Ahlberg R, Yi Q, Pirskanen R, Matell G, Sundevall A C, Aberg B, Lefvert A K
Immunological Research Laboratory and Section of Hematology and Immunology, Department of Medicine, Karolinska Hospital, Stockholm, Sweden.
J Neuroimmunol. 1997 Apr;74(1-2):45-54. doi: 10.1016/s0165-5728(96)00204-4.
Eleven patients with myasthenia gravis were followed for three years after thymectomy. Acetylcholine receptor-specific T-cell stimulation was found in 8/11 patients before operation as compared to 2/11 three years after thymectomy. Changes of T-cell antireceptor-reactivity were commonly paralleled by changes in disease severity. The numbers of cells secreting IL-2 upon stimulation with human acetylcholine receptor correlated with those secreting IFN-gamma. T-cell reactivity against a monoclonal acetylcholine receptor antibody did not decrease after thymectomy. Such reactivity could reflect a beneficial immune response counteracting anti-receptor reactivity. The frequency of autoantibody-secreting cells remained unchanged, while the serum concentration of acetylcholine receptor antibodies started to decrease one year after thymectomy. All examined thymus-cell suspensions contained autoreactive T- and B-lymphocytes. There was a preferential enrichment of autoreactive lymphocytes in the thymus in a few patients with recent onset of disease.
11例重症肌无力患者在胸腺切除术后接受了3年的随访。术前11例中有8例发现乙酰胆碱受体特异性T细胞刺激，而胸腺切除术后3年为11例中的2例。T细胞抗受体反应性的变化通常与疾病严重程度的变化平行。用人乙酰胆碱受体刺激后分泌IL-2的细胞数量与分泌IFN-γ的细胞数量相关。胸腺切除术后，T细胞对单克隆乙酰胆碱受体抗体的反应性并未降低。这种反应性可能反映了一种有益的免疫反应，可抵消抗受体反应性。自身抗体分泌细胞的频率保持不变，而乙酰胆碱受体抗体的血清浓度在胸腺切除术后1年开始下降。所有检测的胸腺细胞悬液均含有自身反应性T淋巴细胞和B淋巴细胞。在少数近期发病的患者中，胸腺中自身反应性淋巴细胞有优先富集。
