Francesca Beretta
Preferential binding to adult or fetal acetylcholine receptor isoform as a promising predictive biomarker in myasthenia gravis
Autori
- FRANCESCA BERETTA (DEPARTMENT OF NEUROSCIENCES, PSYCHOLOGY, DRUG RESEARCH AND CHILD HEALTH, UNIVERSITY OF FLORENCE, FLORENCE, ITALY – NEUROLOGIA)
- EBE SCHIAVO (DEPARTMENT OF NEUROSCIENCES, PSYCHOLOGY, DRUG RESEARCH AND CHILD HEALTH, UNIVERSITY OF FLORENCE, FLORENCE, ITALY – BIOLOGIA MOLECOLARE E CELLULARE)
- GREGORIO SPAGNI (DEPARTMENT OF NEUROSCIENZE, UNIVERSITÀ CATTOLICA DEL SACRO CUORE, ROME, ITALY; GERMAN CENTER FOR NEURODEGENERATIVE DISEASES (DZNE) BERLIN, BERLIN, GERMANY – NEUROLOGIA)
- SILVIA FALSO (DEPARTMENT OF NEUROSCIENZE, UNIVERSITÀ CATTOLICA DEL SACRO CUORE, ROME, ITALY – NEUROLOGIA (SPECIALIZZANDO))
- SARA CORNACCHINI (DEPARTMENT OF NEUROSCIENCES, PSYCHOLOGY, DRUG RESEARCH AND CHILD HEALTH, UNIVERSITY OF FLORENCE, FLORENCE, ITALY – NEUROLOGIA (SPECIALIZZANDO))
- MASSIMILIANO UGO VERZA (DEPARTMENT OF NEUROSCIENCES, PSYCHOLOGY, DRUG RESEARCH AND CHILD HEALTH, UNIVERSITY OF FLORENCE, FLORENCE, ITALY – NEUROLOGIA (SPECIALIZZANDO))
- LEONARDO PALAZZO (DEPARTMENT OF NEUROSCIENCES, PSYCHOLOGY, DRUG RESEARCH AND CHILD HEALTH, UNIVERSITY OF FLORENCE, FLORENCE, ITALY – NEUROLOGIA (SPECIALIZZANDO))
- LUCA MASSACESI (DEPARTMENT OF NEUROSCIENCES, PSYCHOLOGY, DRUG RESEARCH AND CHILD HEALTH, UNIVERSITY OF FLORENCE, FLORENCE, ITALY – NEUROLOGIA)
- AMELIA EVOLI (DEPARTMENT OF NEUROSCIENZE, UNIVERSITÀ CATTOLICA DEL SACRO CUORE, ROME, ITALY – NEUROLOGIA)
- VALENTINA DAMATO (DEPARTMENT OF NEUROSCIENCES, PSYCHOLOGY, DRUG RESEARCH AND CHILD HEALTH, UNIVERSITY OF FLORENCE, FLORENCE, ITALY – NEUROLOGIA)
Presentatore
FRANCESCA BERETTA (DEPARTMENT OF NEUROSCIENCES, PSYCHOLOGY, DRUG RESEARCH AND CHILD HEALTH, UNIVERSITY OF FLORENCE, FLORENCE, ITALY)
Modalità
Oral Communication
Abstract
“INTRODUCTION
Myasthenia gravis (MG) is an autoimmune disorder mediated in most cases by autoantibodies against the nicotinic acetylcholine receptor (AChR). It is known that antibodies can target specifically either the adult or the fetal AChR isoform, but their clinical significance remains uncertain. No reliable biomarker of MG clinical outcome has been proven to date, therefore we investigated whether preferential antibody reactivity for the adult-AChR or the fetal-AChR isoform correlates with MG clinical outcome.
METHODS
Patients with a confirmed MG diagnosis and positive radioimmunoassay for AChR-antibodies were included in the study (n=174). Antibody reactivity against the adult-AChR vs the fetal-AChR isoforms was assessed by live cell based assay on flow cytometry. Clinical outcome was assessed through the “patient acceptable symptom state” (PASS-question) and the post-intervention status (PIS).
RESULTS
We found a lower adult/fetal AChR immunoreactivity ratio (A/F) in less severely affected patients (those who answered “yes” to the PASS-question vs “no”; p=0.039, Mann-Whitney test) indicating that when clinical outcome is acceptable (PASS=yes) most serum antibodies bind to fetal-AChR. This finding was confirmed not only when comparing A/F between patients with a PIS of minimal manifestations or better (“MM or better”) vs those who were still symptomatic (p=0.001, Mann-Whitney test), but also between patients in complete stable remission vs those with MM (p=0.04, Mann-Whitney test). No differences in A/F were found between patients with ocular or generalized MG.
CONCLUSIONS
The adult/fetal AChR immunoreactivity ratio is a promising predictive biomarker of AChR-MG outcome and should be investigated in larger prospective studies.”