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Autoantibodies to low‐density lipoprotein receptor–related protein 4 in myasthenia gravis
Author(s) -
Higuchi Osamu,
Hamuro Johko,
Motomura Masakatsu,
Yamanashi Yuji
Publication year - 2011
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.22312
Subject(s) - myasthenia gravis , autoantibody , acetylcholine receptor , antibody , pathogenesis , immunology , neuromuscular junction , receptor , endocrinology , medicine , chemistry , biology , neuroscience
Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction, where acetylcholine receptor (AChR), muscle‐specific kinase (MuSK), and low‐density lipoprotein (LDL) receptor‐related protein 4 (Lrp4) are essential. About 80% and 0% to 10% of patients with generalized MG have autoantibodies to AChR and MuSK, respectively, but pathogenic factors are elusive in others. Here we show that a proportion of AChR antibody‐negative patients have autoantibodies to Lrp4. These antibodies inhibit binding of Lrp4 to its ligand and predominantly belong to the immunoglobulin G1 (IgG1) subclass, a complement activator. These findings together indicate the involvement of Lrp4 antibodies in the pathogenesis of AChR antibody‐negative MG. Ann Neurol 2011