title: Clinical and scientific aspects of acetylcholine receptor myasthenia gravis.
abstract: OBJECTIVE
  Myasthenia gravis is a rare disease that causes impairment of the neuromuscular junction. In this review we will focus on the literature published in the last 18 months regarding autoimmune myasthenia gravis caused by antibodies against the nicotinic acetylcholine receptor myasthenia gravis. Acetylcholine receptor is the most common target of this autoimmune disease.
  
  
  RESULTS
  A high number of long-lived plasma cells are present in myasthenia gravis patients. Treatments to eliminate these plasma cells, such as proteasome inhibitors, have proved utility in experimental autoimmune myasthenia gravis. MicroRNAs may have a role as biomarkers in myasthenia gravis. Epstein-Barr virus and human polyomavirus 7 are often found in myasthenia gravis thymus and may play a role in the initiation of the autoimmune process. Robotic thymectomy has been proved well tolerated and minimally invasive for the patients and is likely to replace open surgery.
  
  
  CONCLUSIONS
  Knowledge of the initiation and perpetuation of the autoimmune response in myasthenia gravis condition is increasing every year. This knowledge is paired with in-vivo and in-vitro studies that are directed to further understand this disease, and to improve current treatment options in severe or nonresponding patients. Specific treatments and diagnosis in myasthenia gravis tend to an early detection and a better quality of life.
authors.affiliation: aDepartment of Cardiothoracic Surgery and Pulmonology, Maastricht University Medical Centre, Maastricht and GROW School for Oncology and Developmental Biology, Maastricht University bSchool for Mental Health and Neuroscience, MHeNS, Maastricht University Medical Centre, Maastricht, The Netherlands cNeuromuscular DiseasesUnit, Institut de Recerca del Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain *Marlies Keijzers and Gisela Nogales-Gadea contributed equally to the writing of this article.
authors.forename: Marlies
authors.initials: M
authors.lastname: Keijzers
authors.forename: Gisela
authors.initials: G
authors.lastname: Nogales-Gadea
authors.forename: Marc
authors.initials: M
authors.lastname: de Baets
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D004854:Herpesvirus 4, Human; D006801:Humans; D035683:MicroRNAs / Q000235:genetics / Q000378:metabolism; D009157:Myasthenia Gravis / Q000235:genetics / Q000473:pathology / Q000628:therapy; D011120:Polyomavirus; D011950:Receptors, Cholinergic / Q000276:immunology*; D013934:Thymectomy
chemical_list: D001323:Autoantibodies; D035683:MicroRNAs; D011950:Receptors, Cholinergic