Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Department of Neurology, Japanese Red Cross Narita Hospital, Narita, Japan.
Scand J Immunol. 2024 May;99(5):e13360. doi: 10.1111/sji.13360. Epub 2024 Feb 14.
Myasthenia gravis (MG) is an autoantibody-mediated disease of the neuromuscular junction. Semaphorin 4A (Sema4A) is involved in the activation of T cells in various inflammatory disorders. In this study, we aimed to investigate whether Sema4A is involved in the pathogenesis of MG. We measured serum Sema4A concentrations in 30 treatment-naïve MG patients with acetylcholine receptor (AChR) antibodies, 7 with muscle-specific tyrosine kinase (MuSK) antibodies and 21 normal controls. As a result, serum Sema4A levels were significantly higher in patients with AChR antibody-positive MG and MuSK antibody-positive MG than in controls (p ≤ 0.0001 for both MG groups). Serum Sema4A levels were correlated with AChR antibody levels (Spearman's ρ = 0.39, p = 0.03) and MG Foundation of America clinical classification classes (Spearman's ρ = 0.38, p = 0.04) in patients with AChR antibody-positive MG. In conclusion, high serum Sema4A levels may reflect T-cell activation, and this molecule could be a potential marker of disease activity in MG.
重症肌无力（MG）是一种神经肌肉接头的自身抗体介导的疾病。信号素 4A（Sema4A）参与各种炎症性疾病中 T 细胞的激活。在本研究中，我们旨在研究 Sema4A 是否参与 MG 的发病机制。我们测量了 30 名未经治疗的乙酰胆碱受体（AChR）抗体阳性 MG 患者、7 名肌肉特异性酪氨酸激酶（MuSK）抗体阳性 MG 患者和 21 名正常对照者的血清 Sema4A 浓度。结果显示，AChR 抗体阳性 MG 和 MuSK 抗体阳性 MG 患者的血清 Sema4A 水平明显高于对照组（两组 p 值均≤0.0001）。AChR 抗体阳性 MG 患者的血清 Sema4A 水平与 AChR 抗体水平（Spearman's ρ=0.39，p=0.03）和美国重症肌无力基金会临床分类（Spearman's ρ=0.38，p=0.04）呈正相关。综上所述，高血清 Sema4A 水平可能反映 T 细胞激活，该分子可能是 MG 疾病活动的潜在标志物。
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