Abstract
B-cell activating factor (BAFF), a member of tumor necrosis factor family, activates B cells, promotes their survival and proliferation. BAFF is considered to have an influence on development of autoimmune diseases including myasthenia gravis (MG). We aimed to evaluate BAFF serum levels in MG patients, their potential connection with therapy and course of MG. Cross-sectional study. Two hundred eighteen adult patients with MG (67% women, age: 18–89 years, 82.6% AChR antibody seropositive (AChRAb(+)). Serum BAFF levels, their relationship with severity of clinical symptoms, therapy conducted, clinical and demographic features and other factors were analyzed. Patients with AChRAb(+) MG demonstrated significantly higher BAFF levels than MuSK-MG patients (831.2 ± 285.4 pg/ml vs. 745.6 ± 633.4 pg/ml, respectively; p = 0.030). Serum BAFF levels in women were significantly higher than in men (855.9 ± 302.5 vs. 756.6 ± 289.4, respectively; p = 0.017). Mean serum BAFF level was significantly decreased in patients who were ever treated with corticosteroids (CS) (770.4 ± 327.8 pg/ml vs. 891.3 ± 246.1 pg/ml, respectively; p = 0.001). Thymoma-MG patients demonstrated significantly lower BAFF levels (671.2 ± 244.9 vs. 833.5 ± 302.4, respectively; p = 0.044). Thymectomized patients did not differ in BAFF levels from the MG patients who had not undergone thymectomy. In multiple linear regression model, recent CS therapy and male sex were found to be independent predictors of lower BAFF levels. Serum BAFF level is decreased in patients treated with CS, which may suggest inhibiting influence of CS on BAFF—a potential mechanism contributing to the effectiveness of such therapy.
Highlights
B-cell activating factor (BAFF) belongs to tumor necrosis factor (TNF) family and is a crucial factor for development and survival of B lymphocytes
Clinical diagnosis of MG was confirmed by positive result of repetitive nerve stimulation test or SFEMG and/or serum anti-AChR or anti-MuSK antibodies levels. 67% of tested patients were women; age ranged 18–89 years; 82.6% of subjects were seropositive for AChR antibodies (AChRAb(+)). 56.4% of patients were classified as earlyonset MG (EOMG; ≤ 50 years), 37.2% as late-onset MG (LOMG; > 50 years); 6.4% had thymoma-MG (T-MG)
Serum BAFF levels in patients treated with CS within last three months were significantly decreased in comparison with those who have not received such therapy recently (723.8 ± 329.2 pg/ml vs. 914.6 ± 243.5 pg/ml, respectively; p < 0.001)
Summary
B-cell activating factor (BAFF) belongs to tumor necrosis factor (TNF) family and is a crucial factor for development and survival of B lymphocytes. Binding BAFF to its receptor on B cells results in stimulation of B cells and promotes antibody production by several different mechanisms, increasing B cells survival and proliferation with blockade of self-reactive B cells. BAFF was confirmed to be one of key factors in promoting autoimmunity MG can co-exist with various autoimmune diseases, most frequently (26.8%) with autoimmune thyroid diseases (Kubiszewska et al 2016). It is typically treated with acetylcholinesterase inhibitors and immunosuppressants, and, in selected cases, with thymectomy. Higher serum BAFF levels in MG patients in comparison with healthy controls have been already reported (Kang et al 2016; Kim et al. Vol.:(0123456789)
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