Acetylcholinesterase activity and menstrual remissions in myasthenia gravis.

Vijayan, Neelima; Vijayan, Vijaya K.; Dreyfus, P

doi:10.1136/jnnp.40.11.1060

Cited by 18 publications

(11 citation statements)

References 20 publications

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“…[74][75][76] In contrast to these disorders, myasthenia gravis generally improves premenstrually. 77 Although one early report indicated better outcomes if breast surgery was performed in the luteal phase, 78 subsequent investigators have been unable to confirm this finding. 79…”

Section: I S C E L L a N E O U S D I S O R D E R Smentioning

confidence: 99%

Menstrual cycle effects on common medical conditions

Case

Reid

2001

Compr Ther

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Section: I S C E L L a N E O U S D I S O R D E R Smentioning

confidence: 99%

Menstrual cycle effects on common medical conditions

Case

Reid

2001

Compr Ther

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“…Most patients in this subgroup present the human leukocyte antigen-B8 and -DR3 phenotype (30,31). Modulation of the clinical symptoms of MG during pregnancy or menstruation has been reported, and this phenomenon disappears after thymectomy (32).…”

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confidence: 98%

Differential Estrogen Receptor Expression in Autoimmune Myasthenia Gravis

Nancy¹,

Berrih‐Aknin²

2005

Endocrinology

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Myasthenia gravis (MG) is an autoimmune disease associated with thymic hyperplasia and is much more prevalent in women than men. In this study we investigated potential changes in estrogen receptor (ER) expression in thymic hyperplasia. We first quantified by real-time PCR the relative expression of ER alpha and ER beta in normal thymus and found that the ER beta to ER alpha ratio was inverted in thymocytes (8.6 +/- 1.2), compared with thymic epithelial cells (0.18 +/- 0.05). The ER transcript number gradually decreased in thymic epithelial cells during culture, indicating that the thymic environment influences ER expression. CD4+ helper T cells expressed higher level of ERs, compared with CD8+ cells, as assessed by flow cytometry in thymocytes and peripheral blood mononuclear cells. In MG patients, we found an increased expression of ER alpha on thymocytes and both ERs on T cells from peripheral blood mononuclear cells, indicating that the signals provided by thymic and peripheral microenvironments are distinct. Finally, activation of normal thymocytes by proinflammatory cytokines induced increased expression of ERs especially in the CD4+ subset, suggesting that an excess of proinflammatory cytokines could explain the increase of ERs expression on MG lymphocytes. The dysregulation of ER expression in MG lymphocytes could affect the maintenance of the homeostatic conditions and might influence the progression of the autoimmune response.

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“…Current studies demonstrate no increase in spontaneous abortion rate (14,15). Some reports have shown a tendency for MG to improve before and during menstruation, whereas others have shown a worsening during this same time (16). A prospective study showed that MG frequently exacerbates before and during the menstrual period in 67% of patients (5).…”

Section: Discussionmentioning

confidence: 94%