title: Increased frequency of thymic T follicular helper cells in myasthenia gravis patients with thymoma.
abstract: BACKGROUND
  To investigate the presence of T follicular helper (TFH) cells and their associated molecules in myasthenia gravis (MG) patients with thymoma.
  
  
  METHODS
  TFH cells are detected in thymus around the thymoma region of 50 patients and atrophic thymus in 10 patients as control. The percentage of TFH cells among CD4(+) T cells and the expression level of surface markers CXC chemokine receptor 5 (CXCR5), inducible co-stimulator (ICOS), programmed cell death 1 and the cytoplasmic marker B cell lymphoma 6 (Bcl-6) were analyzed by immunohistochemistry (IHC) staining, immunofluorescence (IF) and western blotting (WB).
  
  
  RESULTS
  Higher percentage of thymic TFH cells was found in MG patients with thymoma compared with both thymoma patients without MG and control group. The expression levels of the four markers in thymoma of MG patients were significantly higher than thymoma patients without MG and control group. No significant difference was found in the levels of programmed cell death 1 (PD-1) and Bcl-6 between thymoma patients without MG and the control, while the levels of CXCR5 and ICOS in thymoma patients without MG were higher than control group.
  
  
  CONCLUSIONS
  These results suggested thymic TFH cells might involve in the pathogenesis of MG with thymoma. However, it needs further study to test if the inhibition of the function of TFH cells could effectively alleviate the severity of MG.
authors.affiliation: 1 Department of Cardio-thoracic Surgery, 2 Department of Neurology, 3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Song
authors.affiliation: 1 Department of Cardio-thoracic Surgery, 2 Department of Neurology, 3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhou
authors.affiliation: 1 Department of Cardio-thoracic Surgery, 2 Department of Neurology, 3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Miao
authors.affiliation: 1 Department of Cardio-thoracic Surgery, 2 Department of Neurology, 3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.affiliation: 1 Department of Cardio-thoracic Surgery, 2 Department of Neurology, 3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: 1 Department of Cardio-thoracic Surgery, 2 Department of Neurology, 3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Gao
authors.affiliation: 1 Department of Cardio-thoracic Surgery, 2 Department of Neurology, 3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Yiqing
authors.initials: Y
authors.lastname: Wang
authors.affiliation: 1 Department of Cardio-thoracic Surgery, 2 Department of Neurology, 3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Liewen
authors.initials: L
authors.lastname: Pang
authors.affiliation: 1 Department of Cardio-thoracic Surgery, 2 Department of Neurology, 3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Chongbo
authors.initials: C
authors.lastname: Zhao
authors.affiliation: 1 Department of Cardio-thoracic Surgery, 2 Department of Neurology, 3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Xiaotian
authors.initials: X
authors.lastname: Sun
authors.affiliation: 1 Department of Cardio-thoracic Surgery, 2 Department of Neurology, 3 Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Chen
keywords: Myasthenia gravis (MG); T follicular helper cells (TFH cells); program death 1 (PD-1); thymoma