| Background & Objective:Myasthenia gravis (MG) is a kind of acquired autoimmune disease which has nerves- muscle joints transfer barrier. The pathogenesis of MG has not yet been fully understood. And the previous research on mechanism of MG is that acetylcholine receptors was destroyed by its own antibodies in the nerve-muscle joints postsynaptic membrane so that endplate potentials can not be produced amply, eventually leading to transfer difficultly. So AchR-Ab is also the earliest founded autoantibody with myasthenia gravis. In addition, people detected other autoantibody in MG patients serum, such as PsMAb, Nonstriated muscle antibody, Fight cytoskeleton protein antibody and so on, which also can influence nerve-muscle conduction in various ways. Especially, the Titin antibodies and the RyR antibodies are close to MGT patients. The above three get more concern from scholars both at home and abroad. This research, compared these three kinds of antibodies in MG by the different grouped, is going to investigate the clinical significance of the above antibodies with the diagnosis and treatment of MG. Especially, the changes of these antibodies levels after the thymectomy in patients will be in-depth study to evaluate the importance in estimating the prognosis of recovery with MG.Method:ELISA detection was carried out to detect the levels of the above three kinds of antibodies respectively in serum of 34 cases diagnosed with MG and accepted the thymus complete resection.In addition,28 cases of patients with clinical diagnosis of other neurological disease and 30 cases of normal, healthy people were detected in the same time for comparative analysis. And the antibodies between postoperative week and postoperative three months were also reviewed for comparative analysis. According to the differences of thymus pathological type, onset ages and the Osserman types, the levels of the antibodies was grouping compared.Results:The positive rate of AchR antibodies and Titin antibodies in the group of MG patients was significantly higher than other two groups (P<0.01), RyR antibodies' positive rate was also higher than the other two groups (P<0.05). RyR antibodies and Titin antibodies in MGT group were significantly higher than MGH and MGC groups (P<0.01), and AchR antibodies in MGT group was also higher than other thymus pathological type group (P<0.05). However, three kinds of antibodies had no statistical significance between different onset ages and different serious condition level of the disease (P>0.05). In the group of MGT, the decline of AchR-Ab occurred after postoperative a week (P<0.01), and the decline of RyR-Ab occurred after postoperative three months (P<0.05). The rest had no change(P>0.05).Conclusion:AchR-Ab, Titin-Ab and RyR-Ab are associated with the pathogenesis of MG; they are helpful for the preliminary diagnosis of MG patients, Especially, the diagnosis of MGT can be more fully identified from MGH or MGC by Titin-Ab and RyR-Ab. Three kinds of antibodies can be the important objective indicators to diagnose MGT. The relationship between different onset ages and the antibodies, or between different serious condition level of the disease and the antibodies can be further study to ascertain by increasing the cases. As far as MGT patients, AchR-Ab may be the initial testing indicator to evaluate the condition after the thymectomy. And RyR-Ab also could be an objective indicators to reflect the therapeutic effect of medium and long-term. Though, the relativity between these two antibodies indicators and the condition of prognosis in MGT patients remains to further study. |
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