Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1975 Nov;38(11):1039–1047. doi: 10.1136/jnnp.38.11.1039

Absence of cellular hypersensitivity to muscle and thymic antigens in myasthenia gravis.

W M Behan, P O Behan, J A Simpson
PMCID: PMC492153  PMID: 1206412

Abstract

Humoral antibodies to skeletal muscle and its components and to thymus have been demonstrated in the sera of patients with myasthenia gravis. A role for cellular hypersensitivity to similar antigens in the pathogenesis of the disease has been suggested by some reports of the presence of cellular immunity. A detailed immunological study using muscle and thymic antigens, including those prepared from the patients' own tissues, failed to confirm these findings. It is suggested that previous reports of cellular hypersensitivity represent the demonstration of an epiphenomenon.

Full text

PDF
1039

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ADNER M. M., SHERMAN J. D., ISE C., SCHWAB R. S., DAMESHEK W. AN IMMUNOLOGIC SURVEY OF FORTY-EIGHT PATIENTS WITH MYASTHENIA GRAVIS. N Engl J Med. 1964 Dec 24;271:1327–1333. doi: 10.1056/NEJM196412242712601. [DOI] [PubMed] [Google Scholar]
  2. Aarli J. A. Myasthenia gravis. Antibodies to an acid-soluble antigen in striated muscle. Clin Exp Immunol. 1972 Mar;10(3):453–461. [PMC free article] [PubMed] [Google Scholar]
  3. Abramsky O., Aharonov A., Webb C., Fuchs S. Cellular immune response to acetylcholine receptor-rich fraction, in patients with myasthenia gravis. Clin Exp Immunol. 1975 Jan;19(1):11–16. [PMC free article] [PubMed] [Google Scholar]
  4. Alpert L. I., Rule A., Norio M., Kott E., Kornfeld P., Osserman K. E. Studies in myasthenia gravis: cellular hypersensitivity to skeletal muscle. Am J Clin Pathol. 1972 Dec;58(6):647–653. doi: 10.1093/ajcp/58.6.647. [DOI] [PubMed] [Google Scholar]
  5. Armstrong R. M., Nowak R. M., Falk R. E. Thymic lymphocyte function in myasthenia gravis. Neurology. 1973 Oct;23(10):1078–1083. doi: 10.1212/wnl.23.10.1078. [DOI] [PubMed] [Google Scholar]
  6. Behan P. O., Simpson J. A., Dick H. Letter: Immune response genes in myasthenia gravis. Lancet. 1973 Nov 3;302(7836):1033–1033. doi: 10.1016/s0140-6736(73)91130-6. [DOI] [PubMed] [Google Scholar]
  7. Beutner E. H., Chorzelski T. P., Hale W. L., Hausmanowa-Petrusewicz I. Autoimmunity in concurrent myasthenia gravis and pemphigus erythematosus. JAMA. 1968 Mar 4;203(10):845–849. [PubMed] [Google Scholar]
  8. Brown J. W., Nelson J. R., Hermann C., Jr Sjogren's syndrome with myopathic and myasthenic features. Bull Los Angeles Neurol Soc. 1968 Jan;33(1):9–20. [PubMed] [Google Scholar]
  9. Caspary E. A., Currie S., Field E. J. Sensitized lymphocytes in muscular dystrophy: evidence for a neural factor in pathogenesis. J Neurol Neurosurg Psychiatry. 1971 Jun;34(3):353–356. doi: 10.1136/jnnp.34.3.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Caspary E. A., Currie S., Walton J. N., Field E. J. Lymphocyte sensitization to nervous tissues and muscle in patients with the Guillain-Barré syndrome. J Neurol Neurosurg Psychiatry. 1971 Apr;34(2):179–181. doi: 10.1136/jnnp.34.2.179. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Cohen S. M., Waxman S. Myasthenia gravis, chronic lymphocytic leukemia, and autoimmune hemolytic anemia. "A spectrum of thymic abnormalities? Arch Intern Med. 1967 Dec;120(6):717–720. [PubMed] [Google Scholar]
  12. Currie S., Saunders M., Knowles M., Brown A. E. Immunological aspects of polymyositis. The in vitro activity of lymphocytes on incubation with muscle antigen and with muscle cultures. Q J Med. 1971 Jan;40(157):63–84. [PubMed] [Google Scholar]
  13. DJANIAN A. Y., BEUTNER E. H., WITEBSKY E. TANNED-CELL HEMAGGLUTINATION TEST FOR DETECTION OF ANTIBODIES IN SERA OF PATIENTS WITH MYASTHENIA GRAVIS. J Lab Clin Med. 1964 Jan;63:60–70. [PubMed] [Google Scholar]
  14. Da Costa J. A., White A. G., Parker A. C., Grigor G. B. Increased incidence of HL-A 1 and 8 in patients showing IgG or complement coating on their red cells. J Clin Pathol. 1974 May;27(5):353–355. doi: 10.1136/jcp.27.5.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Dausset J., Degos L., Hors J. The association of the HL-A antigens with diseases. Clin Immunol Immunopathol. 1974 Sep;3(1):127–149. doi: 10.1016/0090-1229(74)90029-4. [DOI] [PubMed] [Google Scholar]
