Abstract

Myasthenia gravis (MG) is an autoimmune disease in which antibodies bind to acetylcholine receptors (AChR) or other functional molecules in the postsynaptic membrane at the neuromuscular junction. Vitamin D (VD) has a number of pluripotent effects, which include immune-regulation and bone metabolism. The immunomodulatory actions of 1,25(OH)2D3 are mediated by its binding to a vitamin D receptor (VDR). In the study, we undertook a case-control study to explore the association between VDR gene polymorphism and the susceptibility and severity of MG patients. Four hundred and eighty MG patients and 487 healthy controls were included and gene polymorphisms of VDR were determined with improved multiplex ligation detection reaction technique and SNPscanTM technique. MG patients were classified into subgroups by essential clinical features and by a comprehensive classification. The frequencies of alleles and genotypes were compared between the MG group and the control group, between each MG subgroup and the control group, and between each pair of MG subgroups. There were no significant differences in frequencies of alleles and genotypes between MG patients and healthy controls, between MG subgroups and healthy controls, or between each pair of MG subgroups in the analysis of subgroups classified by essential clinical features (onset age, gender, thymoma, AChRAb positivity, onset involvement) and the maximal severity (modified Oosterhuis score). In the analysis of subgroups with a comprehensive classification, the frequencies of alleles and genotypes in rs731236 showed significant differences between adult non-thymoma AChRAb negative MG subgroup and the control group, as well as the adult non-thymoma AChRAb positive MG group. In the Chinese Han population, rs731236 was found to be possibly associated with adult non-thymoma AChRAb negative MG patients, although this needs further confirmation.

Highlights

  • Myasthenia gravis (MG) is an autoimmune disease in which antibodies bind to acetylcholine receptors (AChR) or to other functional molecules, such as muscle-specific kinase (MuSK) and lipoprotein-receptor-related protein 4 (LRP4), in the postsynaptic membrane at the neuromuscular junction (NMJ) [1]

  • We further compared between the MuSK antibody positive and MuSK antibody negative group within the AChRAb negative MG patients

  • We found there were no significant differences between MG patients and healthy controls, between MG subgroups and healthy controls, or between each pair of MG subgroups in the analysis of subgroups classified by essential clinical features and the maximal severity

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Summary

Introduction

Myasthenia gravis (MG) is an autoimmune disease in which antibodies bind to acetylcholine receptors (AChR) or to other functional molecules, such as muscle-specific kinase (MuSK) and lipoprotein-receptor-related protein 4 (LRP4), in the postsynaptic membrane at the neuromuscular junction (NMJ) [1]. Various immune cells involving innate and adaptive immunity participate in the pathogenesis of MG, including dendritic cells and B and T lymphocytes [2]. Immunemodulating molecules, such as cytokines, are major mediators. An aberrant regulation of the immune system is presumed to be involved in the susceptibility and the severity of MG. Immune response is modulated by other molecules, such as vitamin D [3]. Vitamin D (VD) has a number of pluripotent effects, which include immune-regulation and bone metabolism. 1,25(OH)2D3 promotes the differentiation of monocytes and inhibits the maturation of dendritic cells [4]. 1,25(OH)2D3 inhibits proliferation and differentiation of plasma cells [6]

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