Jan 14, 2016
V. Yilmaz1, P. Oflazer2, F. Aysal3, Y.G. Parman2, H. Direskeneli4, F. Deymeer2,G. Saruhan-Direskeneli1
I.U. Istanbul Medical Faculty Departments of Physiology and Neurology, (3) Bakirkoy Hospital (4) Marmara University, Faculty of Medicine, Division of Rheumatology, Istanbul/Turkey
Neuromuscular junctionVincent A ,
Auto-antibodies in MGAnti-AChR antibody(AP)85-90 %IgG1-2a (Complement activated)Seronegative MG 15-10%Anti-AChR (-) Anti-MuSK (-)(SN)56% 5-8%Anti-MuSK (Muscle specific kinase) (MP)44% 4-6%IgG4 and IgG1 (Complement activity?)
b |Complement C9 deposition in MG
NT: nerve terminal PSF: postsynaptic foldsRole of the complement activation in anti-AChR (+) MG
T cell helpCD40L (Ligand) interactionCytokine
NMean ageImmunosuppressive treatmentMG75502543.133AP37152242.711MP1541139.712SN236174610Rheumatoid Arthritis (RA)2361753.211Controls32161640.6
SUBGROUPS of MG% of CD19+CD27+
p: 0.001p: 0.006SUBGROUPS of MG
p: 0.04p: 0.015
T cell helpCD40L (Ligand) interactionCytokine
BOTH MG and CON were higher than RACON
NO TREATMENTMP> RASN>RAT Cell Help: CD40L expression in CD4+ T cells
CONCON
CONCON
B cell activationB cell receptor (BCR = Ig)Specific antigenAChR/MuSKImmunoglobulinPoly IgT cell helpCD40- CD40L
B cell co-receptors TLRTLR-9CpG/non-CpG
Regulatory Role of B Cells by IL-10 Secretion
AChRMP < CON*RA < CON*IL-6 Response to Specific StimuliNo subgroup related antigen specific responses
No differences in responses to AChR and MuSK between groupsAP MP SN RA CON
CONCLUSIONB cell related or B cell derived cytokine activity in antibody-based subgroups of MG did not reveal a specific pattern for disease developmentThe differences between RA and MG point to differential cytokine effects in these diseasesUntreated patients in all subgroups are needed to clairify the differential features in this disease.
Only RA higher than MG and controlsIL-10Lower in AP compared to RA and ControlsIL-13Higher in RA only
mRNA expression in CD19+ B cells
IL-6 Response to Specific Stimuli in Non-treated Patients
IL-6 Response to Non-specific Stimuli in Non-treated PatientsBasalPoly IgCpG
IL-6 production of B cells in response to specific antigens
TNF-a Response to Non-specific Stimuli in Un-treated Patients
TNFB-
TNFA Antigen-Specific Stimulation