HLA in myasthenia gravis: From superficial correlation to underlying mechanism

Publication date: Available online 16 July 2019Source: Autoimmunity ReviewsAuthor(s): Huahua Zhong, Chongbo Zhao, Sushan LuoAbstractMyasthenia gravis (MG) is a rare autoimmune disease characterized by muscle weakness and abnormal fatigability. Like many other autoimmune diseases, genetic contribution to MG has been studied where the HLA system appears to play the most vital role. Although many correlations have been revealed in these studies, the underlying mechanism for them is still in the veil. Based on current evidence, we propose two synergetic mechanisms underlying the MG predisposition via HLA. In brief, the first advocates specific MHC II-peptide patterns that influence the efficacy of antigen presentation, and the second emphasizes the role of classical MHC alleles in shaping the TCR repertoire for MG predisposition. Besides, possible explanations for unresolved or controversial MG-related epidemiological phenomenon or clinical problems are addressed as well. Then, we discuss three factors influencing the effect of HLA on MG: gender discrepancy, inflammatory microenvironment, and epigenetic regulation. Lastly, from a provisional angle, we introduce several precautious treatments for people highly predisposed to MG. Although this is a review focusing on MG, the underlying mechanisms might be applicable in other autoimmune diseases as well.
Source: Autoimmunity Reviews - Category: Allergy & Immunology Source Type: research

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Here we describe a 79 years old man admitted to our unit for worsening diplopia and fatigue, started a few weeks after an episode of bronchitis and flu vaccination. Past medical history included myasthenia gravis well controlled by Pyridostigmine, Azathioprine and Prednisone. During the first days, the patient developed progressive ocular movement abnormalities up to complete external ophthalmoplegia, severe limb and gait ataxia and mild dysarthria. Deep tendon reflexes were absent in lower limbs. Since not all the symptoms were explainable with the previous diagnosis of myasthenia gravis, other etiologies were investiga...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
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Source: Autoimmunity Reviews - Category: Allergy & Immunology Source Type: research
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Source: Autoimmune Diseases - Category: Allergy & Immunology Tags: Autoimmune Dis Source Type: research
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Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
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Source: Advances in Mind Body Medicine - Category: Psychiatry Tags: Adv Mind Body Med Source Type: research
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Source: Metabolomics - Category: Biology Source Type: research
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Source: Neuromuscular Disorders - Category: Neurology Authors: Source Type: research
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Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
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Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
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Source: Puerto Rico Health Sciences Journal - Category: International Medicine & Public Health Tags: P R Health Sci J Source Type: research
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