The effect of glucocorticoids on radiology and histology of thymoma in myasthenia gravis

Zouvelou, Vasiliki; Vamvakaris, Ioannis; Tentolouris-Piperas, Vasileios; Potaris, Konstantinos; Velonakis, Georgios

doi:10.1007/s13760-021-01731-0

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…At the same time, from the perspective of cell composition (14), thymomas of different pathologic types more or less contain lymphocytes, so we believe that steroid therapy is effective for thymomas, and patients with rich lymphocyte components have a more effective response than patients with fewer. Zouvelou et al confirmed our hypothesis by reviewing cases and finding that preoperative prednisolone therapy can cause tumor shrinkage (26).…”

Section: Discussionsupporting

confidence: 67%

“…Compared with single radiotherapy, simultaneous chemotherapy can not only kill tumors but also increase radiotherapy sensitivity ( 25 ). Steroids are a common treatment for autoimmune diseases such as MG, and can induce apoptosis of lymphocytes as a lytic agent ( 26 ). At the same time, from the perspective of cell composition ( 14 ), thymomas of different pathologic types more or less contain lymphocytes, so we believe that steroid therapy is effective for thymomas, and patients with rich lymphocyte components have a more effective response than patients with fewer.…”

Section: Discussionmentioning

confidence: 99%

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Developing and validating a nomogram to predict myasthenia gravis exacerbation in patients with postoperative thymoma recurrence

Cheng¹,

Xue²,

Gu³

et al. 2022

Gland Surg

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Background: Myasthenia gravis (MG) is one of the most common accessory syndromes for thymoma patients. To reduce MG exacerbation and guide clinical practice, we developed a nomogram for predicting MG exacerbation in patients with postoperative thymoma recurrence. Methods: Retrospective study of 176 patients with recurrence following thymoma resection who were admitted to the People's Hospital of Shijiazhuang's Center of Treatment of Myasthenia Gravis between 2013 and 2021. Among them, 120 patients with recurrent thymoma from 2013 to 2020 were selected as the training cohort, and 56 patients in 2021 as the validation cohort. Univariate and multivariate logical regression was used to determine the risk factors and draw the nomogram, and the parameters in the nomogram were proportionally assigned from 0 to 100 points. Finally, the performance of the model is evaluated by internal inspection and external inspection.Results: Multivariate analysis revealed that postoperative treatment plan and the pathologic classification of the thymoma were independent predictors of MG exacerbation in the training cohort (n=120), so they were used to create the nomogram, which had a well-fit calibration curve and good concordance index of 0.77 [95% confidence interval (CI): 0.69-0.86] for the training cohort and 0.74 (95% CI: 0.58-0.91) for the validation cohort, respectively. Calculations were made to determine the nomogram's sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV). The training cohort were 75.7% (95%

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Developing and validating a nomogram to predict myasthenia gravis exacerbation in patients with postoperative thymoma recurrence

Cheng¹,

Xue²,

Gu³

et al. 2022

Gland Surg

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“…The mechanism of action of prednisolone in thymoma-associated MG is to prevent the formation of GC, but not the production of antibodies by thymic B cells, and to reduce the expression of chemokines (CXCL 13, CCL 21, and CCL 19) and the number of HEV (Truffault et al 2017 ). Studies have shown that in thymoma-associated MG, preoperative application of prednisolone to improve symptoms of muscle weakness may result in radiological shrinkage of the thymoma, with pathological manifestations of marked loss of thymic lymphoid tissue but preservation of epithelial components (Zouvelou et al 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone improves thymoma-associated myasthenia gravis via the AKT-mTOR pathway

Liu¹,

Chen²,

Wang³

et al. 2023

Naunyn-Schmiedeberg's Arch Pharmacol

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Clinically, thymoma patients are often complicated with myasthenia gravis (MG). Dexamethasone, a glucocorticoid with anti-inflammatory effects, could be used as an immunosuppressant for thymoma-associated MG, but the mechanism of action remains to be explored. In this study, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, weighted gene co-expression network analysis (WGCNA) of potential targets was performed by screening the intersection targets of dexamethasone and thymoma-associated MG from the database. Furthermore, the key targets and core active components were identified by topological analysis of the protein–protein interaction (PPI) network. Molecular docking technology was applied to screen the complexes with stable binding of dexamethasone and core targets. Patients with thymoma were divided into two groups according to whether they received dexamethasone before operation, and immunohistochemistry and western blot were used to verify the selected target of dexamethasone in treating thymoma-associated MG. The results showed that the action pathway of dexamethasone on the disease was closely enriched to phosphatidylinositol 3-kinase (PI3K)-protein kinase B (PKB/AKT), mammalian target of rapamycin (mTOR) signaling pathways. The expressions of AKT1 and its downstream molecule mTOR in the thymoma microenvironment of thymoma-associated MG patients who did not receive dexamethasone before operation were higher than those in the group receiving dexamethasone before operation. This study demonstrates that dexamethasone can promote apoptosis through the AKT-mTOR pathway for the treatment of thymoma-associated MG, as validated by network pharmacology predictions and clinical specimen experiments, and can be verified by large-scale clinical trials in the future. This study also provides theoretical support and new research perspectives for this disease.

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Outcomes after robotic thymectomy in nonthymomatous versus thymomatous patients with acetylcholine-receptor-antibody-associated myasthenia gravis

Marcuse¹,

Hoeijmakers²,

Hochstenbag³

et al. 2023

Neuromuscular Disorders

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The effect of glucocorticoids on radiology and histology of thymoma in myasthenia gravis

Cited by 3 publications

References 4 publications

Developing and validating a nomogram to predict myasthenia gravis exacerbation in patients with postoperative thymoma recurrence

Developing and validating a nomogram to predict myasthenia gravis exacerbation in patients with postoperative thymoma recurrence

Dexamethasone improves thymoma-associated myasthenia gravis via the AKT-mTOR pathway

Outcomes after robotic thymectomy in nonthymomatous versus thymomatous patients with acetylcholine-receptor-antibody-associated myasthenia gravis

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