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Anti-acetylcholine receptor antibody specificities in serum and in thymic cell culture supernatants from myasthenia gravis patients

Department of Neurological Science, Royal Free Hospital School of Medicine, London, England. Present addresses: Dr. Heidenreich, Department of Neurology, University of Dusseldorf, FRG; Drs. Vincent, Willcox, and Newsom-Davis, Neurosciences Group, Institute for Molecular Medicine, John Radcliffe Hospital, Oxford, UK.

We investigated the role of the thymus in myasthenia gravis by comparing the antigenic specificities of antiacetylcholine receptor antibodies (anti-AChR), defined by competition with mouse monoclonal antibodies that bind to five different regions on human muscle AChR, in thymic culture supernatants and in serum pre- and post-thymectomy. Anti-AChR specificities present in the serum were broadly unchanged in 16 non-thymoma and six thymoma patients 7-30 months after thymectomy compared with an initial sample, although total anti-AChR frequently fell. The fine specificities of the anti-AChR synthesized in vitro by cultured lymphocytes from the thymus of ten patients (without thymoma) correlated significantly with that of the anti-AChR in the serum at the same time. We conclude that AChR-specific B cells in the thymus are representative of the total AChR-specific repertoire, and that thymectomy does not selectively deplete particular B cell clones.

Address correspondence and reprint requests to Dr. Vincent, Neurosciences Group, Institute for Molecular Medicine, John Radcliffe Hospital, Oxford 0X3 9DU, UK.

Received January 20, 1988. Accepted for publication in final form May 12, 1988.

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