Treatment principles in the management of autoimmune myasthenia gravis

Annals of the New York Academy of Sciences

Volumn 998, Issue , 2003, Pages 457-472

  Richman, David P ^a   Agius, Mark A ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

Acetylcholine receptor; Acetylcholinesterase; Autoimmune; Immunosuppression; Intravenous immunoglobulln; Myasthenia gravis; Neuromuscular junction; Plasma exchange; Treatment

Indexed keywords

3,4 DIAMINOPYRIDINE; ANTIGEN; AZATHIOPRINE; CHOLINERGIC RECEPTOR; CHOLINESTERASE INHIBITOR; CORTICOSTEROID; CYCLOPHOSPHAMIDE; CYCLOSPORIN A; EPHEDRINE; IMMUNOGLOBULIN; IMMUNOSUPPRESSIVE AGENT; MITOXANTRONE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; PYRIDOSTIGMINE; RITUXIMAB;

ANXIETY DISORDER; ARTIFICIAL VENTILATION; AUTOIMMUNE DISEASE; AVASCULAR NECROSIS; BLADDER DISEASE; BONE MARROW SUPPRESSION; BRADYCARDIA; CARCINOMA; CATARACT; CLINICAL TRIAL; CONFERENCE PAPER; COST BENEFIT ANALYSIS; DEPRESSION; DIABETES MELLITUS; DIARRHEA; DIGESTIVE SYSTEM PERFORATION; DISEASE SEVERITY; DOSE RESPONSE; DRUG EFFECT; FASCICULATION; GASTROINTESTINAL DISEASE; GASTROINTESTINAL SECRETION; GLAUCOMA; HUMAN; HYPERTENSION; IMMUNOSUPPRESSIVE TREATMENT; INSOMNIA; INTENSIVE CARE; JOINT NECROSIS; KIDNEY INJURY; LEUKOPENIA; LIVER DYSFUNCTION; LUNG DISEASE; MUSCLE CRAMP; MYASTHENIA GRAVIS; MYOPATHY; NEPHROTOXICITY; NEUROMUSCULAR TRANSMISSION; OBESITY; OPPORTUNISTIC INFECTION; OSTEOPOROSIS; PATHOGENESIS; PLASMAPHERESIS; PSYCHOSIS; REMISSION; SIDE EFFECT; STOMACH FUNCTION DISORDER; STOMACH MOTILITY; SURGICAL TECHNIQUE; SWEATING; THROMBOCYTOPENIA; THYMECTOMY; ULCER; VOMITING; WEIGHT GAIN;

EID: 0141838992     PISSN: 00778923     EISSN: None     Source Type: Book Series    
DOI: 10.1196/annals.1254.060     Document Type: Conference Paper

References (79)

