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Antibody-induced degradation of acetylcholine receptor in myasthenia gravis

Clinical correlates and pathogenetic significance

Department of Pharmacology and CNR Center of Cytopharmacology (Drs. Tronconi, Brigonzi, Fumagalli, sher, and Clementi), University of Milano, and the Department of Neurology (Drs. Cosi and Piccolo), University of Pavia.

Address correspondence and reprint requests to Dr. Clementi, Department of Pharmacology, Via Vanvitelli 32, 20129 Milano, Italy.

sera of myasthenic patients containing anti-AChR antibodies increase the rate of degradation of mammalian AChR. This phenomenon, antigenic modulation (AMd), was tested on AChR of rat myotubes in serum from 48 myasthenic patients. Sixty-six percent of the sera increased AChR degradation. AMd activity was higher in more severely affected patients, paralleled clinical evolution in individual patients, and was related to AChR-antibody titer. Steroid treatment and thymectomy did not affect AMd activity. Patients who had a thymoma always had greater AMd activity.