Effect of corticosteroids on the thymus in myasthenia gravis

Factors influencing the clinical type and course of myasthenia gravis

Myasthenia gravis is considered to be an autoimmune disease in which several factors reciprocally influence the clinical type and course. We investigated the relative importance of the following factors: anti-acetylcholine receptor antibody (AChR Ab), HLA, age at onset, autoimmunity, thymic abnormality, duration of treatment, change in AChR Ab titer and immunosuppressive therapy. The pretreatment-AChR Ab titer and HLA were shown to significantly influence the clinical type. On the other hand, the age at onset significantly influenced the clinical course. The finding that with an onset at less than 5-year-old there was a tendency for a good prognosis suggests an association between the immaturity of the muscle and immune systems, and the clinical course.

Dramatic response of recurrent invasive thymoma to high doses of corticosteroids

We report the case of a widely invasive thymoma non-associated with myasthenia gravis which responded only to high doses of corticosteroids. We review the other few reported cases of complete response achieved by this treatment and we stress the possible use of high doses of corticosteroids in the management of recurrent invasive thymoma.

Rabbit antiserum to a citric acid extract of human skeletal muscle staining thymomas from myasthenia gravis patients

Rabbit antiserum to a citric acid extract of human skeletal muscle (CA) stained both the cell membrane and the cross-striational bands of skeletal muscle cells. The rabbit antiserum also stained the cell membrane of epithelial thymoma cells from myasthenia gravis (MG) patients. Normal and hyperplastic thymus tissue were not stained, apart from scattered myoid thymic cells. Absorption of the antiserum with CA abolished staining of the thymoma, indicating that human skeletal muscle and epithelial thymoma cells possess common antigens.

The in vivo effects of corticosteroids on thymocyte subsets in myasthenia gravis

The in vivo effects of corticotherapy on thymocyte subpopulations have been evaluated in patients with myasthenia gravis (MG). Ten patients receiving high-dose, long-term treatment were studied and compared with two control groups (MG untreated patients and normal age-matched subjects). In the treated group, the thymus was generally involuted; the percentage of OKT6+ or OKT4+T8+ thymocytes was profoundly decreased compared to controls. A significant percentage of OKT10 - cells was detected particularly among older patients, suggesting steroid-induced immigration. Conversely the percentage of more mature OKT3+ cells was increased. The balance between OKT4+T8- and OKT4-T8+ cells was unchanged in young patients (less than 40 years old) and increased in the older group. These data show that, as in the mouse, corticosteroids profoundly alter human thymocyte subsets.