| Objective: 1.To detect the positive rate and level of antibodies(AchR antibody,MuSK antibody,Titin antibody,LRP4 antibody)in peripheral blood of children with Ocular myasthenia gravis(OMG);2.To detect the levels of peripheral blood T lymphocytes(Th1,Th2,Th17)and related cytokines(IL-2,IL-4,IL-6,IL-10,TNF-α and IFN-γ)before and after the treatment of Pyridostigmine Bromide(PB),Glucocorticoid(GC)with PB.3.To investigate the positive rate and level of antibody in peripheral blood of children with OMG,and the effect of GC and PB on the expression of helper T lymphocytes and related cytokines in children with OMG and its clinical significance.Methods: A total of 90 children with a diagnosis of ocular myasthenia gravis and a myasthenia gravis-related antibody were enrolled in the neurology department of the Children’s Hospital of Chongqing Medical University from January 2018 to March 2019.Among them,25 patients were newly diagnosed.Peripheral blood-related antibodies were detected by radioimmunoassay.Flow cytometry was used to detect the expression levels of T lymphocytes and related cytokines in 25 newly diagnosed OMG children.To understand and explore the effects of GC and PB on immune function and regulation mechanism in children with OMG.Results:1.The positive rate of AchR antibody in peripheral blood of children with OMG was 60%,and the remaining antibodies were negative.2.There was no significant difference in the levels of T lymphocytes and related cytokines before and after treatment with pyridostigmine bromide(P>0.05).3.Th1(t=2.568),IL-6(t=2.203),TNF-α(t=2.854),and IFN-γ(t=2.205)decreased after treatment with pyridostigmine bromide combined with glucocorticoids therapy.Th2(t=-2.165)was higher than before treatment(P<0.05),and the difference was statistically significant.4.Pyridostigmine bromide combined with glucocorticoids therapy group,Th1(t=2.099),IL-6(t=2.225),IL-10(t=2.319),IFN-γ(t=2.514),the level was lower than that of the treatment group with pyridostigmine bromide(P<0.05),and the difference was statistically significant.Conclusion:1.In 90 patients with OMG,54 cases(60%)of AntiAchR-Ab were positive in the peripheral blood,with a mean of 1.69±0.55nmol/L;4 cases(4.44%)were suspicious,the remaining antibodies w ere negative,and there was no correlation with gender.Compared with adult OMG,Anti-AchR-Ab has a higher positive rate,but its expression level is significantly reduced,and adult OMG can have Anti-MuSk Ab,while children with OMG are negative.2.PB showed no significant ef fect on the expression of T lymphocytes and related cytokines in periph eral blood of children with OMG.3.GC has a down-regulation effect o n Th1,IL-6,IL-10 and IFN-γ in peripheral blood of children with OM G,indicating that GC does have certain influence and regulation on the immune function of children with OMG.It is said to be positive and v ery beneficial to improve and restore the clinical symptoms of children with MG and prevent the conversion to GMG.4.However,due to the small sample size,this study can not predict whether the Th2 cells can regulate the occurrence and development of OMG in children in the positive or negative direction.Later,the sample size can be expanded to f urther analyze the pathogenesis of Th2 cells in MG and the role of GC and its mechanism of regulation in the course of MG. |
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