title: Production of anti-acetylcholine receptor-alpha antibody in vitro by peripheral blood lymphocytes of patients with myasthenia gravis: role of immunoregulatory T cells and monocytes.
abstract: To study the role of T cells in T and B cell interaction resulting in production of antibody (Ab) to the alpha chain of acetylcholine receptor (anti-AChR-alpha Ab) in myasthenia gravis (MG), we cocultured peripheral blood-purified B and T cells of patients with MG and of control subjects with and without multiple sclerosis in the presence of AChR-alpha or pokeweed mitogen. Under these conditions, a high level of anti-AChR-alpha Ab was produced by cells of patients with MG but not of control subjects. Production of anti-AChR-alpha Ab by B cells was stimulated by autologous purified or cloned CD4+ T cells, whereas autologous CD8+ T cells had no effect. CD8+ T cells did not suppress anti-AChR-alpha Ab production when added to B cells cocultured with CD4+ T cell clones. Anti-AChR-alpha Ab production was inhibited by monoclonal antibodies against CD4 and class II major histocompatibility complex (MHC) antigens, indicating that these antigens are required for productive T-B cell interactions resulting in anti-AChR-alpha Ab synthesis. Anti-AChR-alpha Ab production by peripheral blood lymphocytes of patients with MG was significantly lower than that by their purified or cloned T cells cultured with B cells. Cell-mixing experiments indicated that anti-AChR-alpha Ab synthesis was inhibited by monocytes. The prostaglandin synthetase inhibitor, indomethacin, partially restored the suppressive effect of monocytes on anti-AChR-alpha Ab synthesis. These results indicate that induction of anti-AChR-alpha Ab production by CD4+ T cell clones requires CD4 and class II MHC antigens and is inhibited by suppressor macrophages and not by CD8+ T cells.
authors.affiliation: Department of Medicine, Maimonides Medical Center, Brooklyn, NY 11219.
authors.forename: W
authors.initials: W
authors.lastname: Ofosu-Appiah
authors.forename: F
authors.initials: F
authors.lastname: Mokhtarian
authors.forename: D
authors.initials: D
authors.lastname: Shirazian
authors.forename: D
authors.initials: D
authors.lastname: Grob
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000494:pharmacology; D000917:Antibody Formation; D001402:B-Lymphocytes / Q000276:immunology* / Q000473:pathology / Q000502:physiology*; D015704:CD4 Antigens / Q000032:analysis; D016827:CD8 Antigens / Q000032:analysis; D002450:Cell Communication / Q000187:drug effects / Q000502:physiology; D002478:Cells, Cultured; D005260:Female; D000949:Histocompatibility Antigens Class II / Q000276:immunology; D006801:Humans; D007213:Indomethacin / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology* / Q000473:pathology / Q000502:physiology*; D009157:Myasthenia Gravis / Q000276:immunology* / Q000378:metabolism / Q000503:physiopathology; D010641:Phenotype; D011950:Receptors, Cholinergic / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology* / Q000473:pathology / Q000502:physiology*
chemical_list: D000911:Antibodies, Monoclonal; D015704:CD4 Antigens; D016827:CD8 Antigens; D000949:Histocompatibility Antigens Class II; D011950:Receptors, Cholinergic; D007213:Indomethacin