Use of Torpedo-mouse hybrid acetylcholine receptors reveals immunodominance of the alpha subunit in myasthenia gravis antisera.

The nicotinic acetylcholine receptor (AChR), a pentameric complex of alpha 2 beta gamma delta subunits, is the autoantigen in the human autoimmune disease myasthenia gravis (MG). Anti-AChR antibodies are found in approximately 90% of MG patients and using indirect methods (competitive binding to solubilized AChR), peptides, or synthetic peptides, the majority of these antibodies have been shown to bind to the AChR alpha subunit. In order to determine directly the AChR subunit specificities of MG antibodies, we employed as antigens a novel set of hybrid AChR composed of species cross-reacting and non-cross-reacting subunits stably expressed in fibroblasts. Sequence similarities of homologous subunits among species can vary widely, with mammalian subunits having 87%-96% identity and Torpedo-mammalian subunits having 54%-80% identity. These findings are reflected in antigenic specificities, with human anti-AChR antisera frequently recognizing mouse AChR but rarely recognizing Torpedo. By establishing separate cell lines stably expressing all-Torpedo, all-mouse, and different combinations of Torpedo and mouse subunits, we were able to provide the first direct evidence of a predominant anti-alpha subunit specificity in MG antisera. Functional hybrid AChR stably expressed in an intact cell membrane provide us with a system that best mimics the in vivo environment of the MG antibody in a binding assay. Such a system allows us to investigate a perplexing observation in the field: a poor correlation between the patient's clinical status and antibody titer. Those antibodies which can interfere with AChR function, such as ones with the ability to cross-link AChR and induce their accelerated internalization and degradation (antigenic modulation) might represent a subpopulation of MG antibodies important in disease induction or maintenance. In this report, we demonstrate that wild-type and hybrid AChR expressed in fibroblasts can be antigenically modulated by intermolecular cross-linking antibodies as AChR are in native muscle cells. Because we can monitor dynamic interactions between AChR and MG antibodies, this system may allow us to define crucial pathogenic epitopes in MG by expressing hybrid, chimeric, and mutant AChR.