+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Plasmaperfusion on triptophan columns can improve the clinical outcome of patients affected with Myasthenia Gravis

Plasmaperfusion on triptophan columns can improve the clinical outcome of patients affected with Myasthenia Gravis

Artificial Cells Blood Substitutes & Immobilization Biotechnology 31(1): 69-79, February

Myasthenia Gravis (MG) is a neuromuscular disease often associated with thymic pathology due to neuromuscular transmission impairment by circulating antibodies directed against the cholinergic postsynaptic receptor on the neuromuscular junction (Anti-AchR-Ab). The treatment of MG includes cholinesterase inhibitors, steroids and thymectomy. Plasmapheresis can remove Anti-AchR-Ab but more recently plasma-perfusion (PP), a more specific apheresis for selective removal of noxious plasma components, has been developed. Aim of the study: To study the effect of PP treatment, performed by using specific immunocolumns for Anti-AchR-Ab, on the clinical outcome of MG patients non-responder to steroid therapy or thymectomy. Matherials and Methods: We treated 8 patients suffering from severe MG by a cycle of 6 sessions of PP. We used columns containing triptophan as a specific ligand for Anti-AchR-Ab. In order to evaluate the effectiveness of treatment we used functional tests (muscular tests, respiratory function, electromyography) and laboratory tests (Anti-AchR-Ab; immunoglobulins, complement fractions, immunocomplexes). Results: After one to three PP sessions, early clinical improvement in bulbar and respiratory symptoms were found in all patients and EMG showed improvement of neuromuscular transmission. Serum concentration of immunological markers decreased progressively and significantly during the treatment. Clinical improvements were progressive despite the tendency for Anti-AchR-Ab to reach initial values between one session and another. We observed no side effects due to the type of immunocolumns used. Conclusions: Triptophan columns appear to be able to remove large quantities of Anti-AchR-Ab and immunological markers from plasma. Our experience shows that PP performed using triptophan columns in patients suffering from severe MG provides good clinical results, improving patients' outcome, without any risk linked to the procedure.

Accession: 011159770

Download citation: RISBibTeXText

PMID: 12602818

DOI: 10.1081/bio-120018004

Download PDF Full Text: Plasmaperfusion on triptophan columns can improve the clinical outcome of patients affected with Myasthenia Gravis

Related references

VATS thymectomy for nonthymomatous myasthenia gravis: standardized outcome assessment using the myasthenia gravis foundation of America clinical classification. Innovations 6(2): 104-109, 2012

Comparison of clinical manifestations between patients with ocular myasthenia gravis and generalized myasthenia gravis. Korean Journal of Ophthalmology 25(1): 1-7, 2011

The long-term clinical outcome of myasthenia gravis in patients with thymoma. Neurology 51(4): 1198-1200, 1998

Thymoma-associated myasthenia gravis: outcome, clinical and pathological correlations in 197 patients on a 20-year experience. Journal of Neuroimmunology 201-202: 237-244, 2008

Clinical features, diagnostic approach, and therapeutic outcome in myasthenia gravis patients with thymectomy. Acta Neurologica Taiwanica 18(1): 21-25, 2009

Clinical outcome and predictive factors of irradiation-associated myasthenia gravis exacerbation in thymomatous patients. Neurological Sciences 36(11): 2121-2127, 2016

The predictive value of the presence of different antibodies and thymus pathology to the clinical outcome in patients with generalized myasthenia gravis. Clinical Neurology and Neurosurgery 115(4): 432-437, 2013

A randomised clinical trial comparing prednisone and azathioprine in myasthenia gravis. Results of the second interim analysis. Myasthenia Gravis Clinical Study Group. Journal of Neurology, Neurosurgery, and Psychiatry 56(11): 1157-1163, 1993

Changes of plasma proteins after immunoadsorption using Ig-Adsopak columns in patients with myasthenia gravis. Transfusion and Apheresis Science 30(2): 125-129, 2004

Clinical trial of plasma exchange and high-dose intravenous immunoglobulin in myasthenia gravis. Myasthenia Gravis Clinical Study Group. Annals of Neurology 41(6): 789-796, 1997

Use of immunoadsorbent columns for antiacetylcholine receptor antibody removal from plasma of myasthenia gravis patients. Plasma Therapy and Transfusion Technology 9(1): 73-75, 1988

Extended thymectomy in myasthenia gravis: a team-work of neurologist, thoracic surgeon and anaesthesist may improve the outcome. European Journal of Cardio-Thoracic Surgery 19(5): 570-575, 2001

Clinical Profile and Outcome of Postthymectomy versus Non-Thymectomy Myasthenia Gravis Patients in the Philippine General Hospital: A 6-Year Retrospective Study. Frontiers in Neurology 7(): 96-96, 2016

Clinical characteristics of early onset autoimmune myasthenia gravis and persistent neonatal myasthenia gravis. Annals of Neurology 18(3): 401, 1985