Kang Sa-Yoon, Oh Jung-Hwan, Song Sook Keun, Lee Jung Seok, Choi Jay Chol, Kang Ji-Hoon
Department of Neurology, Jeju National University School of Medicine, 1 Ara 1-dong, Jeju-si, Jeju, 690-756, Republic of Korea,
Neurol Sci. 2015 Jul;36(7):1167-71. doi: 10.1007/s10072-015-2236-8. Epub 2015 May 12.
Myasthenia gravis (MG) is an autoimmune disease associated with antibodies directed to the postsynaptic muscle components of the neuromuscular junction. The heterogeneous nature of the acetylcholine receptor (AChR) antibody response had led to the categorization of AChR antibodies into 3 types: binding, blocking, and modulating antibodies. The purpose of this study is to compare the AChR antibodies' type with the clinical severity of MG patients. The patients enrolled in the study had been tested for both binding and blocking antibodies and had disease duration exceeding 2 years since diagnosis. The patients were divided into five main classes by the Myasthenia Gravis Foundation of America clinical classification. Again, the enrolled patients were divided into ocular and generalized group. We compared the type and titer of antibodies and the thymus status between the ocular and generalized group. Thirty-five patients met the inclusion criteria. Of these, 16 patients (47 %) had both blocking and binding AChR antibodies, 11 patients (31 %) had only binding antibodies, and 8 patients (22 %) had only blocking antibodies. By defined clinical classification, the ocular and generalized groups included 10 and 25 patients, respectively. Sixteen patients in the generalized group possessed both AChR antibodies, with the remaining patients displaying only the binding antibody. All the patients with only blocking antibody were classified into ocular group. Use of binding and blocking antibodies' tests may, therefore, be more helpful in predicting the prognosis and diagnoses of MG patient.
重症肌无力（MG）是一种自身免疫性疾病，与针对神经肌肉接头突触后肌肉成分的抗体有关。乙酰胆碱受体（AChR）抗体反应的异质性导致AChR抗体被分为3种类型：结合抗体、阻断抗体和调节抗体。本研究的目的是比较AChR抗体类型与MG患者的临床严重程度。纳入研究的患者已检测结合抗体和阻断抗体，且自诊断以来病程超过2年。根据美国重症肌无力基金会临床分类，将患者分为五个主要类别。同样，将纳入的患者分为眼肌型和全身型组。我们比较了眼肌型和全身型组之间的抗体类型和滴度以及胸腺状态。35例患者符合纳入标准。其中，16例患者（47%）同时具有阻断和结合AChR抗体，11例患者（31%）仅具有结合抗体，8例患者（22%）仅具有阻断抗体。根据既定的临床分类，眼肌型组和全身型组分别包括10例和25例患者。全身型组中有16例患者同时拥有两种AChR抗体，其余患者仅显示结合抗体。所有仅具有阻断抗体的患者均被分类为眼肌型组。因此，使用结合抗体和阻断抗体检测可能对预测MG患者的预后和诊断更有帮助。
