Effect of thymectomy and immunosuppressive therapy on anti-neuroblastoma antibody levels in patients with myasthenia gravis.
Antibodies reacting with human neuroblastoma cells (NBL) are distinct from the "classical" anti-acetylcholine receptor (AChR) antibodies in myasthenia gravis (MG). The influence of therapeutic interventions on serum anti-NBL antibody levels was followed in 42 MG patients. Thymectomy alone was performed in 28 patients while immunosuppressive medication was given to 14 patients out of whom 10 also had a thymectomy. In most patients serum anti-NBL antibody titers declined after thymectomy and/or during immunosuppressive treatment, though individual variations in the antibody response could be observed. Sequential examinations of individual patients revealed an association between the clinical severity of MG and anti-NBL antibody levels. No correlation between the treatment-induced changes of anti-NBL and anti-acetylcholine receptor (AChR) antibody titers could be observed during the follow-up period in MG patients positive for both types of antibodies. These findings further emphasize the immunological complexity of MG. Anti-NBL antibodies represent a pathogenic marker of the disease and display a regulation different from that of the anti-AChR antibodies.
Müller
K M
KM
Department of Neurology, University of Helsinki, Finland.
Nykyri
E
E
Andersson
L C
LC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000032:analysis*; D001379:Azathioprine / Q000627:therapeutic use*; D002460:Cell Line; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000276:immunology* / Q000628:therapy; D009419:Nerve Tissue Proteins / Q000276:immunology*; D009447:Neuroblastoma; D011241:Prednisone / Q000627:therapeutic use*; D011950:Receptors, Cholinergic / Q000276:immunology; D013934:Thymectomy; D014407:Tumor Cells, Cultured / Q000276:immunology
D001323:Autoantibodies; D009419:Nerve Tissue Proteins; D011950:Receptors, Cholinergic; D001379:Azathioprine; D011241:Prednisone