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Investigation on the Mechanism of Exacerbation of myasthenia gravis by Aminoglycoside Antibiotics in Mouse Model

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2005年第3期25卷 294-296页

作者：刘昌勤胡芳 Department of Neurology Union Hospital Tongji Medical College Huazhong University of Science and Technology

To investigate the underlying mechanism of the exacerbation of myasthenia gravis by aminoglycoside antibiotics. C57/BL6 mice were immunized with acetylcholine receptor (AChR), extracted from electric organ of Narcine timilei according to Xu Haopeng's methods, in complete Fruend's adjuvant (CFA) to establish experimental autoimmune myasthenia gravis (EAMG). EAMG mice were divided randomly into 5 groups: MG group, NS group and three antibiotics groups. The clinical symptom scores of mice were evaluated on d7 after the last immunization and d14 of antibiotics treatment. Repetitive nerve stimulation (RNS) was performed and the levels of anti-AChR antibody (AChR-Ab) were tested at the same time. The mean clinical symptom grades of gentamycin group (1.312, 2.067), amikacin group (1.111, 1.889) and etimicin group (1.263, 1.632) were significantly higher than those of MG group (1.000, 1.200) (Pmyasthenia gravis. The exacerbation of myasthenia gravis by these antibiotics probably involves competitively restraining the release of acetylcholine from presynaptic membrane, impairing the depolarization of postsynaptic membrane, depressing the irritability of myocyte membrane around the end-plate membrane and consequently leading to the blockade of neuromuscular junction.

关键词： Aminoglycoside antibiotics myasthenia gravis mice

Study on the Clinical Effectiveness of Thymectomy for myasthenia gravis

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The Chinese-German Journal of Clinical Oncology 2002年第1期1卷 36-37页

作者： PAN Tiecheng, YAN Hua, ZHANG Ni, PAN Youming, TANG Yingxiong, WEN Xiang, SONG Dingwei, HU Ming, LIU Ligang, LIU Zixiong, YANG Mingshan, XU Jinzhi, PU Bitao, GAO Boting Department of Thoracis Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China Department of Thoracis Surgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China

Objective To investigate the theoretical basis and clinical significance of thymectomy in the treatment of myasthenia gravis (MG). Methods Analyze the changes in the contents of serum AchRab and sIL-2R, lymphocyte subtypes in peripheral blood lymphocytes before and after thymectomy in 69 patients.Results In the study group significant changes were found in serum contents of AchRab and sIL-2R before and after operation and there was also remarkable change in the number and constitution of peripheral blood lymphocyte subtypes. Conclusion Thymectomy is an effective therapy for MG.

关键词： myasthenia gravis thymectomy

Experimental Study on Induction of Tolerance to Experimental Autoimmune myasthenia gravis by Immature Dendritic Cells

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2005年第2期25卷 215-218页

作者：李罗清孙圣刚曹学兵王云甫常丽英殷小平 Department of Neurology Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 China

Summary: To investigate the effect of immature dendritic cells (iDCs) on experimental autoimmune myasthenia gravis (MG), iDCs were generated in low dose of GM-CSF, and then they were pulsed with acetylcholine receptor (AchR) and transferred to allogeneic rats. After 3 weeks, all rats were immunized with AchR and complete Freund's adjuvant (CFA) and observed for the corresponding indices of MG for 7 weeks. Our results showed that compared with mature DCs (mDCs) generated at high dose of GM-CSF plus additional stimulation by lipopolysaccharide, iDCs expressed significantly lower levels of MHC-Ⅱ, CD80 and CD86, and their ability to uptake FITC-Dextran was stronger but the ability of stimulating proliferation of allogeneic T cells were weaker. Like controls, after immunization, all rats transferred with iDCs, mDCs and AchR-pulsed mDCs showed typical symptoms in 4 to 7 weeks. The amplitude of electromyogram wave dropped obviously, the level of serum AchRab increased and neuromuscular junction showed typical damage of MG. In contrast, no conspicuous changes were noted in rats transferred with AchR-pulsed iDCs. The results suggest that iDCs could be generated by inducing bone marrow precursors in low dose of GM-CSF, AchR-pulsed iDCs could induce tolerance of EAMG. The dysfunction of DCs may play an important role in the initiation and maintenance of normal immune response in MG.

