Journal article
AChR phosphorylation and indirect inhibition of AChR function in seronegative MG.
- Abstract:
- BACKGROUND: Approximately 10% to 20% of patients with autoimmune MG do not have antibodies to the acetylcholine receptor (AChR), so-called seronegative MG (SNMG). IgG antibodies from up to 70% of SNMG patients bind to the muscle-specific receptor tyrosine kinase, MuSK. The plasmas and non-IgG fractions from SNMG patients (and some with AChR antibodies) also contain a factor, perhaps an IgM antibody, that inhibits AChR function, but it is not clear how this factor acts and whether it is related to the MuSK IgG antibodies. METHODS: The authors studied 12 unselected SNMG plasmas and their non-IgG fractions; seven were positive for MuSK IgG antibodies. Ion flux assays, electrophysiology, phosphorylation, and kinase assays were used to look at mechanisms of action. RESULTS: Eight of the 12 plasmas and their non-IgG fractions inhibited AChR function, but the inhibitory activity was transient and did not correlate with the presence of MuSK IgG antibodies. Two of three plasmas added outside of a cell-attached patch pipette inhibited AChR function within the patch, and these two plasmas also increased AChR phosphorylation. CONCLUSIONS: The authors propose that a plasma factor(s) in SNMG patients, distinct from MuSK IgG antibodies, binds to a muscle membrane receptor and activates a second messenger pathway leading to AChR phosphorylation and reduced AChR function. Identifying the target for this factor should lead to improved diagnosis of MG in MuSK antibody-negative patients and may provide new insights into the function of the neuromuscular junction and pathophysiological mechanisms in MG.
- Publication status:
- Published
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- Publisher copy:
- 10.1212/01.wnl.0000041625.41937.ff
Authors
- Journal:
- Neurology More from this journal
- Volume:
- 59
- Issue:
- 11
- Pages:
- 1682-1688
- Publication date:
- 2002-12-01
- DOI:
- EISSN:
-
1526-632X
- ISSN:
-
0028-3878
- Language:
-
English
- Keywords:
-
- Pubs id:
-
pubs:241750
- UUID:
-
uuid:04f1313e-3743-46c6-aac9-5d549753a7bc
- Local pid:
-
pubs:241750
- Source identifiers:
-
241750
- Deposit date:
-
2012-12-19
- ARK identifier:
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- Copyright date:
- 2002
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