Thymus pathology in myasthenia gravis with anti-acetylcholine receptor antibodies and concomitant Hashimoto’s thyroiditis. A four-case series and literature review

Ionescu, Lidia; Costea, Claudia Florida; Dănilă, Radu; Bogdănici, Camelia Margareta; Scripcariu, Dragoş Viorel; Livadariu, Roxana Maria; Dumitrescu, Gabriela; Gavrilescu, Cristina Maria; Dragomir, Raluca; Sava, Anca; Cucu, Andrei; Turliuc, Mihaela Dana; Apostol, Delia Gabriela Ciobanu

doi:10.47162/rjme.62.1.07

Cited by 5 publications

(3 citation statements)

References 25 publications

(35 reference statements)

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“…In two patients with MG, the histopathological report showed thymic atrophy, with a substantial decrease in the thymic cortex section, degenerated cystic architecture with calcified HCs in late-onset MG patients, and distended cystic HCs in ocular-associated MG patients. The cysts origin, as modified HCs, is supported by the intense CK AE1/AE3 immunopositivity of cells lining the internal side of the cysts [94].…”

Section: Hassall's Corpuscles (Hcs)mentioning

confidence: 86%

Untitled

2022

Rom J Morphol Embryol

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This article focuses on the latest histological knowledge in the field regarding the peripheral lymphoid system [mucosa-associated lymphoid tissue (MALT), bronchus-associated lymphoid tissue (BALT), gut-associated lymphoid tissue (GALT)], the thymus stroma, some of the various corpuscles of the human body (Hassall's corpuscles in thymus, arenaceous corpuscles in pineal gland, corpora amylacea in prostate and other locations) and Fañanas glial cells in the cerebellum.

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Section: Hassall's Corpuscles (Hcs)mentioning

confidence: 86%

Untitled

2022

Rom J Morphol Embryol

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“…Morphologically, they both exhibit abundant lymphocyte infiltration, mainly distributed in follicles formed by germinal centers (50). Hashimoto thyroiditis and MG show high Ki67 labeling index and strong p63 immunopositivity (51). From an analysis of coexisting antibodies, MG patients often have the presence of thyroid autoantibodies, while MuSK antibody-positive MG patients exhibit coexisting autoimmune diseases, predominantly Hashimoto thyroiditis and rheumatoid arthritis (52).…”

Section: Discussionmentioning

confidence: 99%

Autoimmune thyroid disease and myasthenia gravis: a study bidirectional Mendelian randomization

Wang,

Chen

et al. 2024

Front. Endocrinol.

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BackgroundPrevious studies have suggested a potential association between AITD and MG, but the evidence is limited and controversial, and the exact causal relationship remains uncertain.ObjectiveTherefore, we employed a Mendelian randomization (MR) analysis to investigate the causal relationship between AITD and MG.MethodsTo explore the interplay between AITD and MG, We conducted MR studies utilizing GWAS-based summary statistics in the European ancestry. Several techniques were used to ensure the stability of the causal effect, such as random-effect inverse variance weighted, weighted median, MR-Egger regression, and MR-PRESSO. Heterogeneity was evaluated by calculating Cochran’s Q value. Moreover, the presence of horizontal pleiotropy was investigated through MR-Egger regression and MR-PRESSOResultsThe IVW method indicates a causal relationship between both GD(OR 1.31,95%CI 1.08 to 1.60,P=0.005) and autoimmune hypothyroidism (OR: 1.26, 95% CI: 1.08 to 1.47, P =0.002) with MG. However, there is no association found between FT4(OR 0.88,95%CI 0.65 to 1.18,P=0.406), TPOAb(OR: 1.34, 95% CI: 0.86 to 2.07, P =0.186), TSH(OR: 0.97, 95% CI: 0.77 to 1.23, P =0.846), and MG. The reverse MR analysis reveals a causal relationship between MG and GD(OR: 1.50, 95% CI: 1.14 to 1.98, P =3.57e-3), with stable results. On the other hand, there is a significant association with autoimmune hypothyroidism(OR: 1.29, 95% CI: 1.04 to 1.59, P =0.019), but it is considered unstable due to the influence of horizontal pleiotropy (MR PRESSO Distortion Test P < 0.001). MG has a higher prevalence of TPOAb(OR: 1.84, 95% CI: 1.39 to 2.42, P =1.47e-5) positivity and may be linked to elevated TSH levels(Beta:0.08,95% CI:0.01 to 0.14,P =0.011), while there is no correlation between MG and FT4(Beta:-9.03e-3,95% CI:-0.07 to 0.05,P =0.796).ConclusionAITD patients are more susceptible to developing MG, and MG patients also have a higher incidence of GD.

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“…While the specific functions of HCs are unknown, previous studies have proposed that secretion of TSLP from corpuscular mTECs promotes CD80/CD86 expression on DCs, which in turn supports the development of Tregs and may also play a role in negative selection 9,66 . Expression of auto-antigens has been reported in HCs, with connections to various auto-immune thyroiditis [67][68][69][70] . In addition, several studies have suggested association of HCs with cell types such as B cells, pDCs, and neutrophils in addition to Treg cells [71][72][73] .…”

Section: Specific Mtec Subsets Show Increased Association With Hassal...mentioning

confidence: 99%

A spatial human thymus cell atlas mapped to a continuous tissue axis

Yayon,

Kedlian,

Boehme

et al. 2023

Preprint

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T cells develop from circulating precursors, which enter the thymus and migrate throughout specialised sub-compartments to support maturation and selection. This process starts already in early fetal development and is highly active until the involution of the thymus in adolescence. To map the micro-anatomical underpinnings of this process in pre- vs. post-natal states, we undertook a spatially resolved analysis and established a new quantitative morphological framework for the thymus, the Cortico-Medullary Axis. Using this axis in conjunction with the curation of a multimodal single-cell, spatial transcriptomics and high-resolution multiplex imaging atlas, we show that canonical thymocyte trajectories and thymic epithelial cells are highly organised and fully established by post-conception week 12, pinpoint TEC progenitor states, find that TEC subsets and peripheral tissue genes are associated with Hassall`s Corpuscles and uncover divergence in the pace and drivers of medullary entry between CD4 vs. CD8 T cell lineages. These findings are complemented with a holistic toolkit for spatial analysis and annotation, providing a basis for a detailed understanding of T lymphocyte development.

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Thymus pathology in myasthenia gravis with anti-acetylcholine receptor antibodies and concomitant Hashimoto’s thyroiditis. A four-case series and literature review

Cited by 5 publications

References 25 publications

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Autoimmune thyroid disease and myasthenia gravis: a study bidirectional Mendelian randomization

A spatial human thymus cell atlas mapped to a continuous tissue axis

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