Huang G Z, Lo Y L
Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
J Clin Neuromuscul Dis. 2013 Jun;14(4):209-17. doi: 10.1097/CND.0b013e31828a0090.
Myasthenia gravis is the most common chronic autoimmune neuromuscular disease. Anti-acetylcholine receptor (AChR) antibodies are found in at least 80% of patients with generalized myasthenia and have been implicated in disease pathogenesis. Thymic abnormalities are frequently found in seropositive patients, and the thymus is thought to be involved in generation of autoimmunity. This article reviews existing literature on the role of AChR antibodies in the pathogenesis of myasthenia gravis, and the correlation between AChR antibody titers and thymic pathology. Most studies found that highest titers are seen in thymic hyperplasia, followed by intermediate titers in thymoma, and lowest titers in atrophic or normal thymus. One publication found no difference between titers in thymoma and normal thymus.
重症肌无力是最常见的慢性自身免疫性神经肌肉疾病。至少80%的全身型重症肌无力患者体内可检测到抗乙酰胆碱受体(AChR)抗体,这些抗体与疾病的发病机制有关。血清学阳性患者常伴有胸腺异常,胸腺被认为参与了自身免疫的发生。本文综述了关于AChR抗体在重症肌无力发病机制中的作用以及AChR抗体滴度与胸腺病理之间相关性的现有文献。大多数研究发现,胸腺增生患者的抗体滴度最高,其次是胸腺瘤患者的滴度中等,而萎缩或正常胸腺患者的滴度最低。有一篇文献发现胸腺瘤患者和正常胸腺患者的抗体滴度没有差异。