Development of ultra-sensitive enzyme immunoassay for anti-acetylcholine receptor autoantibody

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The pathobiochemical studies on myasthenia gravis (MG) by using a novel ultra-sensitive enzyme immunoassay is described. The results from this study is as follows.1. Ultra-sensitive enzyme immunoassay (immune complex transfer enzyme immunoassay) using thirteen synthetic peptides, which corresponded to the sequence of the extra cellular domain of the acetylcholine receptor alpha-subunit, as antigens has been developed.2. The present method has enabled to definitively diagnose not only the generalized MG but also ocular MG (sensitivity=94%).3. In generalized MG patients, the present method has enabled to prognosticate the effectiveness of thymectomy before operation (sensitivity=64%, and specificity=90%) and the antibody titer has correlated with HLA genotype (DOB1^<**>0302, ^<**>0303 and ^<**>5031).4. In ocular MG patients, the class-II HLA genotype (DQB1^<**>03.) and class-I HLA (HLA-B) have correlated with effectiveness of the thymectomy.These results suggested that the pathogenicity of the generalized MG and ocular MG were related to humoral immune response and cellular immune response, respectively.