Strategies for the Treatment of Myasthenia Gravis

Drachman, Daniel B.; McIntosh, Kevin R.; Silva, Shari de; Kuncl, Ralph W.; Kahn, Carolyn R.

doi:10.1111/j.1749-6632.1988.tb27060.x

Cited by 21 publications

(2 citation statements)

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“…Immunoglobulins to postsynaptic receptors have not yet been identified following neurotoxic exposures but are likely to play a role in neuropathy. This is recognized in myasthenia gravis with autoantibodies to the nicotinic acetylcholine (ACh) receptor (49), antimuscarinic (m)AChR in Chagas disease (162), and anti-P-adrenoceptors in dilated cardiomyopathy (163,164).…”

Section: Anti-nf-68mentioning

confidence: 99%

Neuroimmunotoxicology: humoral assessment of neurotoxicity and autoimmune mechanisms.

El-Fawal

Waterman

Feo

et al. 1999

Environ Health Perspect

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The interactions between the nervous and immune systems have been recognized in the development of neurodegenerative disease. This can be exploited through detection of the immune response to autoantigens in assessing the neurotoxicity of environmental chemicals. To test this hypothesis, the following questions were addressed. a) Are autoantibodies to nervous system (NS) antigens detected in populations exposed to environmental or occupational chemicals? In sera of male workers exposed to lead or mercury, autoantibodies, primarily IgG, to neuronal cytoskeletal proteins, neurofilaments (NFs), and myelin basic protein (MBP) were prevalent. These findings were confirmed in mice and rats exposed to either metal. b) Do autoantibodies to NS antigens relate to indices of exposure? In humans exposed to either metal, and similarly in exposed rats, titers of IgG against NFs and MBP significantly correlated with blood lead or urinary mercury, the typical indices of exposure. c) Do autoantibodies correlate with sensorimotor deficits? In workers exposed to lead or mercury, a significant correlation was observed between IgG titers and subclinical deficits. Doses of metals used in rat exposures were subclinical, suggesting that autoantibodies may be predictive of neurotoxicity. d) Is the detection indicative of nervous system pathology? In rats exposed to metals, histopathology indicated central nervous system (CNS) and peripheral nervous system (PNS) damage. In addition there was evidence of astrogliosis, which is indicative of neuronal damage in the CNS, and the presence of IgG concentrated along the blood-brain barrier, as indicated by immunostaining for antibodies. e) Are immune responses to NS antigens pathogenic? Immunoglobulin fractions from rat and human sera interfered with neuromuscular function. These studies suggest that the detection of autoantibodies to NS-specific antigens may be used to monitor the development of neurotoxicity to environmental chemicals and that immune mechanisms may be involved in the progression of neurodegeneration.ImagesFigure 5Figure 6Figure 7

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Section: Anti-nf-68mentioning

confidence: 99%

Neuroimmunotoxicology: humoral assessment of neurotoxicity and autoimmune mechanisms.

El-Fawal

Waterman

Feo

et al. 1999

Environ Health Perspect

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“…This disease also presented in both Vietnamese men and women, with a female/ male ratio of 1.2:1 which is lower than the previously reported ratio of 1.5:1 in a Western population. 4 MG was common in this cohort of thymoma patients (84.9%); most were class I and IIA (37.8% and 62.2%, respectively). In a Western population, Strollo and colleagues 5 reported a lower rate of MG of 30%-50% in thymoma patients.…”

Section: Discussionmentioning

confidence: 73%

Video-assisted thoracoscopic thymectomy for thymoma: a single-center experience

Nguyêñ

Nguyen

et al. 2018

Asian Cardiovasc Thorac Ann

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Background Thymoma is a primary tumor derived from the epithelial cells of the thymus, which is commonly seen in the mediastinum. Surgical thymectomy is the radical treatment for thymoma. The recent introduction of video-assisted thoracoscopic surgery has improved the quality of thymectomy surgery. The clinical characteristics of thymoma and the outcomes of video-assisted thoracoscopic thymectomy in Vietnamese patients are still lacking. The objectives of this study were to investigate the clinical and laboratory characteristics of thymoma and to evaluate the early results of video-assisted thoracoscopic thymectomy for thymoma in Vietnamese patients. Methods All 53 thymoma patients with or without myasthenia gravis who underwent video-assisted thoracoscopic thymectomy in Military Hospital 103, Vietnam, from October 2013 to July 2017 were included. Results The mean age was 46.5 7.1 years, and the female/male ratio was 1.2:1. Myasthenia gravis, mostly stage IIA, was present in 84.9% of patients. There was no hospital mortality or major postoperative complication. The mean operative time was 65 min, intensive care unit stay was 22 ± 5 h, and postoperative hospital stay was 7.5 ± 1.7 days. Conclusion Thoracoscopic thymectomy for thymoma in Vietnamese patients achieved improved cosmesis and was safe for both non-myasthenia gravis and myasthenia gravis patients.

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Myasthenic Crisis

Stricker¹

1993

Arch Neurol

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Strategies for the Treatment of Myasthenia Gravis

Cited by 21 publications

References 50 publications

Neuroimmunotoxicology: humoral assessment of neurotoxicity and autoimmune mechanisms.

Neuroimmunotoxicology: humoral assessment of neurotoxicity and autoimmune mechanisms.

Video-assisted thoracoscopic thymectomy for thymoma: a single-center experience

Myasthenic Crisis

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