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ANGELA VINCENT,
LESLIE JACOBSON,
PAUL PLESTED,
AGATA POLIZZI, TERESA TANG,
SIETSKE RIEMERSMA,
CLAIRE NEWLAND,
SARA GHORAZIAN,
JEREMY FARRAR,
CAL MACLENAN,
NICHOLAS WILLCOX,
DAVID BEESON,
JOHN NEWSDOM‐DAVIS
Annals of the New York Academy of Sciences 02/2006; 841(1):482 - 496. · 3.15 Impact Factor
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Angela Vincent,
John McConville,
Maria Elena Farrugia,
John Bowen,
Paul Plested, Teresa Tang,
Amelia Evoli,
Ian Matthews,
Gary Sims,
Paolo Dalton,
Leslie Jacobson,
Agata Polizzi,
Frans Blaes,
Bethan Lang,
David Beeson,
Nick Willcox,
John Newsom-Davis,
Werner Hoch
[show abstract]
[hide abstract]
ABSTRACT: Acetylcholine receptor (AChR) antibodies are present in around 85% of patients with myasthenia gravis (MG) as measured by the conventional radioimmunoprecipitation assay. Antibodies that block the fetal form of the AChR are occasionally present in mothers who develop MG after pregnancy, especially in those whose babies are born with arthrogryposis multiplex congenita. The antibodies cross the placenta and block neuromuscular transmission, leading to joint deformities and often stillbirth. In these mothers, antibodies made in the thymus are mainly specific for fetal AChR and show restricted germline origins, suggesting a highly mutated clonal response; subsequent spread to involve adult AChR could explain development of maternal MG in those cases who first present after pregnancy. In the 15% of "seronegative" MG patients without AChR antibodies (SNMG), there are serum factors that increase AChR phosphorylation and reduce AChR function, probably acting via a different membrane receptor. These factors are not IgG and could be IgM or even non-Ig serum proteins. In a proportion of SNMG patients, however, IgG antibodies to the muscle-specific kinase, MuSK, are present. These antibodies are not found in AChR antibody-positive MG and are predominantly IgG4. MuSK antibody positivity appears to be associated with more severe bulbar disease that can be difficult to treat effectively.
Annals of the New York Academy of Sciences 10/2003; 998:324-35. · 3.15 Impact Factor
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ANGELA VINCENT,
JOHN McCONVILLE,
MARIA ELENA FARRUGIA,
JOHN BOWEN,
PAUL PLESTED, TERESA TANG,
AMELIA EVOLI,
IAN MATTHEWS,
GARY SIMS,
PAOLA DALTON,
LESLIE JACOBSON,
AGATA POLIZZI,
FRANS BLAES,
BETHAN LANG,
DAVID BEESON,
NICK WILLCOX,
JOHN NEWSOM-DAVIS,
WERNER HOCH
[show abstract]
[hide abstract]
ABSTRACT: Acetylcholine receptor (AChR) antibodies are present in around 85% of patients with myasthenia gravis (MG) as measured by the conventional radioimmunoprecipitation assay. Antibodies that block the fetal form of the AChR are occasionally present in mothers who develop MG after pregnancy, especially in those whose babies are born with arthrogryposis multiplex congenita. The antibodies cross the placenta and block neuromuscular transmission, leading to joint deformities and often stillbirth. In these mothers, antibodies made in the thymus are mainly specific for fetal AChR and show restricted germline origins, suggesting a highly mutated clonal response; subsequent spread to involve adult AChR could explain development of maternal MG in those cases who first present after pregnancy. In the 15% of “seronegative” MG patients without AChR antibodies (SNMG), there are serum factors that increase AChR phosphorylation and reduce AChR function, probably acting via a different membrane receptor. These factors are not IgG and could be IgM or even non-Ig serum proteins. In a proportion of SNMG patients, however, IgG antibodies to the muscle-specific kinase, MuSK, are present. These antibodies are not found in AChR antibody-positive MG and are predominantly IgG4. MuSK antibody positivity appears to be associated with more severe bulbar disease that can be difficult to treat effectively.
Annals of the New York Academy of Sciences 08/2003; 998(1):324 - 335. · 3.15 Impact Factor
