Biological implications of thymectomy for myasthenia gravis.

Surgery Today
Meinoshin OkumuraHiroyuki Shiono

Abstract

Myasthenia gravis (MG) is an autoimmune disease mediated by autoantibodies to the striated muscle tissue. It is often treated by thymectomy. We review recent studies to investigate the biological implications of thymectomy. In anti-acetylcholine receptor antibody (anti-AchR Ab)-positive patients without a thymoma, abnormal germinal center formation in the thymus seems to play an essential role in the pathogenesis of MG. Specific differentiation of B cells producing anti-AchR Ab takes place uniquely in the thymus, and thymectomy is thought to assist in terminating the provision of high-affinity anti-AchR antibody-producing cells to peripheral organs. Thymectomy is not indicated for anti-AchR Ab-negative MG patients who are antimuscle specific kinase antibody (anti-MuSK Ab)-positive, although some anti-MuSK Ab-negative patients may benefit from the procedure. A thymoma can be considered as an acquired thymus with insufficient function of negative selection. The resection of a thymoma is thought to terminate the production of self-reactive T cells. Thus, the biological implications of thymectomy for MG have been partially revealed. Nevertheless, additional studies are needed to elucidate the ontogeny of T cells that recognize AchR...Continue Reading

References

Jan 1, 1988·Advances in Immunology·J LindstromY Fujii
Dec 1, 1993·Current Opinion in Immunology·N Willcox
Jan 1, 1996·Clinical Immunology and Immunopathology·A I Levinson, L M Wheatley
Sep 1, 1996·The Annals of Thoracic Surgery·A MasaokaY Monden
Apr 1, 1997·European Journal of Immunology·H ShionoH Matsuda
Aug 26, 1998·Developmental Immunology·A MarxH K Müller-Hermelink
Aug 8, 2001·The Journal of Immunology : Official Journal of the American Association of Immunologists·G P SimsD I Stott
Jun 25, 2003·Neurology·D B SandersA Vincent
Nov 1, 2003·Annals of the New York Academy of Sciences·H ShionoN Willcox
Feb 26, 2005·Annals of Neurology·Maria Isabel LeiteAngela Vincent
Aug 21, 2007·Journal of Neuroimmunology·Akio HayashiYoshiki Sawa
Apr 11, 2008·General Thoracic and Cardiovascular Surgery·Meinoshin OkumuraYoshiki Sawa

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Citations

Sep 29, 2011·Neuroimmunomodulation·Jacqueline Mays, Cherié L Butts
Jan 12, 2012·Autoimmune Diseases·Samia Ragheb, Robert P Lisak
Dec 20, 2011·The Journal of Thoracic and Cardiovascular Surgery·Vincenzo Ambrogi, Tommaso Claudio Mineo
Jun 2, 2015·Internal Medicine·Kyoko NiimiKoichiro Asano
Sep 17, 2011·Muscle & Nerve·Paola CavalcanteRenato Mantegazza
Dec 30, 2014·Orphanet Journal of Rare Diseases·Carolina BarnettVera Bril
Jan 15, 2013·The Journal of Thoracic and Cardiovascular Surgery·Tommaso Claudio Mineo, Vincenzo Ambrogi
Jun 22, 2016·Pediatrics International : Official Journal of the Japan Pediatric Society·Yusuke HirataKeiichi Ozono
Oct 16, 2010·Current Opinion in Ophthalmology

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