Uzawa Akiyuki, Kanai Tetsuya, Kawaguchi Naoki, Oda Fumiko, Himuro Keiichi, Kuwabara Satoshi
Department of Neurology, Graduate School of Medicine, Chiba University, Japan.
Department of Neurology, Neurology Chiba Clinic, Japan.
Sci Rep. 2016 May 13;6:25886. doi: 10.1038/srep25886.
Myasthenia gravis (MG) is an autoimmunological inflammatory disorder of the neuromuscular junction. Inflammation could be a key player for understanding the pathogenesis of MG. We measured the serum levels of 24 inflammatory cytokines in 43 patients with anti-acetylcholine receptor antibody-positive MG and 25 healthy controls. In patients with MG, serum levels of a proliferation-inducing ligand (APRIL), IL-19, IL-20, IL-28A and IL-35 were significantly increased as compared with controls (p < 0.05). Among them, IL-20, IL-28A and IL-35 were significantly decreased after treatment (p < 0.05). In clinical subtype analyses, APRIL and IL-20 were increased in patients with late-onset MG and IL-28A levels were increased in patients with thymoma-associated MG compared with healthy controls (p < 0.01). The results of the present study demonstrate both anti-inflammatory and inflammatory cytokines are upregulated in MG, reflecting the importance of cytokine-mediated inflammation and its regulation in MG pathophysiology.
重症肌无力（MG）是一种神经肌肉接头处的自身免疫性炎症性疾病。炎症可能是理解MG发病机制的关键因素。我们检测了43例抗乙酰胆碱受体抗体阳性的MG患者和25名健康对照者血清中24种炎性细胞因子的水平。与对照组相比，MG患者血清中增殖诱导配体（APRIL）、IL-19、IL-20、IL-28A和IL-35的水平显著升高（p<0.05）。其中，治疗后IL-20、IL-28A和IL-35显著降低（p<0.05）。在临床亚型分析中，与健康对照相比，迟发性MG患者的APRIL和IL-20升高，胸腺瘤相关MG患者的IL-28A水平升高（p<0.01）。本研究结果表明，抗炎和炎性细胞因子在MG中均上调，反映了细胞因子介导的炎症及其调节在MG病理生理学中的重要性。