关键词： myasthenia gravis dendritic cells maturational stage immunotolerance

Histologic Classification of Thymoma and Its Relationship with myasthenia gravis and Clinical Stages of the Tumor

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The Chinese-German Journal of Clinical Oncology 2005年第5期4卷 314-316,327页

作者：王新允陈云新王爱香张淑敏天津市泌尿外科研究所 300070

Objective： To investigate the relationship among the latest WHO classification of thymoma, myasthenia gravis （MG） and clinical stages. Methods： To review the pathological sections of 74 patients with thymoma from 1980-2004 using WHO classification （1999）, the statistical software was used to analyze the relationship among the WHO classification, MG and clinical stages. Results：（1） Two cases of type A, 23 cases of type AB, 4 cases of type B1, 27 cases of type B2, 16 cases of type B3 and 2 cases of type C were classified. Type B2 more likely accompanied MG （P〈0.05）, while none with MG occurred for type C. （2） One patient was in stage Ⅰ, 30 were in stage Ⅱ, 38 were in stage Ⅲ, and 5 were in stage Ⅳ. The latest histologic classification was significantly correlated with Masaoka stages （P〈0.01）. Conclusion： The latest WHO classification was correlated with occurrence of MG and finely reflected clinical stage. It can also evaluate the prognosis of patients.

关键词： thymoma myasthenia gravis clinical stages

Effect of treatment with Fufang Huangqi decoction(复方黄杞汤剂) on dose reductions and discontinuation of pyridostigmine bromide tablets, prednisone, and tacrolimus in patients with type Ⅰ or Ⅱ myasthenia gravis

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Journal of Traditional Chinese Medicine 2022年第5期42卷 810-817页

作者： SHAN Caifeng ZHANG Jingsheng LIN Yi HUANG Xueshi WANG Zhanyou PAN Haiou QIAO Wenjun Affiliated Hospital of Liaoning University of Traditional Chinese Medicine Liaoning Provincial Key Laboratory for Diagnosis and Treatment of Myasthenia GravisLiaoning University of Traditional Chinese MedicineShenyang 110033China Department of General Surgery the First People's Hospital of ShenyangShenyang 110091China Institute of Microbial Pharmaceuticals College of Life and Health SciencesNortheastern UniversityShenyang 110819China Institute of Health Sciences Key Laboratory of Medical Cell Biology of Ministry of EducationChina Medical UniversityShenyang 110122China Liaoning University of Traditional Chinese Medicine foreign language collegeLiaoning University of Traditional Chinese MedicineShenyang 110033China

OBJECTIVE: To investigate the clinical efficacy of Fufang Huangqi decoction(复方黄杞汤剂) in combination with pyridostigmine bromide tablets, prednisone, and tacrolimus in the treatment of type Ⅰ and Ⅱ myasthenia gravis(MG) through changes in the clinical symptom scores of 100 patients with type Ⅰ and Ⅱ MG. This study also aimed to examine dose reductions and discontinuation of these 3 Western medicines after administration of Fufang Huangqi decoction. METHODS: The clinical data on 100 patients with type I or II MG who were treated in the outpatient department of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, China, between June 2017 and June 2020 were collected. The patients were divided into 4 groups based on whether they had taken pyridostigmine bromide tablets, prednisone, and/or tacrolimus at the time of their hospital visit: the Fufang Huangqi decoction group(group A), the pyridostigmine bromide tablets + Fufang Huangqi decoction group(group B), the pyridostigmine bromide tablets + prednisone + Fufang Huangqi decoction group(group C), and the pyridostigmine bromide tablets + tacrolimus + Fufang Huangqi decoction group(group D). The average treatment time was(15.6 ± 11.5) months(range: 0.5-55 months). Changes in the clinical symptom scores of the 4 groups of patients after medication administration and dose reductions and discontinuation of the 3 Western medicines were analyzed. RESULTS: An overall effectiveness rate of 86.00% was achieved in the 100 patients after treatment for(15.6 ± 11.5) months(range 0.5-55 months). The effectiveness rates were 85.71% in group A, 88.24% in group B, 76.92% in group C, and 80.00% in group D. The dosage of pyridostigmine bromide was reduced for 69.12% of the patients in group B for the first time after(4.2 ± 4.1) months, and 45.59% of the patients in group B discontinued pyridostigmine bromide after(8.8 ± 6.1) months. The dosage of pyridostigmine bromide was reduced for 46.15% of the patients in grou

