Background: Thymectomy (Tx) is a common therapeutic option to treat myasthenia gravis (MG), but its effects on the immune system are still obscure in humans. Objective: We sought to evaluate long-term immunologic effects of therapeutic Tx in patients with MG. Methods: T- and B-cell subsets and T-cell repertoire were analyzed in 35 patients with MG, 16 with previous Tx (at least 8 years before), 6 with recent (<1 year) Tx, and 13 without Tx, as well as in 32 healthy subjects used as normal control subjects. Serum immunoglobulins and a variety of autoantibodies were also measured. A subsequent 3-gear clinical follow-up was performed to verify the possible appearance of systemic autoimmune diseases. Results: The long-term thymectomized (Txd) patients had mild T-cell lymphopenia and an expansion of some V beta families among circulating CD4+ and CD8+ T cells. They displayed a normal number of total B and CD5+ B-circulating lymphocytes, but they also displayed a polyclonal increase in serum IgM and IgG associated with the presence of high levels of a variety of organ- and nonorgan-specific autoantibodies, including anti-dsDNA and anticardiolipin, without clinical evidence of autoimmune disease. These serologic abnormalities mere not detectable in both non-Txd and recently Txd patients. After 3 years, 2 long-term Txd patients had systemic lupus erythematosus and an undifferentiated connective tissue disease. Conclusions: The association between MG and laboratory findings of systemic autoimmune disease may be in part related to Tx rather than to MG. Tx may represent a risk for the development of systemic autoimmune disorders over years in patients with MG.

Long-term immunologic effects of thymectomy in patients with myasthenia gravis / Gerli, R; Paganelli, R; Cossarizza, Andrea; Muscat, C; Piccolo, G; Barbieri, D; Mariotti, S; Monti, D; Bistoni, O; Raiola, E; Venanzi, Fm; Bertotto, A; Franceschi, C.. - In: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. - ISSN 0091-6749. - STAMPA. - 103:(1999), pp. 865-872.

Long-term immunologic effects of thymectomy in patients with myasthenia gravis

COSSARIZZA, Andrea;
1999-01-01

Abstract

Background: Thymectomy (Tx) is a common therapeutic option to treat myasthenia gravis (MG), but its effects on the immune system are still obscure in humans. Objective: We sought to evaluate long-term immunologic effects of therapeutic Tx in patients with MG. Methods: T- and B-cell subsets and T-cell repertoire were analyzed in 35 patients with MG, 16 with previous Tx (at least 8 years before), 6 with recent (<1 year) Tx, and 13 without Tx, as well as in 32 healthy subjects used as normal control subjects. Serum immunoglobulins and a variety of autoantibodies were also measured. A subsequent 3-gear clinical follow-up was performed to verify the possible appearance of systemic autoimmune diseases. Results: The long-term thymectomized (Txd) patients had mild T-cell lymphopenia and an expansion of some V beta families among circulating CD4+ and CD8+ T cells. They displayed a normal number of total B and CD5+ B-circulating lymphocytes, but they also displayed a polyclonal increase in serum IgM and IgG associated with the presence of high levels of a variety of organ- and nonorgan-specific autoantibodies, including anti-dsDNA and anticardiolipin, without clinical evidence of autoimmune disease. These serologic abnormalities mere not detectable in both non-Txd and recently Txd patients. After 3 years, 2 long-term Txd patients had systemic lupus erythematosus and an undifferentiated connective tissue disease. Conclusions: The association between MG and laboratory findings of systemic autoimmune disease may be in part related to Tx rather than to MG. Tx may represent a risk for the development of systemic autoimmune disorders over years in patients with MG.
103
865
872
Long-term immunologic effects of thymectomy in patients with myasthenia gravis / Gerli, R; Paganelli, R; Cossarizza, Andrea; Muscat, C; Piccolo, G; Barbieri, D; Mariotti, S; Monti, D; Bistoni, O; Raiola, E; Venanzi, Fm; Bertotto, A; Franceschi, C.. - In: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. - ISSN 0091-6749. - STAMPA. - 103:(1999), pp. 865-872.
Gerli, R; Paganelli, R; Cossarizza, Andrea; Muscat, C; Piccolo, G; Barbieri, D; Mariotti, S; Monti, D; Bistoni, O; Raiola, E; Venanzi, Fm; Bertotto, A; Franceschi, C.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/7849
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