Myasthenia gravis - autoantibody characteristics and their implications for therapy.
Myasthenia gravis (MG) is an autoimmune disorder caused by autoantibodies that target the neuromuscular junction, leading to muscle weakness and fatigability. Currently available treatments for the disease include symptomatic pharmacological treatment, immunomodulatory drugs, plasma exchange, thymectomy and supportive therapies. Different autoantibody patterns and clinical manifestations characterize different subgroups of the disease: early-onset MG, late-onset MG, thymoma MG, muscle-specific kinase MG, low-density lipoprotein receptor-related protein 4 MG, seronegative MG, and ocular MG. These subtypes differ in terms of clinical characteristics, disease pathogenesis, prognosis and response to therapies. Patients would, therefore, benefit from treatment that is tailored to their disease subgroup, as well as other possible disease biomarkers, such as antibodies against cytoplasmic muscle proteins. Here, we discuss the different MG subtypes, the sensitivity and specificity of the various antibodies involved in MG for distinguishing between these subtypes, and the value of antibody assays in guiding optimal therapy. An understanding of these elements should be useful in determining how to adapt existing therapies to the requirements of each patient.
Department of Clinical Medicine, University of Bergen, Postboks 7804, 5020 Bergen, Norway.|Department of Neurology, Haukeland University Hospital, Postbox 1400, 5021 Bergen, Norway.
Nils Erik
NE
Gilhus
Department of Clinical Medicine, University of Bergen, Postboks 7804, 5020 Bergen, Norway.|Department of Neurology, Haukeland University Hospital, Postbox 1400, 5021 Bergen, Norway.
Geir Olve
GO
Skeie
Department of Clinical Medicine, University of Bergen, Postboks 7804, 5020 Bergen, Norway.|Department of Neurology, Haukeland University Hospital, Postbox 1400, 5021 Bergen, Norway.
Fredrik
F
Romi
Department of Neurobiology, Hellenic Pasteur Institute, 127 Vassilissis Sofias Avenue 115 21, Ampelokipi, Athens, Greece.
Konstantinos
K
Lazaridis
Department of Neurobiology, Hellenic Pasteur Institute, 127 Vassilissis Sofias Avenue 115 21, Ampelokipi, Athens, Greece.
Paraskevi
P
Zisimopoulou
Department of Neurobiology, Hellenic Pasteur Institute, 127 Vassilissis Sofias Avenue 115 21, Ampelokipi, Athens, Greece.
Socrates
S
Tzartos
D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D006801:Humans; D009157:Myasthenia Gravis / Q000097:blood* / Q000145:classification / Q000503:physiopathology / Q000628:therapy; D009469:Neuromuscular Junction / Q000276:immunology*
D001323:Autoantibodies; D015415:Biomarkers