How myasthenia gravis alters the safety factor for neuromuscular transmission.

How myasthenia gravis alters the safety factor for neuromuscular transmission.
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DOI:
10.1016/j.jneuroim.2008.04.038
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发表时间:
2008-09-15
影响因子:
3.3
通讯作者:
Lennon VA
Lennon VA
中科院分区:
医学4区
文献类型:
--
作者:
Ruff RL;Lennon VA

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重症肌无力 (MG) 是最常见的自身免疫性肌无力综合征,其特征是针对骨骼肌乙酰胆碱受体 (AChR) 的抗体。终板 Na+ 通道通过降低触发动作电位所需的阈值去极化来确保神经肌肉传输的效率。重症肌无力的神经肌肉接头中突触后 AChR 和电压门控 Na+ 通道均丢失。本研究探讨了突触后电压门控 Na+ 通道丢失对神经肌肉传递安全系数的影响。在 MG 患者的肋间神经肌肉制剂中,我们发现终板 AChR 损失会降低终板电位的大小,而终板 Na+ 通道损失会增加产生肌肉动作电位所需的阈值去极化。为了评估 AChR 特异性抗体是否损害 Na+ 通道的功能,我们测试了注射单克隆致肌无力 IgG 的大鼠的肩胛舌骨神经肌肉制剂(MG 被动转移模型 [PTMG])。产生 PTMG 的 AChR 抗体不会改变 Na+ 通道的功能。我们得出的结论是,MG 中终板 Na+ 通道的丢失是由于补体介导的终板膜丢失,而不是致肌无力抗体对终板 Na+ 通道的直接影响。
Myasthenia gravis (MG), the most common of autoimmune myasthenic syndromes, is characterized by antibodies directed against the skeletal muscle acetylcholine receptors (AChRs). Endplate Na+ channels ensure the efficiency of neuromuscular transmission by reducing the threshold depolarization needed to trigger an action potential. Postsynaptic AChRs and voltage-gated Na+ channels are both lost from the neuromuscular junction in MG. This study examined the impact of postsynaptic voltage-gated Na+ channel loss on the safety factor for neuromuscular transmission. In intercostal nerve-muscle preparations from MG patients, we found that endplate AChR loss decreases the size of the endplate potential, and endplate Na+ channel loss increases the threshold depolarization needed to produce a muscle action potential. To evaluate whether AChR-specific antibody impairs the function of Na+ channels, we tested omohyoid nerve-muscle preparations from rats injected with monoclonal myasthenogenic IgG (passive transfer model of MG [PTMG]). The AChR antibody that produces PTMG did not alter the function of Na+ channels. We conclude that loss of endplate Na+ channels in MG is due to complement-mediated loss of endplate membrane rather than a direct effect of myasthenogenic antibodies on endplate Na+ channels.
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