| About the author: |
O. I. Kalbus, O. O. Nefodov |
| Heading |
CLINICAL MEDICINE |
| Type of article |
Scentific article |
| Annotation |
182 patients with myasthenia gravis aged 18 to 83 years were examined. The severity of myasthenia gravis was quantified on the Quantitative Myasthenia Gravis scale. An immunological test was performed to determine the presence and titer of antibodies to acetylcholine receptors, muscle-specific receptor tyrosine kinase, and to determine the presence of antibodies against titin and SOX1. Antibodies to acetylcholine receptors were detected in 124 (68.1 %) patients, including 108 (73.5 %) with generalized and 16 (45.7 %) with the ocular form of the disease. Antibodies to muscle-specific kinase were detected in 16 (10.9 %) patients with generalized myasthenia gravis. Titin antibodies were detected in 53 (29.1 %) patients with generalized myasthenia gravis. Antibodies to SOX1 have been diagnosed in 10 (6.8 %) subjects with a generalized form of myasthenia. The ability of these immunological markers to predict the development of severe myasthenia gravis was assessed by ROC analysis. It was found that the titer of antibodies to acetylcholine can be used to predict the severe course of myasthenia gravis. If the antibody titer level to acetylcholine is above 6.9 nmol/L, the ratio of chances of severe disease in patients with myasthenia gravis compared to patients with a lower level of titer of these antibodies is 22.35 (95.0 % CI 6.98–71.56), p<0.001. |
| Tags |
myasthenia gravis, antibodies, titin, SOX1, muscle-specific kinase, acetylcholine receptors, prognosis, course |
| Bibliography |
- Kalbus O. Medyko-statystychni ta epidemiolohichni kharakterystyky poshyrenosti miastenii v Ukraini. Ukrainskyi medychnyi chasopys. 2019;4(132):1–4. Doi: 10.32471/umj.1680-3051.132.161828[in Ukrainian]
- Filenko B. Suchasnyy pohlyad na etiolohiyu, patohenez, patomorfolohiyu miasteniyi: ohlyad literatury ta vypadok iz praktyky. Visnyk Problem Biolohiyi i Medytsyny. 2019;4(2):47–52 Doi: 10.29254/2077-4214-2019-4-2-154-47-52 [In Ukrainian]
- Chen Y, Tao X, Wang Y, Xu S, Yang Y, Han J et al. Clinical Characteristics and Prognosis of Anti-AChR Positive Myasthenia Gravis Combined With Anti-LRP4 or Anti-Titin Antibody. Frontiers in Neurology. 2022;13. Doi: 10.3389/fneur.2022.873599
- Chou C, Su I, Chou I, Lin J, Lan S, Wang Y et al. Correlation of anti-acetylcholine receptor antibody levels and long-term outcomes of juvenile myasthenia gravis in Taiwan: a case control study. BMC Neurology. 2019;19(1). Doi: 10.1186/s12883-019-1397-0
- Dresser L, Wlodarski R, Rezania K, Soliven B. Myasthenia Gravis: Epidemiology, Pathophysiology and Clinical Manifestations. Journal of Clinical Medicine. 2021;10(11):2235. Doi: 10.3390/jcm10112235
- Jaretzki A 3rd, Barohn RJ, Ernstoff RM, Kaminski HJ, Keesey JC, Penn AS et al. Myasthenia gravis: recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America. Neurology. 2000;55(1):16–23. doi: 10.1212/wnl.55.1.16
- Kojima Y, Uzawa A, Ozawa Y, Yasuda M, Onishi Y, Akamine H et al. Rate of change in acetylcholine receptor antibody levels predicts myasthenia gravis outcome. Journal of Neurology, Neurosurgery & Psychiatry. 2021;92(9):963–968. Doi: 10.1136/jnnp-2020-325511
- König N, Stetefeld H, Dohmen C, Mergenthaler P, Kohler S, Schönenberger S et al. MuSK-antibodies are associated with worse outcome in myasthenic crisis requiring mechanical ventilation. Journal of Neurology. 2021;268(12):4824–4833. Doi: 10.1007/s00415-021-10603-9
- Lazaridis K, Tzartos S. Autoantibody Specificities in Myasthenia Gravis; Implications for Improved Diagnostics and Therapeutics. Frontiers in Immunology. 2020;11. doi: 10.3389/fimmu.2020.00212
- Stergiou C, Lazaridis K, Zouvelou V, Tzartos J, Mantegazza R, Antozzi C et al. Titin antibodies in “seronegative” myasthenia gravis – A new role for an old antigen. Journal of Neuroimmunology. 2016;292:108-115. Doi: 10.1016/j.jneuroim.2016.01.018
- Wang L, Wang S, Yang H, Han J, Zhao X, Han S et al. No correlation between acetylcholine receptor antibody concentration and individual clinical symptoms of myasthenia gravis: A systematic retrospective study involving 67 patients. Brain and Behavior. 2021;11(7). Doi: 10.1002/brb3.2203
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| Publication of the article |
«World of Medicine and Biology» №2(80), 2022 year, 074-078 pages, index UDK 616.74-007.23:616.8-009.17-036-037 |
| DOI |
10.26724/2079-8334-2022-2-80-74-78 |
