Plasma exchange in myasthenia gravis: effect on anti-AChR antibodies and other autoantibodies

Abstract

Plasma exchange (PE) was performed in 6 patients with myasthenia gravis (MG). Acetylcholine receptor (AChR) antibodies and other MG-correlated antibodies were quantified each day before, during and after PE. The antibody concentrations decreased during PE with a consisting increase between two exchanges. Repeated PE induced a transient decline in the AChR antibody concentration. The clinical improvement was maximal during the week after PE and correlated in time with increasing concentrations of AChR antibodies.

MuSK antibody clearance during serial sessions of plasmapheresis for myasthenia gravis

“…Similarly, it has been observed that an elevated level of AchRAb in a single individual predicted clinical deterioration for AchR-MG patients [7]. Therefore, regardless of types of antibodies (AchRAb or MuSKAb) in MG patients, the declining level of antibodies broadly correlated with clinical improvement.…”

The Role of Pathogenic Autoantibodies in Autoimmunity

“…Herpes gestationis yes [21,22] no [23] antigen differs yes [24][25][26][27] yes [28] Requires neutrophils yes [29] IvIg [20] Collagen VII Epidermolysis bullosa acquisita yes [30] limited cross-reactivity yes [31] yes [32] Requires neutrophils yes [33] IvIg [20] TSH receptor- 47] yes [48] yes [49] yes [50,51] Presynaptic voltagegated Ca ++ channels…”

Current and emerging treatments for the management of myasthenia gravis

“…In MG, the concentration of AChR and MuSK antibodies has been shown to decrease with plasma exchange 74,75. Plasma exchange was first used in the 1970s in MG 76.…”