Nature and Action of Antibodies in Myasthenia Gravis.

Robert L Ruff, Robert P Lisak

Journal: Neurologic clinics 2019;36(2):275-291

PMID: 29655450

Full Text on Elsevier Science View on PubMed

Abstract

This article discusses antibodies associated with immune-mediated myasthenia gravis and the pathologic action of these antibodies at the neuromuscular junctions of skeletal muscle. To explain how these antibodies act, we consider the physiology of neuromuscular transmission with emphasis on 4 features: the structure of the neuromuscular junction; the roles of postsynaptic acetylcholine receptors and voltage-gated Na channels and in converting the chemical signal from the nerve terminal into a propagated action potential on the muscle fiber that triggers muscle contraction; the safety factor for neuromuscular transmission; and how the safety factor is reduced in different forms of autoimmune myasthenia gravis.

Address: Department of Neurology, Case Western University School of Medicine, The Metro Health System, 2500 Metro Health Drive, Cleveland, OH 44109, USA; Department of Neurosciences, Case Western Reserve University, Cleveland, OH, USA.; Department of Neurology, Wayne State University School of Medicine, 8D University Health Center, 4201 St Antoine, Detroit, MI 48201, USA; Department of Biochemistry, Microbiology and Immunology, Wayne State University, Detroit, MI, USA. Electronic address: [email protected].

DOI: 10.1016/j.ncl.2018.01.001

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MeSH Terms: Autoantibodies, Humans, Muscle, Skeletal, Myasthenia Gravis, Neuromuscular Junction, Receptors, Cholinergic