Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Myasthenia gravis is an antibody-mediated autoimmune disease in which circulating acetylcholine receptor (AChR) antibodies have been identified that bind to the receptor sites in voluntary muscles, thereby damaging and blocking the receptors. Selective removal of the blocking antibody by plasmapheresis or specific immunoadsorption provides important methods in the treatment of patients with myasthenia gravis. Novel immunoadsorbent columns have been developed especially for the treatment of patients with myasthenia gravis, using a specific affinity ligand (Torpedo 183-200, a synthetic peptide) to remove the blocking antibody. This immunoadsorbent produced specific removal of the blocking antibody without reducing other plasma proteins. Clinical improvement was observed in 78% of myasthenia gravis patients. There were no adverse effects.Miastenija gravis je autoimuna bolest kod koje se cirkulirajuća protutijela protiv receptora za acetilkolin vežu za receptorska mjesta na poprečnoprugastim mišićima i dovode do blokiranja i oštećenja receptora. Blokirajuća protutijela mogu se specifično odstraniti iz plazme bolesnika s miastenijom gravis pomoću plazmafereze ili specifične imunoadsorpcije. Nove kolone za imunoadsorpciju u kojima se kao specifični vezač za blokirajuće protutijelo acetilkolinskih receptora rabi sintetički peptid Torpedo 183-200 pokazale su visoku specifičnost u odstranjivanju blokirajućih protutijela, a da pritom nisu utjecale na koncentraciju drugih bjelančevina u plazmi. Do kliničkog poboljšanja došlo je u 78% bolesnika s miastenijom gravis, a da nije zabilježena niti jedna nuspojava
