The Level of Antiacetylcholine Receptor Antibodies in the Patients with Myasthenia Gravis

Antiacetylcholine receptor antibodies cause acetylcholine receptor loss, damage of the postsynaptic membrane at the neuromuscular junction, and failure of the neuromuscular transmission. These make the myasthenia gravis (MG) which may cause ptosis, diplopia, dysarthria, dysphagia, generalized weakness, or even respiratory failure. In the previous studies level of antiacetylcholine receptor antibody did not correlate to the severity of patients with MG. In our best knowlegde there was no report of the study correlating the level and repetitive nerve stimulation test (RNS). Some cytokines were related to immunopathogenesis of MG, but there was no report which cytokines were affected by immunotherapy. The authors studied which factors correlated with the level of antiacetylcholine antibodies and which cytokines were affected by immunotherapy. Thirty three patients with MG were included in this study. Diagnosis of MG depended on the typical clinical manifestation and one of the following tests; neostigmin test, RNS, and level of antiacetylcholine receptor antibody. Clinical examination was evaluated according to the modified quantitative MG score (QMGS). Examination of level of antiacetylcholine receptor antibody was performed by immunoprecipitated RIA method. Examinations of cytokines such as tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, IL-4 and IL-10 were performed by ELISA. The RNS tests were fulfilled by Oh's method. The maximal decremental rate was checked in the orbicularis oculi and the abductor digiti minimi muscles. Twenty six among 33 included patients were taken steroids or other immunosuppressants. The levels of the acetylcholine receptor antibody correlated with the maximal decremental rate score of RNS tests (r = 0.5, P < 0.05). The levels, however, did not correlate with any other factors including QMGS and the levels of cytokines. On the other hand, TNF-α, IL-4 and IL-10 was not checked by commercially offered the standard diluent buffer. The level of antiacetylcholine receptor antibodies correlated with the score of the maximal decremental rate of RNS tests. This finding may result from the similar reflection of the status of impairment in neuromuscular junction because the standard immunoprecipitated RIA examines "binding antibodies" which destruct the acetylcholine receptor mainly.

Author dc:creator

• 이, 진수

Contributors dc:contributor

• 주, 인수
• 대학원 의학과
• 104249

• 중증근무력증
• 아세틸콜린수용체 항체
• 반복신경자극검사
• 사이토카인
• myasthenia gravis
• antiacetylcholine receptor antibody
• repetitive nerve stimulation test
• cytokine

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000000167
000000000167

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1480