Devic’s disease or neuromyelitis optica is an autoimmune inflammatory disease of the central nervous system that primarily affects the brain and spinal cord. Autoantibodies target the primary water channel of the brain, aquaporin 4 (Aqp4), and thereby initiate a cascade of downstream events of inflammation, complement activation ultimately resulting in astrocyte death and loss of oligodendrocytes. Proteomic analysis of serum, cerebrospinal fluid as well as urine of NMO patients successfully identified unique protein signatures that get altered. Besides oral steroids and immunosuppressants, Rituximab (RTX) remains the preferred therapy for NMO patients. Our study focuses on the identification of the isoformic patterns of some of the major serum proteins and how the profiles shift in patients after receiving immunosuppressant therapy. Some of the significant modifications include major shifts in the spot pattern of abundant serum proteins like ApoA1, FGG, and HP towards the acidic side of the pH after treatment. This qualitative comparative analysis among NMO patients, before and after therapy, would be useful to provide insight into the associated disease dynamics.
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