The effect of thymectomy on autoreactive T- and B-lymphocytes in myasthenia gravis.
Eleven patients with myasthenia gravis were followed for three years after thymectomy. Acetylcholine receptor-specific T-cell stimulation was found in 8/11 patients before operation as compared to 2/11 three years after thymectomy. Changes of T-cell antireceptor-reactivity were commonly paralleled by changes in disease severity. The numbers of cells secreting IL-2 upon stimulation with human acetylcholine receptor correlated with those secreting IFN-gamma. T-cell reactivity against a monoclonal acetylcholine receptor antibody did not decrease after thymectomy. Such reactivity could reflect a beneficial immune response counteracting anti-receptor reactivity. The frequency of autoantibody-secreting cells remained unchanged, while the serum concentration of acetylcholine receptor antibodies started to decrease one year after thymectomy. All examined thymus-cell suspensions contained autoreactive T- and B-lymphocytes. There was a preferential enrichment of autoreactive lymphocytes in the thymus in a few patients with recent onset of disease.
Ahlberg
R
R
Immunological Research Laboratory and Section of Hematology and Immunology, Department of Medicine, Karolinska Hospital, Stockholm, Sweden. ahlberg@divmed.se
Yi
Q
Q
Pirskanen
R
R
Matell
G
G
Sundevall
A C
AC
Aberg
B
B
Lefvert
A K
AK
D000328:Adult; D000368:Aged; D000906:Antibodies / Q000032:analysis; D000911:Antibodies, Monoclonal / Q000032:analysis / Q000276:immunology; D001323:Autoantibodies / Q000032:analysis; D015551:Autoimmunity; D001402:B-Lymphocytes / Q000276:immunology*; D003208:Concanavalin A / Q000494:pharmacology; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D007376:Interleukin-2 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000503:physiopathology; D009157:Myasthenia Gravis / Q000276:immunology* / Q000503:physiopathology / Q000601:surgery*; D011950:Receptors, Cholinergic / Q000276:immunology / Q000502:physiology; D013601:T-Lymphocytes / Q000276:immunology*; D013934:Thymectomy
D000906:Antibodies; D000911:Antibodies, Monoclonal; D001323:Autoantibodies; D007376:Interleukin-2; D011950:Receptors, Cholinergic; D003208:Concanavalin A; D007371:Interferon-gamma