Myasthenia gravis

Abstract

Sixty patients with myasthenia gravis were examined prospectively by measuring serial titers of antibodies against human acetylcholine receptor, and these were correlated with a quantitative clinical score. Serial titers of antibodies detected by the standard immunoprecipitation assay (binding antibodies) correlated with the clinical score in most patients. Antibodies blocking the binding of alpha-bungarotoxin to receptors (blocking antibodies) were detected in 29 patients. Serial blocking antibody titers correlated with changes in muscle weakness less often than binding antibody titers. Titers of both classes of antibodies often followed a divergent course, suggesting that the autoimmune B-cell clones that formed these classes of antibodies may have been activated asynchronously.

Amphipathic segment of the nicotinic receptor alpha subunit contains epitopes recognized by T lymphocytes in myasthenia gravis.

“…AChR-reactive T cell lines were isolated from two patients who had generalized MG according to clinical, pharmacological, and electrophysiological criteria. The serum concentration of anti-AChR antibodies (measured with a modified radioprecipitation assay (10) and expressed as nanomoles alpha-bungarotoxin-binding sites per liter of serum) was 2.0 in patient 1 (40 yr; male), and 1,690.0 in patient 2 (20 yr; female). The patients had not been taking immunosuppressive medications for at least 3 mo before the time when the T cell cultures were started (see below).…”

Brazilian-Portuguese translation, cross-cultural adaptation and validation of the Myasthenia Gravis Composite scale. A multicentric study

“…Previous studies have described a significant correlation between HRQoL and severity of MG 10,11,12 . We found only three specific tools for evaluating HRQoL in MG patients in the international scientific literature (Myasthenia Gravis Questionnaire 13 , Myasthenia Gravis-specific Activities of Daily Living Profile 14,15 , Questionnaire of Life Quality Specific for Myasthenia Gravis -15 items (MG-QOL- 15) 16 ) and two instruments to assess the clinical evaluation of patients with MG (Quantitative Myasthenia Gravis Score 17 and Myasthenia Gravis Composite scale (MGC) 18 ). From these instruments, only the MG-QOL-15 has been translated into Brazilian Portuguese 19 .…”

Widely varying TNF-α levels in patients with myasthenia gravis

“…Further prospective study with more patients is necessary for TNF-a blocking medications to be a viable alternative choice for managing the clinical course of MG. Molecular methods such as mRNA analysis and enzymelinked immunospot assay should be used to elucidate the role of TNF-a in the pathogenesis of MG. In addition, it might also be helpful to examine the level of TNF-a before therapy and to serially monitor the levels during treatment in a single patient, similar to a case where anti-AChR antibody correlates with relative change of clinical conditions in a patient [6,12].…”