

In recent years, the understanding about the different clinical phenotypes, diagnostic and prognostic factors of myelin oligodendrocyte glycoprotein-antibody-associated disorders (MOGAD) has significantly increased. However, there is still lack of evidence-based treatment protocols for acute attacks and children with a relapsing course of the disease. Currently used acute and maintenance treatment regimens are derived from other demyelinating central nervous system diseases and are mostly centrespecific. Therefore, this part of the Paediatric European Collaborative Consensus attempts to provide recommendations for acute and maintenance therapy based on clinical experience and evidence available from mainly retrospective studies. In the acute attack, intravenous methy

Identifying counterfeit medicines using near infrared spectroscopy

Counterfeit medicines are a growing threat to public health across the world and screening methods are needed to allow their rapid identification. A counterfeiter must duplicate both the physical characteristics and the chemical content of a proprietary product to avoid it being detected as a counterfeit product and this is almost impossible to get right. Counterfeit proprietary medicines are, therefore, relatively easy to identify by near infrared (NIR) spectroscopy which can detect physical as well as chemical differences between products by simple spectral comparison. Identifying generic products is more difficult as they use different excipients in the tablet or capsule matrix. Nevertheless, using appropriate models and a large library, NIR spectroscopy can detect counterfeit generic versions. Detecting sub-standard proprietary medicines can be carried out with NIR spectroscopy models and the most widely used is partial least squares regression (PLSR). General rules for generating accurate quantitative models are easy to describe. Quantifying the active pharmaceutical ingredient (API) in generic products can also be carried out using PLSR models with calibration samples generated by manufacturing laboratory samples or by collecting many generic versions of a medicine so as to obtain a good range of the API content in tablets and capsules. Using hand-held instruments or mobile laboratories allows NIR spectrometers to be taken to places where analyses may be made quickly, rather than taking the samples to a laboratory. This has the enormous advantage that the screening of large numbers of samples may be made in pharmacies and wholesalers. Imaging can bring a whole new dimension to NIR spectroscopy to allow the identification of the API and individual excipients as well as measuring the particle sizes of components and giving a measure of the homogeneity of the matrix. The effect of water on potential misidentifications may be obviated by only using blister-packed samples, having large spectral libraries subjected to different humidities or omitting the spectral region where water absorbs.Peer reviewe