  16. Esiri M. M., MacLennan I. C., Hazleman B. L. Lymphocyte sensitivity to skeletal muscle in patients with polymyositis and other disorders. Clin Exp Immunol. 1973 May;14(1):25–35. [PMC free article] [PubMed] [Google Scholar]
  17. Espinosa E., Kaplan M. H. Antigenic analysis of human heart tissue. Identification of antigens with specificity restricted to heart and skeletal muscle in acid extracts of myocardium. J Immunol. 1968 May;100(5):1020–1031. [PubMed] [Google Scholar]
  18. Falk R. E., Thorsby E., Möller E., Möller G. In vitro assay of cell-mediated immunity: the inhibition of migration of sensitized human lymphocytes by HL-A antigens. Clin Exp Immunol. 1970 Apr;6(4):445–455. [PMC free article] [PubMed] [Google Scholar]
  19. GUNN A., MICHIE W., IRVINE W. J. THE THYMUS IN THYROID DISEASE. Lancet. 1964 Oct 10;2(7363):776–778. doi: 10.1016/s0140-6736(64)90558-6. [DOI] [PubMed] [Google Scholar]
  20. Goldstein G., Mackay I. R. The thymus in systemic lupus erythematosus: a quantitative histopathological analysis and comparison with stress involution. Br Med J. 1967 May 20;2(5550):475–478. doi: 10.1136/bmj.2.5550.475. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Goldstein G., Whittingham S. Experimental autoimmune thymitis. An animal model of human myasthenia gravis. Lancet. 1966 Aug 6;2(7458):315–318. doi: 10.1016/s0140-6736(66)92599-2. [DOI] [PubMed] [Google Scholar]
  22. Goust J. M., Castaigne A., Moulias R. Delayed hypersensitivity to muscle and thymus in myasthenia gravis and polymyositis. Clin Exp Immunol. 1974 Sep;18(1):39–47. [PMC free article] [PubMed] [Google Scholar]
  23. Halperin I. C., Minogue W. F., Komninos Z. D. Autoimmune hemolytic anemia and myasthenia gravis associated with thymoma. N Engl J Med. 1966 Sep 22;275(12):663–664. doi: 10.1056/NEJM196609222751210. [DOI] [PubMed] [Google Scholar]
  24. Houseley J., Oppenheim J. J. Lymphocyte transformation in thymectomized and nonthymectomized patients with myasthenia gravis. Br Med J. 1967 Jun 10;2(5553):679–681. doi: 10.1136/bmj.2.5553.679. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Kalden J. R., Irvine W. J. Experimental myasthenia gravis. Lancet. 1969 Sep 20;2(7621):638–639. doi: 10.1016/s0140-6736(69)90342-0. [DOI] [PubMed] [Google Scholar]
  26. Kalden J. R., Williamson W. G., Irvine W. J. Experimental myasthenia gravis, myositis and myocarditis in guinea-pigs immunized with subcellular fractions of calf thymus or calf skeletal muscle in Freund's complete adjuvant. Clin Exp Immunol. 1973 Jan;13(1):79–88. [PMC free article] [PubMed] [Google Scholar]
  27. Kaufman B. M., Rushworth G., Wright R. Experimental studies related to autoimmunity in myasthenia gravis. J Neurol Neurosurg Psychiatry. 1969 Aug;32(4):281–289. doi: 10.1136/jnnp.32.4.281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Kott E., Genkins G., Rule A. H. Leukocyte response to muscle antigens in myasthenia gravis. Relationship to clinical severity and presence of circulating antibodies. Neurology. 1973 Apr;23(4):374–380. doi: 10.1212/wnl.23.4.374. [DOI] [PubMed] [Google Scholar]
  29. Kott E., Osserman K. E., Rule A. H. Myasthenia gravis: migration inhibition of leucocytes in the presence of central-nervous-tissue antigen and muscle antigens. Lancet. 1971 Oct 9;2(7728):816–816. doi: 10.1016/s0140-6736(71)92765-6. [DOI] [PubMed] [Google Scholar]
  30. Lisak R. P., Zweiman B. Mitogen and muscle extract induced in vitro proliferative responses in myasthenia gravis, dermatomyositis, and polymyositis. J Neurol Neurosurg Psychiatry. 1975 Jun;38(6):521–524. doi: 10.1136/jnnp.38.6.521. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. McFarlin D. E., Barlow M., Strauss A. J. Antibodies to muscle and thymus in nonmyasthenic patients with thymoma. Clinical evaluation. N Engl J Med. 1966 Dec 15;275(24):1321–1326. doi: 10.1056/NEJM196612152752401. [DOI] [PubMed] [Google Scholar]
