Current Treatment, Emerging Translational Therapies, and New Therapeutic Targets for Autoimmune Myasthenia Gravis

Abstract

Myasthenia gravis (MG) is an autoimmune disease associated with the production of autoantibodies against 1) the skeletal muscle acetylcholine receptor; 2) muscle-specific kinase, a receptor tyrosine kinase critical for the maintenance of neuromuscular synapses; 3) low-density lipoprotein receptor-related protein 4, an important molecular binding partner for muscle-specific kinase; and 4) other muscle endplate proteins. In addition to the profile of autoantibodies, MG may be classified according the location of the affected muscles (ocular vs generalized), the age of symptom onset, and the nature of thymic pathology. Immunopathologic events leading to the production of autoantibodies differ in the various disease subtypes. Advances in our knowledge of the immunopathogenesis of the subtypes of MG will allow for directed utilization of the ever-growing repertoire of therapeutic agents that target distinct nodes in the immune pathway relevant to the initiation and maintenance of autoimmune disease. In this review, we examine the pathogenesis of MG subtypes, current treatment options, and emerging new treatments and therapeutic targets.

Perturbed Microbial Ecology in Myasthenia Gravis: Evidence from the Gut Microbiome and Fecal Metabolome

“…[2,3] The clinical symptoms of MG are diverse and overlap with other neurological disorders. [1] Moreover, although conventional hormone and immunosuppressive therapy can improve the symptoms of most MG patients, [5] the Myasthenia gravis (MG) is a devastating acquired autoimmune disease. [1] Moreover, although conventional hormone and immunosuppressive therapy can improve the symptoms of most MG patients, [5] the Myasthenia gravis (MG) is a devastating acquired autoimmune disease.…”

Hepatitis B screening before rituximab therapy: a multicentre South Australian study of adherence

“…3 Rituximab is commonly used to treat lymphoproliferative disorders, 4 but also has other widespread uses, including rheumatological disease, 5 neurological disease, 6 renal disease 7 and humoral-mediated solid organ transplant rejection. 3 Rituximab is commonly used to treat lymphoproliferative disorders, 4 but also has other widespread uses, including rheumatological disease, 5 neurological disease, 6 renal disease 7 and humoral-mediated solid organ transplant rejection.…”

Anti-musk positive myasthenia gravis and three semiological cardinal signs

“…The prevalence of the disease has been increasing over the past five decade. 3,4 This is thought to be due to better recognition of the condition, aging of the population, and the longer life span of affected patients. MG causes weakness, predominantly in bulbar, facial, and extra-ocular muscles, often fluctuating over minutes to weeks, in the absence of wasting, sensory loss, or reflex changes.…”