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Heterogeneity in myasthenia gravis: HLA phenotypes and autoantibody responses in ocular and generalized types
Author(s) -
Kida Kaichi,
Hayashi Masatoshi,
Yamada Itaru,
Matsuda Hiroshi,
Yoshinaga Junji,
Takami Shunsai,
Yashiki Shinji,
Sonoda Shunro
Publication year - 1987
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.410210309
Subject(s) - autoantibody , myasthenia gravis , ocular myasthenia , titer , medicine , immunology , human leukocyte antigen , antibody , autoimmune disease , gastroenterology , antigen
HLA phenotypes and autoantibody responses were studied in 71 Japanese patients with myasthenia gravis. HLA‐A2, Bw61, and DRw9 were associated with ocular myasthenia gravis (corrected p [CP] < 0.05 relative risk [RR] = 2.88; CP < 0.02, RR = 3.60; and CP < 0.001, RR = 4.63, respectively) and HLA‐DRw8 was associated with generalized myasthenia gravis (CP < 0.001, RR = 5.40). Neither HLA‐B8 nor DR3 was found in Japanese patients. The titer of antiacetylcholine receptor antibody (AChR Ab) and the incidence of autoantibodies other than AChR Ab were higher in patients with generalized myasthenia gravis than in those with the ocular type (2.77 ± 0.62 versus 0.17 ± 0.03 pmol/ml, p < 0.001; and 60.6 versus 29.0%, p < 0.02, respectively). Patients with a high titer of AChR Ab or with autoantibodies had an increased frequency of HLA‐DRw8 (CP < 0.02, RR = 4.61, and CP < 0.005, RR = 4.53, respectively); whereas patients with a low titer of AChR Ab or without autoantibodies had an increased frequency of HLA‐DRw9 (CP < 0.001, RR = 8.26, and CP < 0.005, RR = 4.08, respectively). These findings suggest that ocular and generalized myasthenia gravis might have different immunogenetic backgrounds.