1. RICHMAN, D.P., M.A. AGIUS, C.A. KIRVAN et al. 1998. Antibody effector mechanisms in myasthenia gravis: the complement hypothesis. Ann. N.Y. Acad. Sci. 841: 450-465.
2. LISAK, R.P. 1999. Myasthenia gravis. Curr. Treat. Options Neurol. 1: 239-250.
3. VINCENT, A., J. PALACE & D. HILTON-JONES. 2001. Myasthenia gravis. Lancet 357: 2122-2128.
4. LINDSTROM, J.M. 2000. Acetylcholine receptors and myasthenia. Muscle Nerve 23: 453-477.
5. GOMEZ, C.M. & D.P. RICHMAN. 1983. Anti-acetylcholine receptor antibodies directed against the alpha-bungarotoxin binding site induce a unique form of experimental myasthenia. Proc. Natl. Acad. Sci. USA 80: 4089-4093.
6. LEFVERT, A.K., S. CUENOUD & B.W. FULPIUS. 1981. Binding properties and subclass distribution of anti-acetylcholine receptor antibodies in myasthenia gravis. J. Neuroimmunol. 1: 125-135.
7. FULPIUS, B.W., A.K. LEFVERT, S. CUENOUD & A. MOUREY. 1981. Properties and serum levels of specific populations of anti-acetylcholine receptor antibodies in myasthenia gravis. Ann. N.Y. Acad. Sci. 377: 307-315.
8. RICHMAN, D.P. & M.A. AGIUS. 1994. Myasthenia gravis: pathogenesis and treatment. Semin. Neurol. 14: 106-110.
9. ENGEL, A.G. & K. ARAHATA. 1987. The membrane attack complex of complement at the endplate in myasthenia gravis. Ann. N.Y. Acad. Sci. 505: 326-332.
10. MASELLI, R.A., D.P. RICHMAN & R.L. WOLLMANN. 1991. Inflammation at the neuromuscular junction in myasthenia gravis. Neurology 41: 1497-1504.
11. NAKANO, S. & A.G. ENGEL. 1993. Myasthenia gravis: quantitative immunocytochemical analysis of inflammatory cells and detection of complement membrane attack complex at the end-plate in 30 patients. Neurology 43: 1167-1172.
12. DRACHMAN, D.B. 1994. Myasthenia gravis. N. Engl. J. Med. 330: 1797-1810.
13. SIMPSON, J.A. 1966. Myasthenia gravis as an autoimmune disease: clinical aspects. Ann. N.Y. Acad. Sci. 135: 506-516.
14. WOLF, S.M., L.P. ROWLAND, D.L. SCHOTLAND et al. 1966. Myasthenia as an autoimmune disease: clinical aspects. Ann. N.Y. Acad. Sci. 135: 517-535.
15. OOSTERHUIS, H.J.G.H. 1997. Myasthenia Gravis. Groningen Neurologic Press. Groningen.
16. GROB, D. 1999. Natural history of myasthenia gravis. In Myasthenia Gravis and Myasthenic Disorders, pp. 131-145. Oxford University Press. Oxford.
17. HOCH, W., J. McCoNVILLE, S. HELMS et al. 2001. Auto-antibodies to the receptor tyrosine kinase MuSK in patients with myasthenia gravis without acetylcholine receptor antibodies. Nat. Med. 7: 365-368.
18. LIYANAGE, Y., W. HOCH, D. BEESON & A. VINCENT. 2002. The agrin/muscle-specific kinase pathway: new targets for autoimmune and genetic disorders at the neuromuscular junction. Muscle Nerve 25: 4-16.
19. STRAUSS, A.J., B.C. SEEGAL, K.C. HSU et al. 1960. Immunofluorescence demonstration of a muscle-binding complement-fixing serum globulin fraction in myasthenia gravis. Proc. Soc. Exp. Biol. Med. 105: 184-191.
20. AARLI, J.A., K. STEFANSSON, L.S. MARTON & R.L. WOLLMANN. 1990. Patients with myasthenia gravis and thymoma have in their sera IgG autoantibodies against titin. Clin. Exp. Immunol. 82: 284-288.
21. VOLTZ, R.D., W.C. ALBRICH, A. NAGELE et al. 1997. Paraneoplastic myasthenia gravis: detection of anti-MGT30 (titin) antibodies predicts thymic epithelial tumor. Neurology 49: 1454-1457.
22. MYGLAND, A., J.A. AARLI, R. MATRE & N.E. GILHUS. 1994. Ryanodine receptor antibodies related to severity of thymoma associated myasthenia gravis. J. Neurol. Neurosurg. Psychiatry 57: 843-846.
23. ROMI, F., G.O. SKEIE, J.A. AARLI & N.E. GILHUS. 2000. The severity of myasthenia gravis correlates with the serum concentration of titin and ryanodine receptor antibodies. Arch. Neurol. 57: 1596-1600.
24. AGIUS, M.A., S. ZHU, C.A. KIRVAN et al. 1998. Rapsyn antibodies in myasthenia gravis. Ann. N.Y. Acad. Sci. 841: 516-521.
25. VANDERLUGT, C.L. & S.D. MILLER. 2002. Epitope spreading in immune-mediated diseases: implications for immunotherapy. Nat. Rev. Immunol. 2: 85-95.
26. AGIUS, M.A., G.M. TWADDLE & R.H. FAIRCLOUGH. 1998. Epitope spreading in experimental autoimmune myasthenia gravis. Ann. N.Y. Acad. Sci. 841: 365-367.
