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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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摘要 目的将与重症肌无力(MG ) 在病人评估频率,分发和抗体的临床的意义到胎儿或成年的醋胆素受体(AChR ) 。方法 AChR 抗体被基于房间的试金在眼睛的 MG (OMG ) 的浆液检测(n = 90 ) 并且概括 MG (GMG ) 病人(n = 110 ) 。fetaltype (2: : :) 并且成年类型(2: : :) AChR 被用作抗原,并且他们到疾病表示的关联被估计。结果反成年、反胎儿的 AChR 抗体的全面频率在检查的所有 200 个病人是类似的,与 14 有对 AChR- 子单元特定的浆液,并且 22 到 AChR- 子单元。全面敏感当当仅仅使用胎儿的 AChR 抗体时,使用胎儿、成年的 AChR 抗体比那高时(P = 0.015 ) 。与 OMG 病人相比,在疾病发作和到 AChR 的两 isoforms 的抗体的积极比率的吝啬的年龄在随后进行了到 GMG 的病人是显著地更高的。有反胎儿、反成年的 AChR 抗体的更老的病人和病人为得概括疾病有更大的风险[机会比率(或) , 1.03;95% 信心间隔(CI ) , 1.011.06 并且或, 5.09;95% CI, 2.2311.62 ] 。把胎儿类型、成年类型的 AChRs 用作抗原的结论可能比使用任何一个子类型是更敏感的。有对两 isoforms 特定的浆液的病人在进行到 GMG 的更大的风险。有在先进年龄的疾病发作的病人看起来有 GMG 变换的更高的频率。 Objective To 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). Methods AChR antibodies were detected by cell-based assay in the serum of ocular MG (OMG) (n = 90) and generalized MG (GMG) patients (n = 110). The fetal-type (2α: β: γ: δ) and adult-type (2α: β: ε: δ) AChR were used as antigens, and their relevance to disease presentation was assessed. Results The 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-ε 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]. Conclusion Using 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.
作者 Qi-Guang Shi Zhi-Hong Wang Xiao-Wei Ma Da-Qi Zhang Chun-Sheng Yang Fu-Dong Shi Li Yang Qi-Guang Shi , Zhi-Hong Wang , Xiao-Wei Ma , Da-Qi Zhang , Chun-Sheng Yang , Fu-Dong Shi , Li Yang ( 1. Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, China ;2. Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA )
出处 《神经科学通报:英文版》 SCIE CAS CSCD 2012年第5期469-474,共6页 Neuroscience Bulletin
基金 supported by the National Natural Science Foundation of China (31170864 and 81171183).
关键词 乙酰胆碱受体 抗体检测 重症肌无力 临床意义 胎儿 成人 全身性疾病 ACHR myasthenia gravis acetylcholine receptor antibodies acetylcholine receptor subunit cell-based assay adult fetal
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