Antibodies in Myasthenia Gravis and Related Disorders
| Autor: | John McConville, Nick Willcox, Werner Hoch, Angela Vincent, John Newsom-Davis, David Beeson, Leslie Jacobson, Maria Elena Farrugia, Agata Polizzi, Gary Sims, Paola Dalton, Amelia Evoli, Paul Plested, Ian Matthews, Frans Blaes, Bethan Lang, Teresa Tang, John Bowen |
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| Rok vydání: | 2003 |
| Předmět: |
Fetal Proteins
Aging medicine.medical_specialty Immunoglobulin Variable Region Neuromuscular transmission Biology Antibodies General Biochemistry Genetics and Molecular Biology Fetus History and Philosophy of Science Pregnancy Cell surface receptor Internal medicine Placenta Myasthenia Gravis medicine Humans Receptors Cholinergic Phosphorylation Receptor Acetylcholine receptor Arthrogryposis Myasthenic Syndromes Congenital General Neuroscience Receptor Protein-Tyrosine Kinases medicine.disease Myasthenia gravis Pregnancy Complications medicine.anatomical_structure Endocrinology Immunology biology.protein Female Binding Sites Antibody Antibody |
| Zdroj: | Annals of the New York Academy of Sciences. 998:324-335 |
| ISSN: | 1749-6632 0077-8923 |
| DOI: | 10.1196/annals.1254.036 |
| Popis: | Acetylcholine receptor (AChR) antibodies are present in around 85% of patients with myasthenia gravis (MG) as measured by the conventional radioimmunoprecipitation assay. Antibodies that block the fetal form of the AChR are occasionally present in mothers who develop MG after pregnancy, especially in those whose babies are born with arthrogryposis multiplex congenita. The antibodies cross the placenta and block neuromuscular transmission, leading to joint deformities and often stillbirth. In these mothers, antibodies made in the thymus are mainly specific for fetal AChR and show restricted germline origins, suggesting a highly mutated clonal response; subsequent spread to involve adult AChR could explain development of maternal MG in those cases who first present after pregnancy. In the 15% of "seronegative" MG patients without AChR antibodies (SNMG), there are serum factors that increase AChR phosphorylation and reduce AChR function, probably acting via a different membrane receptor. These factors are not IgG and could be IgM or even non-Ig serum proteins. In a proportion of SNMG patients, however, IgG antibodies to the muscle-specific kinase, MuSK, are present. These antibodies are not found in AChR antibody-positive MG and are predominantly IgG4. MuSK antibody positivity appears to be associated with more severe bulbar disease that can be difficult to treat effectively. |
| Databáze: | OpenAIRE |
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