SIGNIFICANCE OF IMMUNOGENETIC PREDISPOSAL FOR CLINICAL COURSE OF MYASTHENIA
https://doi.org/10.15789/1563-0625-2009-6-549-556
Abstract
Abstract. The aim of this work was to reveal novel criteria for prediction of clinical course in myasthenia, based on immunogenetic characteristics of the patients. Sixty-five patients with different clinical forms, various clinical course and severity of myasthenia were involved into the study. All the patients were subject to complete clinical and neurological examination, and all of them have undergone thymectomy, a histology of thymus has been performed. Immunogenetic studies included HLA class I typing (A and B loci), like as HLA class II typing (DRB* locus). A positive association was found between development of disorder and presence of HLAB8 antigen, HLA-DRB1*03, and their combination, thus allowing for suggesting these specificities as probable markers of genetic predisposition for myasthenia development. An HLA-B7 specificity may have a protective role in evolution of this disease. It was shown that clinical severity in myasthenia and degree of neuromuscular conductive disturbances were more expressed in the patients carrying HLA-B8 antigen and HLA-DRB1*03 allele. Evaluation of immunogenetic state at earlier stages of disorder allows of timely differential diagnostics and individual prediction of clinical variability in myasthenia patients.
About the Authors
L. N. Bubnova
Санкт-Петербургская академия последипломного образования, Санкт-Петербург
Russian Federation
Russian Federation
I. E. Pavlova
Санкт-Петербургская академия последипломного образования, Санкт-Петербург
Russian Federation
Russian Federation
V. V. Baranov
Российский НИИ гематологии и трансфузиологии, Санкт-Петербург
Russian Federation
Russian Federation
N. M. Zhulev
Российский НИИ гематологии и трансфузиологии, Санкт-Петербург
Russian Federation
Russian Federation
References
1. Жулев Н.М., Лобзин В.С., Дементьева Л.Н. Миастения детей и подростков. – СПб. – 1999. – 210 с.
2. Зарецкая Ю.М. Клиническая иммуногенетика. – М.: Медицина, 1983. – 208 с.
3. Певницкий Л.А. Статистическая оценка ассоциаций HLA-антигенов с заболеваниями // Вестник Академии медицинских наук. – 1988. – № 7. – С. 48-51.
4. Серов В.В., Заратьянц О.В. Аутоиммунизация: новые факты, спорные вопросы, перспективы изучения // Тер. арх. – 1991. – № 6. – С. 4-11.
5. Фрейдлин И.С., Тотолян А.А. Клетки иммунной системы III–V. СПб.: Наука, 2001. – 390 с.
6. Matej H., Nowakowska B., Kalamarz M. HLA antigens and susceptibility to myasthenia gravis //Arch. Immunol. Ther. Exp. (Warsz). – 1987. – Vol. 35, N 6 – P. 795-801.
7. Meier T., Marangi P., Moll J. A minigene of neural agrin encoding the laminin-binding and acetylcholine receptor-aggregating domains is sufficient to induce postsynaptic differentiation in muscle fibres // Eur. J. Neurosci. – 1998. – № 10. – P. 3141-3152.
8. Svejgaard A., Ryder L. HLA and disease association: detecting the strongest association // Tissue Antigens. – 1994. – № 43. – С. 18-27.
9. Terasaki P.I., Gjertson D.W. HLA. Oxford Press, USA, 1998.
10. van Rood J.J. The role of HLA-typing in clinical kidney transplants: 30 years late. HLA matching is prime importance in bone marrow transplantation // Clin. Transplant. – 1993. – P. 434-435.
Review
For citations:
Bubnova L.N., Pavlova I.E., Baranov V.V., Zhulev N.M. SIGNIFICANCE OF IMMUNOGENETIC PREDISPOSAL FOR CLINICAL COURSE OF MYASTHENIA. Medical Immunology (Russia). 2009;11(6):549-556. (In Russ.) https://doi.org/10.15789/1563-0625-2009-6-549-556
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