Decreased beta2-adrenergic receptor density on peripheral blood mononuclear cells in myasthenia gravis.

Beta2-adrenergic receptors (beta2AR) are present on both lymphocytes and skeletal muscle cells. Antibodies and T cells that react with these receptors are present in patients with myasthenia gravis (MG). Immune reactivity against the beta2AR may thus modify both the immune and the muscle functions in MG. In this study, we analysed the density and affinity of beta2AR on peripheral blood mononuclear cells using a radioligand binding assay. The density (Bmax) of the receptor on cells from patients with MG was significantly lower than that on cells from patients with other neurological disorders and healthy individuals. The affinity (Kd) of the receptor and the concentration of the second messenger, cAMP, in the cells did not differ between the groups. Serum antibodies against beta2AR were demonstrated in 22% of 27 MG patients vs. 0% of 26 healthy controls. Incubation of cells with serum or purified IgG containing antibodies against the beta2AR resulted in a decline in ligand binding of the receptor in samples from three out of five patients. Thus, this study suggests that a downregulation of the beta2AR may occur in MG. This downregulation might be of importance in the patho-genesis of the disease and its symptoms.