关键词： myasthenia gravis drug tapering drug-related side effects and adverse reactions Fufang Huangqi decoction

New Progress in the Treatment of myasthenia gravis

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Journal of Biosciences and Medicines 2023年第12期11卷 106-119页

作者： Yaping Sun Xianglin Cheng Department of Neurology Jingzhou First People’s Hospital Affiliated to Yangtze University Jingzhou China

In recent decades, the treatment of myasthenia gravis has been extensively developed, but a standardized standard still needs to be used. Its treatment strategy is associated with patient prognosis, economic costs, and complications. This article reviews the pathogenesis, treatment methods, and complications of myasthenia gravis, providing new ideas for diagnosing and treating myasthenia gravis and fully embodies the principle of safety and precision.

关键词： myasthenia gravis Thymusectomy Immunosuppressive Drug Biological Drug

Reduction of natural regulatory T cells in thymomas accompanying myasthenia gravis and its possible association with Foxp3 and thymic stromal lymphopoietin

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Journal of Medical Colleges of PLA(China) 2009年第1期24卷 50-55页

作者： Wang Zhongkui Wang Jinghua Deng Benqiang Ding Suju Wu Tao Department of Neurology Changhai Hospital Second Military Medical University Shanghai 200433 China

Objective: To investigate the expression of both thymic regulatory T cells (CD4+CD25+Foxp3+cells, Treg) and thymic stromal lymphopoietin (TSLP) in thymomas accompanying myasthenia gravis. Methods: We used immunohistochemistry and real-time reverse trancription polymerase chain reaction (real-time RT-PCR) techniques to determine Foxp3+ Treg counts and the expression levels of Foxp3 mRNA and TSLP mRNA in thymomas of 23 MG patients and thymuses of 4 healthy controls. Results: The CD4+ Foxp3+ nTreg (natural regulatory T cells) counts in thymomas were significantly lower than those in normal thymuses (P<0.01), and the expression levels of Foxp3 mRNA and TSLP mRNA were also lower in thymomas(P<0.01). Among the thymoma types, type B1 thymoma had the highest Foxp3+ nTreg count and standard values of Foxp3 mRNA and TSLP mRNA. There was a strong positive correlation between the mRNA transcriptional levels of Foxp3 and TSLP. Conclusion: The insufficient expression of Foxp3 in thymoma, which may be caused by decreased transcription of TSLP, may result in the reduction of Tregs and cause autoimmune disorders.

关键词： myasthenia gravis Thymoma Regulatory T cell Foxp3 Thymic stromal lymphopoietin

Assessment of cognitive function in patients with myasthenia gravis

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Neuroimmunology and Neuroinflammation 2014年第1期1卷 141-146页

作者： Sherifa A.Hamed Ahmad H.Youssef Mohamad A.Abd ElHameed Mohamed F.Mohamed Amal M.Elattar Department of Neurology and Psychiatry Assiut University HospitalAssiut 71516AssiutEgypt Department of ENT Audiology UnitAssiut University HospitalAssiut 71516AssiutEgypt

