Direct proof of the in vivo pathogenic role of the AChR autoantibodies from myasthenia gravis patients

PLoS One. 2014 Sep 26;9(9):e108327. doi: 10.1371/journal.pone.0108327. eCollection 2014.

Abstract

Several studies have suggested that the autoantibodies (autoAbs) against muscle acetylcholine receptor (AChR) of myasthenia gravis (MG) patients are the main pathogenic factor in MG; however, this belief has not yet been confirmed with direct observations. Although animals immunized with AChR or injected with anti-AChR monoclonal Abs, or with crude human MG Ig fractions exhibit MG symptoms, the pathogenic role of isolated anti-AChR autoAbs, and, more importantly, the absence of pathogenic factor(s) in the autoAb-depleted MG sera has not yet been shown by in vivo studies. Using recombinant extracellular domains of the human AChR α and β subunits, we have isolated autoAbs from the sera of four MG patients. The ability of these isolated anti-subunit Abs and of the Ab-depleted sera to passively transfer experimental autoimmune MG in Lewis rats was investigated. We found that the isolated anti-subunit Abs were at least as efficient as the corresponding whole sera or whole Ig in causing experimental MG. Abs to both α- and β-subunit were pathogenic although the anti-α-subunit were much more efficient than the anti-β-subunit ones. Interestingly, the autoAb-depleted sera were free of pathogenic activity. The later suggests that the myasthenogenic potency of the studied anti-AChR MG sera is totally due to their anti-AChR autoAbs, and therefore selective elimination of the anti-AChR autoAbs from MG patients may be an efficient therapy for MG.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Autoantibodies / blood*
  • Humans
  • Muscle, Skeletal / immunology*
  • Myasthenia Gravis / immunology*
  • Rats
  • Receptors, Cholinergic / immunology*

Substances

  • Autoantibodies
  • Receptors, Cholinergic

Grants and funding

This work was funded by the Muscular Dystrophy Association of USA (MDA), the Fight-MG grant of the FP7 EC program, the Association Francaise contre les Myopathies (AFM), and by the Greek national funds through the Operational Program “Education and Lifelong Learning” of the National Strategic Reference Framework (NSRF) Research Funding Program: THALES. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.