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The discovery of the pathogenic IgG\u20111 antibody targeting a\u00a0water channel expressed in astrocytes, aquaporin\u00a04, constitutes a\u00a0milestone achievement. Subsequently, multiple pathophysiological aspects of this distinct disease entity have been investigated. Demyelinating lesions and axonal damage ensue from autoantibodies targeting an astroglial epitope. This conundrum has been addressed in the current disease model, where activation of the complement system as well as B\u00a0cells and interleukin\u00a06 (IL-6) emerged as key contributors. It is the aim of this review to address these factors in light of novel treatment compounds which reflect these pathophysiological concepts in aiming for attack prevention, thus reducing disease burden in patients with NMOSD.<\/jats:p>","DOI":"10.1007\/s10354-022-00987-2","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T07:02:39Z","timestamp":1670310159000},"page":"4-15","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Treatment of neuromyelitis optica spectrum disorder: revisiting the complement system and other aspects of pathogenesis","Behandlung der Neuromyelitis-optica-Spektrum-Erkrankung: R\u00fcckblick auf das Komplementsystem und andere Aspekte der Pathogenese"],"prefix":"10.1007","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3709-1845","authenticated-orcid":false,"given":"Markus","family":"Ponleitner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulus Stefan","family":"Rommer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,12,6]]},"reference":[{"key":"987_CR1","first-page":"434","volume-title":"Congr\u00e9s Francais de M\u00e9decine","author":"E Devi\u0107","year":"1894","unstructured":"Devi\u0107\u00a0E. 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