Classification of myasthenia gravis based on autoantibody status

Shigeaki Suzuki, Kimiaki Utsugisawa, Yuriko Nagane, Takashi Satoh, Yasuo Terayama, Norihiro Suzuki, Masataka Kuwana

Research output: Contribution to journalArticle

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Abstract

Objectives: To investigate the autoantibody status of patients with myasthenia gravis (MG) and to evaluate its usefulness for disease classification. Design: Retrospective cohort study of patients with MG, who have autoantibodies to receptors and ion channels expressed at neuromuscular junctions and in muscles that impair neuromuscular transmission. One of the autoantibodies studied was a recently identified, novel, MGspecific autoantibody to a voltage-gated potassium (Kv) channel, Kv1.4. Setting: Keio University Hospital, Tokyo, and Iwate Medical University Hospital, Morioka. Patients: Two hundred nine patients with MG. Main Outcome Measures: Anti-Kv1.4 antibody was measured by an immunoprecipitation assay with sulfur 35-labeled extract from rhabdomyosarcoma cells. Antititin antibody was detected with a commercially available enzyme-linked immunosorbent assay. Results: Anti-acetylcholine receptor, anti-Kv1.4, and antititin antibodies were detected in 150 (72%), 26 (12%), and 50 (24%) of the 209 patients with MG, respectively. All of the patients who were positive for anti-Kv1.4 or antititin antibody were seropositive for the anti-acetylcholine receptor antibody. They were classified into 4 groups based on their status in regard to 3 MG-related autoantibodies: anti-Kv1.4, antititin, and anti-acetylcholine receptor. Clinical associations were found between anti-Kv1.4 and bulbar involvement, myasthenic crisis, thymoma, and concomitant myocarditis and/or myositis; between antititin and older-onset MG; between anti-acetylcholine receptor alone and younger-onset MG; and between seronegativity and ocular MG. In addition, patients with MG in the anti-Kv1.4 group had more severe manifestations of disease than those in the other 3 groups. Conclusion: Classification of patients with MG based on autoantibody status may be useful in defining clinical subsets.

Original languageEnglish
Pages (from-to)1121-1124
Number of pages4
JournalArchives of Neurology
Volume64
Issue number8
DOIs
Publication statusPublished - 2007 Aug

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Myasthenia Gravis
Autoantibodies
Cholinergic Receptors
Antibodies
Voltage-Gated Potassium Channels
Myositis
Thymoma
Rhabdomyosarcoma
Tokyo
Neuromuscular Junction
Muscle Weakness
Myocarditis
Cell Extracts
Ion Channels
Immunoprecipitation
Sulfur
Anti-Idiotypic Antibodies
Cohort Studies
Retrospective Studies
Enzyme-Linked Immunosorbent Assay

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Suzuki, S., Utsugisawa, K., Nagane, Y., Satoh, T., Terayama, Y., Suzuki, N., & Kuwana, M. (2007). Classification of myasthenia gravis based on autoantibody status. Archives of Neurology, 64(8), 1121-1124. https://doi.org/10.1001/archneur.64.8.1121

Classification of myasthenia gravis based on autoantibody status. / Suzuki, Shigeaki; Utsugisawa, Kimiaki; Nagane, Yuriko; Satoh, Takashi; Terayama, Yasuo; Suzuki, Norihiro; Kuwana, Masataka.

In: Archives of Neurology, Vol. 64, No. 8, 08.2007, p. 1121-1124.

Research output: Contribution to journalArticle

Suzuki, S, Utsugisawa, K, Nagane, Y, Satoh, T, Terayama, Y, Suzuki, N & Kuwana, M 2007, 'Classification of myasthenia gravis based on autoantibody status', Archives of Neurology, vol. 64, no. 8, pp. 1121-1124. https://doi.org/10.1001/archneur.64.8.1121
Suzuki S, Utsugisawa K, Nagane Y, Satoh T, Terayama Y, Suzuki N et al. Classification of myasthenia gravis based on autoantibody status. Archives of Neurology. 2007 Aug;64(8):1121-1124. https://doi.org/10.1001/archneur.64.8.1121
Suzuki, Shigeaki ; Utsugisawa, Kimiaki ; Nagane, Yuriko ; Satoh, Takashi ; Terayama, Yasuo ; Suzuki, Norihiro ; Kuwana, Masataka. / Classification of myasthenia gravis based on autoantibody status. In: Archives of Neurology. 2007 ; Vol. 64, No. 8. pp. 1121-1124.
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abstract = "Objectives: To investigate the autoantibody status of patients with myasthenia gravis (MG) and to evaluate its usefulness for disease classification. Design: Retrospective cohort study of patients with MG, who have autoantibodies to receptors and ion channels expressed at neuromuscular junctions and in muscles that impair neuromuscular transmission. One of the autoantibodies studied was a recently identified, novel, MGspecific autoantibody to a voltage-gated potassium (Kv) channel, Kv1.4. Setting: Keio University Hospital, Tokyo, and Iwate Medical University Hospital, Morioka. Patients: Two hundred nine patients with MG. Main Outcome Measures: Anti-Kv1.4 antibody was measured by an immunoprecipitation assay with sulfur 35-labeled extract from rhabdomyosarcoma cells. Antititin antibody was detected with a commercially available enzyme-linked immunosorbent assay. Results: Anti-acetylcholine receptor, anti-Kv1.4, and antititin antibodies were detected in 150 (72{\%}), 26 (12{\%}), and 50 (24{\%}) of the 209 patients with MG, respectively. All of the patients who were positive for anti-Kv1.4 or antititin antibody were seropositive for the anti-acetylcholine receptor antibody. They were classified into 4 groups based on their status in regard to 3 MG-related autoantibodies: anti-Kv1.4, antititin, and anti-acetylcholine receptor. Clinical associations were found between anti-Kv1.4 and bulbar involvement, myasthenic crisis, thymoma, and concomitant myocarditis and/or myositis; between antititin and older-onset MG; between anti-acetylcholine receptor alone and younger-onset MG; and between seronegativity and ocular MG. In addition, patients with MG in the anti-Kv1.4 group had more severe manifestations of disease than those in the other 3 groups. Conclusion: Classification of patients with MG based on autoantibody status may be useful in defining clinical subsets.",
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