Muscle autoantibodies in myasthenia gravis: beyond diagnosis?

Abstract

Myasthenia gravis is an autoimmune disorder of the neuromuscular junction. A number of molecules, including ion channels and other proteins at the neuromuscular junction, may be targeted by autoantibodies leading to abnormal neuromuscular transmission. In approximately 85% of patients, autoantibodies, directed against the postsynaptic nicotinic acetylcholine receptor can be detected in the serum and confirm the diagnosis, but in general, do not precisely predict the degree of weakness or response to therapy. Antibodies to the muscle-specific tyrosine kinase are detected in approximately 50% of generalized myasthenia gravis patients who are seronegative for anti-acetylcholine receptor antibodies, and levels of anti-muscle-specific tyrosine kinase antibodies do appear to correlate with disease severity and treatment response. Antibodies to other muscle antigens may be found in the subsets of myasthenia gravis patients, potentially providing clinically useful diagnostic information, but their utility as relevant biomarkers (measures of disease state or response to treatment) is currently unclear.

Myasthenia gravis at Ouagadougou (Burkina Faso): about 14 cases

“…In the literature, the prevalence of AchR antibodies varies from 75% to 90% for general MG, and from 50% to 60% for ocular MG [27,28]. In most patients with MG, the disease is caused by an immune humoral response directed against the ACh nicotinic muscle receptor [29]. Several reasons may explain the low prevalence of AchR antibodies in our patients.…”

Immunopathogenesis of Myasthenia Gravis (Review)

“…Клетки типа Th17 принимают участие в развитии аутоиммунитета. Т-клетки, продуцирующие ИЛ-17 и ИЛ-10, функционируют в подавлении вос-палительных реакций [3, 38,59,69,72,77,83,88,108]. ИЛ-17 присутствует в местах воспаления тка-ней при аутоиммунных заболеваниях [40].…”

“…Опреде-лен ряд антител к антигенным структурам при миа-стении, что может служить дополнительным диагно-стическим критерием этого заболевания и являться источником информации, позволяющей прогнози-ровать течение болезни [1, 65,69]. Исследование концентрации сывороточных марке-ров является стандартом для диагностики заболева-ния.…”

Neuromuscular Causes of Weakness in Critically Ill Patients

“…Such patients tend to have severe disease and high frequency of respiratory crises compared to an AChR antibody positive patients. 17 A vital capacity of less than 1 liter (or <20-25 ml/kg), or a negative inspiratory factor (NIF) <20 cm of H2O, indicates significant respiratory weakness; both measurements are commonly used to define myasthenic crisis. 18 Between 66%-90% of patients with an MG crisis require intubation, mechanical ventilation, and ICU management of the complications.…”