Severe Myasthenic Manifestation of Leptospirosis Associated with New Sequence Type of<i>Leptospira interrogans</i>

Tomschik, Matthias; Koneczny, Inga; Schötta, Anna‐Margarita; Scharer, Sebastian; Smajlhodzic, Merima; Rosenegger, Paloma Fernandes; Blüthner, Martin; Höftberger, Romana; Zimprich, Fritz; Stanek, Gerold; Markowicz, Mateusz

doi:10.3201/eid2505.181591

Cited by 6 publications

(5 citation statements)

References 14 publications

(15 reference statements)

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“…Lrp4 MG patients are predominantly female (female to male ratio of 2.5:1) and have usually a generalized mild muscular weakness, unless additional antibodies to MuSK or AChR are present [48]. In an exceptional case, Lrp4 MG with severe muscle weakness manifested during infection with a new sequence isotype of Leptospira interrogans [49]. The role of the thymus in Lrp4 MG is unclear; one epidemiological study suggests the occasional presence of thymic hyperplasia [48].…”

Section: Clinical Aspects Of Myasthenia Gravismentioning

confidence: 99%

Myasthenia Gravis: Pathogenic Effects of Autoantibodies on Neuromuscular Architecture

Koneczny

Herbst

2019

Cells

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112

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Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction (NMJ). Autoantibodies target key molecules at the NMJ, such as the nicotinic acetylcholine receptor (AChR), muscle-specific kinase (MuSK), and low-density lipoprotein receptor-related protein 4 (Lrp4), that lead by a range of different pathogenic mechanisms to altered tissue architecture and reduced densities or functionality of AChRs, reduced neuromuscular transmission, and therefore a severe fatigable skeletal muscle weakness. In this review, we give an overview of the history and clinical aspects of MG, with a focus on the structure and function of myasthenic autoantigens at the NMJ and how they are affected by the autoantibodies’ pathogenic mechanisms. Furthermore, we give a short overview of the cells that are implicated in the production of the autoantibodies and briefly discuss diagnostic challenges and treatment strategies.

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Section: Clinical Aspects Of Myasthenia Gravismentioning

confidence: 99%

Myasthenia Gravis: Pathogenic Effects of Autoantibodies on Neuromuscular Architecture

Koneczny

Herbst

2019

Cells

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112

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“…Koneczny et al demonstrated for the first-time severe form of myasthenia gravis as a rare manifestation of acute leptospirosis. The authors isolated a new sequence type of L. interrogans as the causative agent [68].…”

Section: Infections and Autoimmunity During Auto12mentioning

confidence: 99%

The mosaic of autoimmunity - A taste for more. The 12th international congress of autoimmunity 2021 (AUTO12) virtual

Mahroum

Zoubi

Lavine

et al. 2021

Autoimmunity Reviews

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“…Thus, several hypotheses may be raised. A first hypothesis points out molecular mimicry as a pathogenetic mechanism through which dysbiosis induces MG because of the reported case of MG onset after Leptospira interrogans acute infection [ 87 ]. In this view, the re-arrangement of intestinal flora would result in molecular mimicry phenomena underlying MG pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

The Role of Human Microbiota in Myasthenia Gravis: A Narrative Review

Schirò

Iacono

Balistreri

2023

Neurology International

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Myasthenia gravis (MG) is an autoimmune neuromuscular disease characterized by fluctuating weakness of the skeletal muscles. Although antibodies against the neuromuscular junction components are recognized, the MG pathogenesis remains unclear, even if with a well-known multifactorial character. However, the perturbations of human microbiota have been recently suggested to contribute to MG pathogenesis and clinical course. Accordingly, some products derived from commensal flora have been demonstrated to have anti-inflammatory effects, while other have been shown to possess pro-inflammatory properties. In addition, patients with MG when compared with age-matched controls showed a distinctive composition in the oral and gut microbiota, with a typical increase in Streptococcus and Bacteroides and a reduction in Clostridia as well as short-chain fatty acid reduction. Moreover, restoring the gut microbiota perturbation has been evidenced after the administration of probiotics followed by an improvement of symptoms in MG cases. To highlight the role of the oral and gut microbiota in MG pathogenesis and clinical course, here, the current evidence has been summarized and reviewed.

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Severe Myasthenic Manifestation of Leptospirosis Associated with New Sequence Type ofLeptospira interrogans

Cited by 6 publications

References 14 publications

Myasthenia Gravis: Pathogenic Effects of Autoantibodies on Neuromuscular Architecture

Myasthenia Gravis: Pathogenic Effects of Autoantibodies on Neuromuscular Architecture

The mosaic of autoimmunity - A taste for more. The 12th international congress of autoimmunity 2021 (AUTO12) virtual

The Role of Human Microbiota in Myasthenia Gravis: A Narrative Review

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