Clinical significance of detection of antibodies to fetal and adult acetylcholine receptors in myasthenia gravis.
Clinical significance of detection of antibodies to fetal and adult acetylcholine receptors in myasthenia gravis.
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重症肌无力胎儿和成人乙酰胆碱受体抗体检测的临床意义
DOI：
10.1007/s12264-012-1256-0
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发表时间：
2012-10
影响因子：
5.6
通讯作者：
Yang, Li
中科院分区：
文献类型：
--
作者：
Shi, Qi-Guang;Wang, Zhi-Hong;Ma, Xiao-Wei;Zhang, Da-Qi;Yang, Chun-Sheng;Shi, Fu-Dong;Yang, Li
关键词：
目的探讨重症肌无力（MG）患者血清中胎儿和/或成人乙酰胆碱受体（AChR）抗体的频率、分布及临床意义。胎儿类型（2α：β值：Γ：δ）和成人型（2α：β：β：δ）AChR作为抗原，并评估其与疾病presentation.ResultsThe总体频率的抗成人和抗胎儿AChR抗体是相似的，在所有200例患者检查，14例血清特异性AChR-r亚基，22 AChR-r亚基。同时检测胎儿和成人AChR抗体的敏感性高于单独检测胎儿AChR抗体的敏感性（P= 0.015）。与OMG患者相比，平均发病年龄和AChR两种亚型抗体阳性率在随后进展为GMG的患者中显着较高。老年患者和抗胎儿和抗成人AChR抗体的患者发生全身性疾病的风险更大[比值比（OR），1.03; 95%置信区间（CI），1.01-1.06和OR，5.09; 95%CI，2.23-11.62]。具有对两种亚型特异性血清的患者进展为GMG的风险更大。在高龄发病的患者似乎有更高的GMG转换频率。
ObjectiveTo evaluate the frequency, distribution and clinical significance of the antibodies to the fetal and/or adult acetylcholine receptor (AChR) in patients with myasthenia gravis (MG).MethodsAChR antibodies were detected by cell-based assay in the serum of ocular MG (OMG) (n= 90) and generalized MG (GMG) patients (n= 110). The fetaltype (2α: β: Γ: δ) and adult-type (2α: β: ɛ: δ) AChR were used as antigens, and their relevance to disease presentation was assessed.ResultsThe overall frequencies of anti-adult and anti-fetal AChR antibodies were similar in all 200 patients examined, with 14 having serum specific to the AChR-Γ subunit, and 22 to the AChR-ɛ subunit. The overall sensitivity when using the fetal and adult AChR antibodies was higher than that when using the fetal AChR antibody only (P= 0.015). Compared with OMG patients, the mean age at disease onset and the positive ratio of antibodies to both isoforms of the AChR were significantly higher in patients who subsequently progressed to GMG. Older patients and patients with both anti-fetal and anti-adult AChR antibodies had a greater risk for developing generalized disease [odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01–1.06 and OR, 5.09; 95% CI, 2.23–11.62].ConclusionUsing both fetal- and adult-type AChRs as the antigens may be more sensitive than using either subtype. Patients with serum specific to both isoforms are at a greater risk of progressing to GMG. Patients with disease onset at an advanced age appear to have a higher frequency of GMG conversion.
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