What is the antigen that induce myasthenia gravis? : the specificity of anti-AchR antibody in the patient of myasthenia gravis

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Myasthenia gravis is auto-immune disease because of anti-AchR antibody. It is said that auto-immune disease is interacted with auto-reactive T cell. Auto-reactive T cell must be deleted with apoptosis in T cell development. Bcl-2 family proteins regulate programmed cell death, and may play an important role in the selection of lymphocytes. We investigated the expression of Bcl-2, Bcl-x, Bax, Bak and Bim in human lymphocytes using flow-cytometry. Bcl-2 was down-regulated in CD4^+8^+ (DP) thymocytes and CD19^+38^+ tonsillar lymphocytes (GC B cells). Among DP thymocytes, cells co-expressing CD69 up-regulated Bcl-2, suggesting that the role of Bcl-2 is promoting survival of positively selected DP cells. Unexpectedly, the expression level of Bcl-x was higher in DP cells than in Single Positive (SP) cells and in CD69^+ DP thymocytes it was lower than in CD69^- DP thymocytes. Expression of Bim was low in DP thymocytes but high in a subset of GCB cells. Bim and Bax were expressed more highly in SP than in DP thymocytes. Among peripheral blood lymphocytes (PBL), CD8^+ T cells expressed a〜10 fold higher level of Bcl-x than CD4^+ T cells while both subsets expressed similar levels of Bcl-2. Bak expression was low and Bim expression was absent in PBL.These results suggest that not only Bcl-2 but other members of the Bcl-2 family are involved in T cell development in the thymus and affinity maturation of B cells in the germinal center