  32. Middleton G. The incidence of follicular structures in the human thymus at autopsy. Aust J Exp Biol Med Sci. 1967 Apr;45(2):189–199. doi: 10.1038/icb.1967.14. [DOI] [PubMed] [Google Scholar]
  33. Namba T., Grob D. Effect of antibodies against skeletal muscle constituents on muscle function in rats. Rev Can Biol. 1969 Mar;28(1):9–18. [PubMed] [Google Scholar]
  34. Nastuk W. L., Kessler H. J., Grynbaum A., Smith M., Herrmann C., Jr Immunological changes following thymectomy in myasthenia gravis. Arch Neurol. 1966 Jul;15(1):1–12. doi: 10.1001/archneur.1966.00470130005001. [DOI] [PubMed] [Google Scholar]
  35. Oosterhuis H. J., Feltkamp T. E., van der Geld H. R. Muscle antibodies in myasthenic mothers and their babies. Lancet. 1966 Dec 3;2(7475):1226–1227. doi: 10.1016/s0140-6736(66)92306-3. [DOI] [PubMed] [Google Scholar]
  36. Oosterhuis H. J., van der Geld H., Gfeltkamp T. E. Studies in myasthenia gravis. 2. The relation of some clinical and immunological data. J Neurol Sci. 1967 May-Jun;4(3):417–434. doi: 10.1016/0022-510x(67)90027-5. [DOI] [PubMed] [Google Scholar]
  37. Osserman K. E., Tsairis P., Weiner L. B. Myasthenia gravis and thyroid disease: clinical and immunologic correlation. J Mt Sinai Hosp N Y. 1967 Sep-Oct;34(5):469–483. [PubMed] [Google Scholar]
  38. Pirskanen R., Tiilikainen A., Hokkanen E. Histocompatibility (HL-A) antigens associated with myasthenia gravis. A preliminary report. Ann Clin Res. 1972 Oct;4(5):304–306. [PubMed] [Google Scholar]
  39. SIMPSON J. A. An evaluation of thymectomy in myasthenia gravis. Brain. 1958 Mar;81(1):112–144. doi: 10.1093/brain/81.1.112. [DOI] [PubMed] [Google Scholar]
  40. SIMPSON J. A. IMMUNOLOGICAL DISTURBANCES IN MYASTHENIA GRAVIS WITH A REPORT OF HASHIMOTO'S DISEASE DEVELOPING AFTER THYMECTOMY. J Neurol Neurosurg Psychiatry. 1964 Dec;27:485–492. doi: 10.1136/jnnp.27.6.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Shulman S., Lang R., Beutner E., Witebsky E. Precipitation of autoantibody in serum from patients with myasthenia gravis. Immunology. 1966 Apr;10(4):289–303. [PMC free article] [PubMed] [Google Scholar]
  42. Soborg M., Bendixen G. Human lymphocyte migration as a parameter of hypersensitivity. Acta Med Scand. 1967 Feb;181(2):247–256. doi: 10.1111/j.0954-6820.1967.tb07255.x. [DOI] [PubMed] [Google Scholar]
  43. Strauss A. J., van der Geld H. W., Kemp P. G., Jr, Exum E. D., Goodman H. C. Immunological concomitants of myasthenia gravis. Ann N Y Acad Sci. 1965 Jun 30;124(2):744–766. doi: 10.1111/j.1749-6632.1965.tb18999.x. [DOI] [PubMed] [Google Scholar]
  44. VAN DER GELD H., FELTKAMP T. E., VAN LOGHEM J., OOSTERHUIS H. J., BIEMOND A. MULTIPLE ANTIBODY PRODUCTION IN MYASTHENIA GRAVIS. Lancet. 1963 Aug 24;2(7304):373–375. doi: 10.1016/s0140-6736(63)93055-1. [DOI] [PubMed] [Google Scholar]
  45. Vetters J. M. Muscle antibodies in myasthenia gravis. Immunology. 1967 Sep;13(3):275–280. [PMC free article] [PubMed] [Google Scholar]
  46. Vetters J. M., Saikia N. K., Wood J., Simpson J. A. Pemphigus vulgaris and myasthenia gravis. Br J Dermatol. 1973 May;88(5):437–441. doi: 10.1111/j.1365-2133.1973.tb15446.x. [DOI] [PubMed] [Google Scholar]
  47. Vetters J. M., Simpson J. A. Comparison of thymic histology with response to thymectomy in myasthenia gravis. J Neurol Neurosurg Psychiatry. 1974 Oct;37(10):1139–1145. doi: 10.1136/jnnp.37.10.1139. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Vetters J. M., Simpson J. A., Folkarde A. Experimental myasthenia gravis. Lancet. 1969 Jul 5;2(7610):28–31. doi: 10.1016/s0140-6736(69)92601-4. [DOI] [PubMed] [Google Scholar]
  49. Vetters M., Barclay R. S. The incidence of germinal centres in thymus glands of patients with congenital heart disease. J Clin Pathol. 1973 Aug;26(8):583–591. doi: 10.1136/jcp.26.8.583. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Wolf S. M., Barrows H. S. Myasthenia gravis and systemic lupus erythematosus. Arch Neurol. 1966 Mar;14(3):254–258. doi: 10.1001/archneur.1966.00470090026003. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES