Myasthenia Gravis: Epidemiology, Pathophysiology and Clinical Manifestations.

Myasthenia Gravis: Epidemiology, Pathophysiology and Clinical Manifestations.
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重症肌无力:流行病学,病理生理学和临床表现。

DOI:
10.3390/jcm10112235
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发表时间:
2021-05-21
影响因子:
3.9
通讯作者:
Soliven B
Soliven B
中科院分区:
医学2区
文献类型:
--
作者:
Dresser L;Wlodarski R;Rezania K;Soliven B

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重症肌无力(MG)是一种自身免疫性神经疾病,其特征是神经肌肉接头处的传递障碍。该病的发病率为每百万人年4.1至30例,患病率为每百万人150至200例。MG被认为是抗体介导的自身免疫性疾病的经典例子。大多数MG患者都有抗乙酰胆碱受体(AChRs)的自身抗体。不太常见的自身抗体包括针对肌肉特异性激酶(Musk)、低密度脂蛋白受体相关蛋白4(Lrp4)和集聚蛋白的抗体。这些自身抗体通过引起AChRs的下调、破坏、功能性阻断或扰乱AChRs在突触后膜上的聚集,从而扰乱神经末梢和肌肉纤维之间的胆碱能传递。MG的核心临床表现为疲劳性肌肉无力,可累及眼、球、呼吸和四肢肌肉。临床表现因自身抗体的类型和是否存在胸腺瘤而异。
Myasthenia gravis (MG) is an autoimmune neurological disorder characterized by defective transmission at the neuromuscular junction. The incidence of the disease is 4.1 to 30 cases per million person-years, and the prevalence rate ranges from 150 to 200 cases per million. MG is considered a classic example of antibody-mediated autoimmune disease. Most patients with MG have autoantibodies against the acetylcholine receptors (AChRs). Less commonly identified autoantibodies include those targeted to muscle-specific kinase (MuSK), low-density lipoprotein receptor-related protein 4 (Lrp4), and agrin. These autoantibodies disrupt cholinergic transmission between nerve terminals and muscle fibers by causing downregulation, destruction, functional blocking of AChRs, or disrupting the clustering of AChRs in the postsynaptic membrane. The core clinical manifestation of MG is fatigable muscle weakness, which may affect ocular, bulbar, respiratory and limb muscles. Clinical manifestations vary according to the type of autoantibody, and whether a thymoma is present.
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