Aim:During the past decade,there has been an increasing interest in the evaluation of cognitive function in myasthenia gravis(MG),neuromuscular transmission disorder caused by acetylcholine receptor ***,the results of previous studies on cognition and MG are inconsistent and *** study aimed to evaluate cognition in patients with mild/moderate grades of ***:This study included 20 patients with MG with a mean age of 28.45±8.89 years and duration of illness of 3.52±1.15 *** was tested using a sensitive battery of psychometric testing(Mini-mental State Examination[MMSE],Stanford-Binet Intelligence Scale 4^(th) edition[SBIS]and Wechsler Memory Scale-Revised[WMS-R])and by recording P300 component of event-related potentials(ERPs),a neurophysiological analog for cognitive ***:Compared with healthy subjects(n=20),patients had lower total scores of cognitive testing(MMSE,SBIS and WMS-R)(P=0.001),higher Beck Depression Inventory 2^(nd) edition scores(P=0.0001)and prolonged latencies(P=0.01)and reduced amplitudes(P=0.001)of P300 component of *** were identified between total scores of cognitive testing and age(r=-0.470,P=0.010),duration of illness(r=-0.788,P=0.001)and depression scores(r=-0.323,P=0.045).Using linear regression analysis and after controlling for age and depression scores,a significant correlation was identified between total scores of cognitive testing and duration of illness(β=-0.305,P=0.045).Conclusion:Patients with mild/moderate MG may have cognitive *** is important to determine prognosis and managing patients.

关键词： Cognition myasthenia gravis nicotinic acetylcholine receptors

Interventional Effect of Jianpi Bushen Granule Combined with Western Medicine on the Level of Serum Acetylcholine Receptor Antibodies in myasthenia gravis Patients

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World Journal of Traditional Chinese Medicine 2015年第4期1卷 42-47页

作者： Chao Jiang Ping Liu Jing-Sheng Zhang Wen-Jing Bao Yan Liang Shao-Bo Qiu Lin Jiang Department of Neurology Xijing Hospital the Fourth Military Medical University Traditional Chinese Medicine Department of Longhua Hospital Affiliated to Shanghai University of traditional Chinese Medicine Neurological Medical Department of the China Affiliated Hospital of Liaoning University of Traditional Chinese Medicine State Key Laboratory of Bioreactor Engineering & Shanghai Key Laboratory of New Drug Design School of Pharmacy East China University of Science and Technology

Objective: This study is aimed to investigate the clinical significance of regulating effect of Jianpi Bushen Granule(JBG) combined with Western medicine on the level of serum acetylcholine receptor antibodies(AchRAb) in myasthenia gravis(MG) patients, so as to offer a theoretical basis of the targeted therapy with ***: We detected the level of anti-AchRAb with enzyme linked immunosorbent assay(ELISA) in the sera from 60 cases of MG patients(randomly divided into the trial group 30 cases, control group 30) for before and after treatment 6 months, and the clinical evaluation carried out by the Quantitative score of myasthenia gravis(QMG) for before and after treatment 3,6 ***:(1) Comparison of the level of serum AchRAb:All included MG patients, the positive rate of serum AchRAb was about 81.67%(49/60),and the trial group was 83.33%(25/30),the control group was 90%(27/30).and the serum AchRAb levels of the trial group(0.994 ±0.417) was lower than that of the contral group(1.068 ± 0.358),but there was no significant difference between the two groups before treatment(P> 0.05). After 6 months of treatment, the serum AchRAb levels of the trial group(0.721 ± 0.280) was also significantly lower than that of the contral group(0.907 ± 0.387),and the serum AchRAb levels was decreased dramatically compared with the same group before treatment, there was significant difference between the two groups(P<0.05).(2)Comparison of QMG scoring:QMG scoring was decreased dramatically in the trial group compared with that of the control group after treatment, there was significant difference(P < 0.05), moreover,the total effective rate in the trial group(50%,86.67%)was significantly higher than those in the control groups(23.33%, 40%) after 3,6 months treatment(P < 0.05). There was also significant difference in the clinical evaluation by the QMG between the two groups before and after treatment.(3) Adverse reactions: no obvious adverse reactions appeared among the tw

关键词： myasthenia gravis JBG AchRAb ELISIA