Yi Q, Lefvert A K
Immunological Research Laboratory, Karolinska Hospital, Stockholm, Sweden.
Drugs Aging. 1997 Aug;11(2):132-9. doi: 10.2165/00002512-199711020-00005.
Myasthenia gravis (MG) is undoubtedly the most thoroughly understood of all human autoimmune diseases. The basic defect in the disease is a decrease in the number of available acetylcholine receptors (AChR) at neuromuscular junctions caused by an antibody-mediated autoimmune attack. Current treatments aimed at restoring the available AChR, depleting the autoantibodies or suppressing the immune system have been so effective that most patients can lead normal lives. However, prolonged drug treatment is required, and this carries a potential risk of drug toxicity and, in the case of immunosuppressants, systemic immunosuppression. The ideal treatment for MG would eliminate only the abnormal autoimmune response without interfering with the immune system. During the past 20 years, impressive advances have been made in our understanding of the immunology and molecular biology of MG. Accordingly, it should be possible to design rational and immune-based therapies in the future. In this article, we briefly review the current treatment modalities for MG, and discuss the prospects for immunotherapy.
重症肌无力（MG）无疑是所有人类自身免疫性疾病中了解最为透彻的一种。该疾病的基本缺陷是神经肌肉接头处可用乙酰胆碱受体（AChR）数量减少，这是由抗体介导的自身免疫攻击所致。目前旨在恢复可用AChR、消耗自身抗体或抑制免疫系统的治疗方法非常有效，以至于大多数患者能够过上正常生活。然而，需要长期药物治疗，这存在药物毒性的潜在风险，对于免疫抑制剂而言，还存在全身免疫抑制的风险。MG的理想治疗方法应仅消除异常的自身免疫反应，而不干扰免疫系统。在过去20年里，我们对MG的免疫学和分子生物学的理解取得了令人瞩目的进展。因此，未来应该有可能设计出合理的基于免疫的疗法。在本文中，我们简要回顾了MG目前的治疗方式，并讨论了免疫治疗的前景。
