Abstract
Myasthenia gravis (MG) is an autoimmunological inflammatory disorder of the neuromuscular junction. Inflammation could be a key player for understanding the pathogenesis of MG. We measured the serum levels of 24 inflammatory cytokines in 43 patients with anti-acetylcholine receptor antibody-positive MG and 25 healthy controls. In patients with MG, serum levels of a proliferation-inducing ligand (APRIL), IL-19, IL-20, IL-28A and IL-35 were significantly increased as compared with controls (p < 0.05). Among them, IL-20, IL-28A and IL-35 were significantly decreased after treatment (p < 0.05). In clinical subtype analyses, APRIL and IL-20 were increased in patients with late-onset MG and IL-28A levels were increased in patients with thymoma-associated MG compared with healthy controls (p < 0.01). The results of the present study demonstrate both anti-inflammatory and inflammatory cytokines are upregulated in MG, reflecting the importance of cytokine-mediated inflammation and its regulation in MG pathophysiology.
Highlights
Myasthenia gravis (MG) is an autoimmunological inflammatory disorder of the neuromuscular junction
Of the 24 measured cytokines, serum levels of a proliferation-inducing ligand (APRIL) (p = 0.002); IL-19 (p = 0.013); IL-20 (p = 0.031); IL-28A (p = 0.008) and IL-35 (p = 0.042) were significantly higher in all patients with MG compared to healthy controls (HC) (Fig. 1 and Table 1)
Of the significantly changed cytokines (APRIL, IL-19, IL-20, IL-28A and IL-35), only IL-20 (p = 0.008), IL-28A (p = 0.013) and IL-35 (p = 0.036) levels were significantly decreased after immunosuppressive therapy in 10 patients with MG (Fig. 1)
Summary
Myasthenia gravis (MG) is an autoimmunological inflammatory disorder of the neuromuscular junction. We measured the serum levels of 24 inflammatory cytokines in 43 patients with anti-acetylcholine receptor antibodypositive MG and 25 healthy controls. In patients with MG, serum levels of a proliferation-inducing ligand (APRIL), IL-19, IL-20, IL-28A and IL-35 were significantly increased as compared with controls (p < 0.05). APRIL and IL-20 were increased in patients with late-onset MG and IL-28A levels were increased in patients with thymoma-associated MG compared with healthy controls (p < 0.01). A previous study reported serum interleukin (IL)-17 levels are significantly increased and associated with MG severity[6,7] and that serum IL-22 levels are decreased and negatively correlated with anti-AChR antibody levels in patients with MG7.
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