Thomas J A, Willcox H N, Newsom-Davis J
J Neuroimmunol. 1982 Dec;3(4):319-35. doi: 10.1016/0165-5728(82)90035-2.
In frozen sections of thymus from 9 out of 12 myasthenia gravis patients, the medulla contained follicles of B lymphocytes with germinal centres showing the same immunofluorescence staining pattern as is seen normally in reactive lymphoid tissues. Only 1 similar follicle was seen in 9 normal thymus samples. There was a positive association between the extent of germinal centres, plasma anti-acetylcholine receptor (AChR) titre, and spontaneous anti-AChR production by thymocytes in vitro. These thymic changes were not universally found, and are thus probably not central to the initiation of myasthenia. Between the follicles, in 9 cases, there was an apparent increase in interdigitating cells with closely associated 'inducer' (OKT4+)T lymphocytes. Thymic antigen presenting cells--either here or in the germinal centres--could be involved in breaking self-tolerance, or in perpetuating the autoimmune response, and it may be their removal that is therapeutic.
在12例重症肌无力患者中，有9例患者胸腺冰冻切片的髓质含有B淋巴细胞滤泡，其生发中心呈现出与反应性淋巴组织中正常所见相同的免疫荧光染色模式。在9份正常胸腺样本中仅见1个类似滤泡。生发中心的范围、血浆抗乙酰胆碱受体（AChR）滴度以及胸腺细胞体外自发抗AChR产生之间存在正相关。这些胸腺变化并非普遍存在，因此可能并非重症肌无力发病的核心因素。在9例患者中，滤泡之间的指状交叉细胞与紧密相关的“诱导性”（OKT4 +）T淋巴细胞明显增多。胸腺抗原呈递细胞——无论是在此处还是在生发中心——可能参与打破自身耐受性或使自身免疫反应持续存在，而去除它们可能具有治疗作用。
