The role of the thymus in myasthenia gravis.

The experimental work discussed here supports the hypothesis that in the pathogenesis of MG the initial and essential steps take place within the thymus. Most if not all thymuses of MG patients contain B cells capable of producing AChR specific autoantibody along with appropriate stroma elements. Hyperplastic thymuses characteristically contain germinal centers with cellular complexes of AChR-producing MC and surrounding interdigitating dendritic cells. In thymomas, the source of the myasthenogenic autoantigen is less obvious. There are data suggesting that thymoma epithelium expresses a protein sharing certain peptide epitopes with the AChR alpha chain, although there is no further molecular similarity. A unique type of 'molecular self-mimicry' cold be involved in the initiation of thymoma-associated MG.