Clinical and scientific aspects of acetylcholine receptor myasthenia gravis

Marlies Keijzers, Gisela Nogales-Gadea, Marc de Baets
Current Opinion in Neurology 2014, 27 (5): 552-7

PURPOSE OF REVIEW: Myasthenia gravis is a rare disease that causes impairment of the neuromuscular junction. In this review we will focus on the literature published in the last 18 months regarding autoimmune myasthenia gravis caused by antibodies against the nicotinic acetylcholine receptor myasthenia gravis. Acetylcholine receptor is the most common target of this autoimmune disease.

RECENT FINDINGS: A high number of long-lived plasma cells are present in myasthenia gravis patients. Treatments to eliminate these plasma cells, such as proteasome inhibitors, have proved utility in experimental autoimmune myasthenia gravis. MicroRNAs may have a role as biomarkers in myasthenia gravis. Epstein-Barr virus and human polyomavirus 7 are often found in myasthenia gravis thymus and may play a role in the initiation of the autoimmune process. Robotic thymectomy has been proved well tolerated and minimally invasive for the patients and is likely to replace open surgery.

SUMMARY: Knowledge of the initiation and perpetuation of the autoimmune response in myasthenia gravis condition is increasing every year. This knowledge is paired with in-vivo and in-vitro studies that are directed to further understand this disease, and to improve current treatment options in severe or nonresponding patients. Specific treatments and diagnosis in myasthenia gravis tend to an early detection and a better quality of life.

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