Longitudinal epitope mapping in MuSK myasthenia gravis: implications for disease severity

Abstract Muscle weakness in MuSK myasthenia gravis (MG) is caused predominantly by IgG4 antibodies which block MuSK signalling and destabilize neuromuscular junctions. We determined whether the binding pattern of MuSK IgG4 antibodies change throughout the disease course (“epitope spreading”), and af...

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Bibliographic Details
Published in:Journal of neuroimmunology 2016-02, Vol.291, p.82-88
Main Authors: Huijbers, Maartje G, Vink, Anna-Fleur D, Niks, Erik H, Westhuis, Ruben H, van Zwet, Erik W, de Meel, Robert H, Rojas-García, Ricardo, Díaz-Manera, Jordi, Kuks, Jan B, Klooster, Rinse, Straasheijm, Kirsten, Evoli, Amelia, Illa, Isabel, van der Maarel, Silvère M, Verschuuren, Jan J
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Language:eng
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Summary:Abstract Muscle weakness in MuSK myasthenia gravis (MG) is caused predominantly by IgG4 antibodies which block MuSK signalling and destabilize neuromuscular junctions. We determined whether the binding pattern of MuSK IgG4 antibodies change throughout the disease course (“epitope spreading”), and affect disease severity or treatment responsiveness. We mapped the MuSK epitopes of 255 longitudinal serum samples of 53 unique MuSK MG patients from three independent cohorts with ELISA. Antibodies against the MuSK Iglike-1 domain determine disease severity. Epitope spreading outside this domain did not contribute to disease severity nor to pyridostigmine responsiveness. This provides a rationale for epitope specific treatment strategies.
ISSN:0165-5728
1872-8421