27. HAHN, B.H. 2001. Systemic lupus erythematosis. In Harrison's Principles of Internal Medicine, pp. 1922-1928. McGraw-Hill. New York.
28. LIPSKY, O.E. 2001. Rheumatoid arthritis. In Harrison's Principles of Internal Medicine, pp. 1928-1935. McGraw-Hill. New York.
29. VERHASSELT, V. & M. GOLDMAN. 2001. From autoimmune responses to autoimmune disease: what is needed? J. Autoimmun. 16: 327-330.
30. VAN PARIJS, L. & A.K. ABBAS. 1998. Homeostasis and self-tolerance in the immune system: turning lymphocytes off. Science 280: 243-248.
31. CAMPBELL, H. & E. BRAMWELL. 1900. Myasthenia gravis. Brain 23: 277-337.
32. KENNEDY, F.S. & F.P. MOERSCH. 1937. Myasthenia gravis: a clinical review of eighty-seven cases observed between 1915 and the early part of 1932. Can. Med. Assoc. J. 37: 216-223.
33. VIETS, H.R. 1953. A historical review of myasthenia gravis from 1672 to 1900. J. Am. Med. Assoc. 153(14): 1273-1280.
34. ROWLAND, L.P., P.F.A. HOEFER, H. ARANOW & H.H. MERRITT. 1956. Fatalities in myasthenia gravis: a review of 39 cases with 26 autopsies. Neurology 6: 307-326.
35. VERMA, P. & J. OGER. 1992. Treatment of acquired autoimmune myasthenia gravis: a topic review. Can. J. Neurol. Sci. 19: 360-375.
36. PERLO, V.P., D.C. POSKANZER, R.S. SCHWAB et al. 1966. Myasthenia gravis: evaluation of treatment in 1,355 patients. Neurology 16: 431-439.
37. GROB, D., N.G. BRUNNER & T. NAMBA. 1981. The natural course of myasthenia gravis and effect of therapeutic measures. Ann. N.Y. Acad. Sci. 377: 652-669.
38. OOSTERHUIS, H.J. 1981. Observations of the natural history of myasthenia gravis and the effect of thymectomy. Ann. N.Y. Acad. Sci. 377: 678-690.
39. GROB, D., E.L. ARSURA, N.G. BRUNNER & T. NAMBA. 1987. The course of myasthenia gravis and therapies affecting outcome. Ann. N.Y. Acad. Sci. 505: 472-499.
40. BOERS, M., A.C. VERHOEVEN, H.M. MARKUSSE et al. 1997. Randomised comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone in early rheumatoid arthritis. Lancet 350: 309-318.
41. KREMER, J.M. 2001. Rational use of new and existing disease-modifying agents in rheumatoid arthritis. Ann. Intern. Med. 134: 695-706.
42. BATHON, J.M., R.W. MARTIN, R.M. FLEISCHMANN et al. 2000. A comparison of etanercept and methotrexate in patients with early rheumatoid arthritis. N. Engl. J. Med. 343: 1586-1593.
43. LANDEWE, R.B., M. BOERS, A.C. VERHOEVEN et al. 2002. COBRA combination therapy in patients with early rheumatoid arthritis: long-term structural benefits of a brief intervention. Arthritis Rheum. 46: 347-356.
44. O'DELL, J.R. 2002. Treating rheumatoid arthritis early: a window of opportunity? Arthritis Rheum. 46: 283-285.
45. WALKER, M.B. 1934. Treatment of myasthenia gravis with physostigmine. Lancet 1: 1200-1201.
46. SIEB, J.P. & A.G. ENGEL. 1993. Ephedrine: effects on neuromuscular transmission. Brain Res. 623: 167-171.
47. LUNDH, H., O. NILSSON & I. ROSEN. 1985. Improvement in neuromuscular transmission in myasthenia gravis by 3,4-diaminopyridine. Eur. Arch. Psychiatry Neurol. Sci. 234: 374-377.
48. PERLO, V.P., B. ARNASON, D. POSKANZER et al. 1971. The role of thymectomy in the treatment of myasthenia gravis. Ann. N.Y. Acad. Sci. 183: 308-315.
49. BUCKINGHAM, J.M., F.M. HOWARD, JR., P.E. BERNATZ et al. 1976. The value of thymectomy in myasthenia gravis: a computer-assisted matched study. Ann. Surg. 184: 453-458.
50. GRONSETH, G.S. & R.J. BAROHN. 2000. Practice parameter: thymectomy for autoimmune myasthenia gravis (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 55: 7-15.
51. ROMI, F., N.E. GILHUS, J.E. VARHAUG et al. 2002. Thymectomy and anti-muscle autoantibodies in late-onset myasthenia gravis. Eur. J. Neurol. 9: 55-61.
52. DEFILIPPI, V.J., D.P. RICHMAN & M.K. FERGUSON. 1994. Transcervical thymectomy for myasthenia gravis. Ann. Thorac. Surg. 57: 194-197.
53. CASE, J.P. 2001. Old and new drugs used in rheumatoid arthritis: a historical perspective. Part 1: The older drugs. Am. J. Ther. 8: 123-143.
54. BARNES, P.J. 2001. Molecular mechanisms of corticosteroids in allergic diseases. Allergy 56: 928-936.
