title: Intercommunication between the neuroendocrine and immune systems: focus on myasthenia gravis.
abstract: Crosstalk exists between the nervous, endocrine, and immune systems, and perturbations in these interactions have been associated with disease. This includes production of neuroendocrine factors that alter immune system activity and increase susceptibility to or severity of immune-related conditions, such as myasthenia gravis (MG)--a T-cell-dependent, B-cell-mediated autoimmune disorder. MG results from impairment of transmission to the neuromuscular junction and involves the thymus--especially in early-onset disease, but the exact mechanism by which the thymus impacts disease is unclear. MG afflicts millions of individuals worldwide each year, and both men and women can develop symptoms. However, prevalence and age of onset differs between men and women. Women exhibit higher incidence and earlier age of onset compared to men, and disease fluctuates during pregnancy. This suggests that sex hormones play a role in influencing disease outcome. In this review, we will consider what is known about the manifestation of MG, theories on how different forms of MG are influenced or alleviated by steroid hormones, current treatment options, and what measures could be important to consider in the future.
authors.affiliation: Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases/National Institutes of Health, and Laboratory of Immunology, Division of Therapeutic Proteins, Office of Biotechnology Products, Center for Drug Evaluation and Research, US Food and Drug Administration, Bethesda, MD 20892, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Mays
authors.forename: Cherié L
authors.initials: CL
authors.lastname: Butts
mesh_terms: D017668:Age of Onset; D005260:Female; D012739:Gonadal Steroid Hormones; D006801:Humans; D007107:Immune System / Q000503:physiopathology*; D008297:Male; D009157:Myasthenia Gravis / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology*; D009490:Neurosecretory Systems / Q000503:physiopathology*; D012307:Risk Factors; D012737:Sex Factors; D013950:Thymus Gland
chemical_list: D012739:Gonadal Steroid Hormones