Analysis of immunoglobulin secretion by lymph organs with myasthenia gravis.
OBJECTIVE
To investigate in vitro anti-acetylcholine receptor (AChR) antibody secretion by lymph organs with myasthenia gravis (MG) with special attention to clinical status and stages.


METHODS
Twenty MG patients before therapy were included in this study. Four patients were negative for serum anti-AChR antibodies (AChRAb). All patients received extended thymectomy. Thymic cells, bone marrow (BM) cells and peripheral blood mononuclear cells (PBMC) were cultured for 1 week. AChRAb secretion and IgG secretion in the culture medium were determined by immunoprecipitation assays and ELISA respectively.


RESULTS
PBMC secreted AChRAb and IgG most efficiently, followed by BM cells, and then thymic cells. Even in patients whose diseases were of short duration (less than 2 months), the tendency was not changed. AChRAb secretion by BM cells and PBMC significantly correlated with serum AChRAb levels. Thymectomy did not change AChRAb or IgG secretion by PBMC within 3 months. AChRAb secretion by PBMC paralleled the clinical status. Some seronegative patients turned positive by culturing PBMC.


CONCLUSIONS
PBMC is the most efficient site at producing AChRAb, even in patients of short duration (equal to, or less than, 2 months). Monitoring AChRAb secretion by PBMC is useful to estimate the autoimmune activity of MG.
Yoshikawa
H
H
Health Service Center, Kanazawa University, Ishikawa, Japan. hiroaki@kenroku.kanazawa-u.ac.jp
Satoh
K
K
Yasukawa
Y
Y
Yamada
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D001854:Bone Marrow Cells / Q000276:immunology; D002478:Cells, Cultured; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008208:Lymphatic System / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology; D009157:Myasthenia Gravis / Q000276:immunology* / Q000601:surgery; D011950:Receptors, Cholinergic / Q000276:immunology*; D013934:Thymectomy; D013950:Thymus Gland / Q000276:immunology
D001323:Autoantibodies; D007074:Immunoglobulin G; D011950:Receptors, Cholinergic