55. BRUNNER, N.G., C.L. BERGER, T. NAMBA & D. GROB. 1976. Corticotropin and corticosteroids in generalized myasthenia gravis: comparative studies and role in management. Ann. N.Y. Acad. Sci. 274: 577-595.
56. SAAG, K.G., R. EMKEY, T.J. SCHNITZER et al. 1998. Alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis: Glucocorticoid-Induced Osteoporosis Intervention Study Group. N. Engl. J. Med. 339: 292-299.
57. POHANKA, E. 2001. New immunosuppressive drugs: an update. Curr. Opin. Urol. 11: 143-151.
58. BROMBERG, M.B., J.J. WALD, D.A. FORSHEW et al. 1997. Randomized trial of azathioprine or prednisone for initial immunosuppressive treatment of myasthenia gravis. J. Neurol. Sci. 150: 59-62.
59. KUKS, J.B., S. DJOJOATMODJO & H.J. OOSTERHUIS. 1991. Azathioprine in myasthenia gravis: observations in 41 patients and a review of literature. Neuromuscul. Disord. 1: 423-431.
60. WITTE, A.S., D.R. CORNBLATH, G.J. PARRY et al. 1984. Azathioprine in the treatment of myasthenia gravis. Ann. Neurol. 15: 602-605.
61. PALACE, J., J. NEWSOM-DAVIS & B. LECKY. 1998. A randomized double-blind trial of prednisolone alone or with azathioprine in myasthenia gravis: Myasthenia Gravis Study Group. Neurology 50: 1778-1783.
62. KISSEL, J.T., R.J. LEVY, J.R. MENDELL & R.C. GRIGGS. 1986. Azathioprine toxicity in neuromuscular disease. Neurology 36: 35-39.
63. EVANS, W.E., Y.Y. HON, L. BOMGAARS et al. 2001. Preponderance of thiopurine S-methyl-transferase deficiency and heterozygosity among patients intolerant to mercaptopurine or azathioprine. J. Clin. Oncol. 19: 2293-2301.
64. McLEOD, H.L. & C. SIVA. 2002. The thiopurine S-methyltransferase gene locus: implications for clinical pharmacogenomics. Pharmacogenomics 3: 89-98.
65. ZHU, L.P., T.R. CUPPS, G. WHALEN & A.S. FAUCI. 1987. Selective effects of cyclophosphamide therapy on activation, proliferation, and differentiation of human B cells. J. Clin. Invest. 79: 1082-1090.
66. PEREZ, M.C., W.L. BUOT, C. MERCADO-DANGUILAN et al. 1981. Stable remissions in myasthenia gravis. Neurology 31: 32-37.
67. NIAKAN, E., Y. HARATI & L.A. ROLAK. 1986. Immunosuppressive drug therapy in myasthenia gravis. Arch. Neurol. 43: 155-156
68. TINDALL, R.S., J.T. PHILLIPS, J.A. ROLLINS et al. 1993. A clinical therapeutic trial of cyclosporine in myasthenia gravis. Ann. N.Y. Acad. Sci. 681: 539-551.
69. MATSUDA, S. & S. KOYASU. 2000. Mechanisms of action of cyclosporine. Immunopharmacology 47: 119-125.
70. ALLISON, A.C. & E.M. EUGUI. 2000. Mycophenolate mofetil and its mechanisms of action. Immunopharmacology 47: 85-118.
71. CHAUDHRY, V., D.R. CORNBLATH, J.W. GRIFFIN et al. 2001. Mycophenolate mofetil: a safe and promising immunosuppressant in neuromuscular diseases. Neurology 56: 94-96.
72. CIAFALONI, E., J.M. MASSEY, B. TUCKER-LIPSCOMB & D.B. SANDERS. 2001. Mycophenolate mofetil for myasthenia gravis: an open-label pilot study. Neurology 56: 97-99.
73. PINCHING, A.J. & D.K. PETERS. 1976. Remission of myasthenia gravis following plasma-exchange. Lancet 2: 1373-1376.
74. DAU, P.C., J.M. LINDSTROM, C.K. CASSEL et al. 1977. Plasmapheresis and immunosuppressive drug therapy in myasthenia gravis. N. Engl. J. Med. 297: 1134-1140.
75. PINCHING, A.J., D.K. PETERS & J.N. DAVIS. 1977. Plasma exchange in myasthenia gravis. Lancet 1: 428-429.
76. FERRERO, B. & L. DURELLI. 2002. High-dose intravenous immunoglobulin G treatment of myasthenia gravis. Neurol. Sci. 23(suppl. 1): S9-S24.
77. ARSURA, E.L., A. BICK, N.G. BRUNNER, et al. 1986. High-dose intravenous immunoglobulin in the management of myasthenia gravis. Arch. Intern. Med. 146: 1365-1368.
78. GAJDOS, P., S. CHEVRET, B. CLAIR et al. 1997. Clinical trial of plasma exchange and high-dose intravenous immunoglobulin in myasthenia gravis: Myasthenia Gravis Clinical Study Group. Ann. Neurol. 41: 789-796.
79. RONAGER, J., M. RAVNBORG, I. HERMANSEN & S. VORSTRUP. 2001. Immunoglobulin treatment versus plasma exchange in patients with chronic moderate to severe myasthenia gravis. Artif. Organs 25: 967-973.