Scenarios for autoimmunization of T and B cells in myasthenia gravis.

We have studied responses in thymoma patients to interferon-alpha and to the acetylcholine receptor (AChR) in early-onset myasthenia gravis (EOMG), seeking clues to autoimmunizing mechanisms. Our new evidence implicates a two-step process: (step 1) professional antigen-presenting cells and thymic ep...

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Κύριοι συγγραφείς: Shiono, H, Roxanis, I, Zhang, W, Sims, G, Meager, A, Jacobson, L, Liu, J, Matthews, I, Wong, Y, Bonifati, M, Micklem, K, Stott, D, Todd, J, Beeson, D, Vincent, A, Willcox, N
Μορφή: Journal article
Γλώσσα:English
Έκδοση: 2003
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author Shiono, H
Roxanis, I
Zhang, W
Sims, G
Meager, A
Jacobson, L
Liu, J
Matthews, I
Wong, Y
Bonifati, M
Micklem, K
Stott, D
Todd, J
Beeson, D
Vincent, A
Willcox, N
author_facet Shiono, H
Roxanis, I
Zhang, W
Sims, G
Meager, A
Jacobson, L
Liu, J
Matthews, I
Wong, Y
Bonifati, M
Micklem, K
Stott, D
Todd, J
Beeson, D
Vincent, A
Willcox, N
author_sort Shiono, H
collection OXFORD
description We have studied responses in thymoma patients to interferon-alpha and to the acetylcholine receptor (AChR) in early-onset myasthenia gravis (EOMG), seeking clues to autoimmunizing mechanisms. Our new evidence implicates a two-step process: (step 1) professional antigen-presenting cells and thymic epithelial cells prime AChR-specific T cells; then (step 2) thymic myoid cells subsequently provoke germinal center formation in EOMG. Our unifying hypothesis proposes that AChR epitopes expressed by neoplastic or hyperplastic thymic epithelial cells aberrantly prime helper T cells, whether generated locally or infiltrating from the circulation. These helper T cells then induce antibody responses against linear epitopes that cross-react with whole AChR and attack myoid cells in the EOMG thymus. The resulting antigen-antibody complexes and the recruitment of professional antigen-presenting cells increase the exposure of thymic cells to the infiltrates and provoke local germinal center formation and determinant spreading. Both these and the consequently enhanced heterogeneity and pathogenicity of the autoantibodies should be minimized by early thymectomy.
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spelling oxford-uuid:1cc711f2-d27c-44e9-98d9-a5ee2a68c8342022-03-26T11:07:24ZScenarios for autoimmunization of T and B cells in myasthenia gravis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1cc711f2-d27c-44e9-98d9-a5ee2a68c834EnglishSymplectic Elements at Oxford2003Shiono, HRoxanis, IZhang, WSims, GMeager, AJacobson, LLiu, JMatthews, IWong, YBonifati, MMicklem, KStott, DTodd, JBeeson, DVincent, AWillcox, NWe have studied responses in thymoma patients to interferon-alpha and to the acetylcholine receptor (AChR) in early-onset myasthenia gravis (EOMG), seeking clues to autoimmunizing mechanisms. Our new evidence implicates a two-step process: (step 1) professional antigen-presenting cells and thymic epithelial cells prime AChR-specific T cells; then (step 2) thymic myoid cells subsequently provoke germinal center formation in EOMG. Our unifying hypothesis proposes that AChR epitopes expressed by neoplastic or hyperplastic thymic epithelial cells aberrantly prime helper T cells, whether generated locally or infiltrating from the circulation. These helper T cells then induce antibody responses against linear epitopes that cross-react with whole AChR and attack myoid cells in the EOMG thymus. The resulting antigen-antibody complexes and the recruitment of professional antigen-presenting cells increase the exposure of thymic cells to the infiltrates and provoke local germinal center formation and determinant spreading. Both these and the consequently enhanced heterogeneity and pathogenicity of the autoantibodies should be minimized by early thymectomy.
spellingShingle Shiono, H
Roxanis, I
Zhang, W
Sims, G
Meager, A
Jacobson, L
Liu, J
Matthews, I
Wong, Y
Bonifati, M
Micklem, K
Stott, D
Todd, J
Beeson, D
Vincent, A
Willcox, N
Scenarios for autoimmunization of T and B cells in myasthenia gravis.
title Scenarios for autoimmunization of T and B cells in myasthenia gravis.
title_full Scenarios for autoimmunization of T and B cells in myasthenia gravis.
title_fullStr Scenarios for autoimmunization of T and B cells in myasthenia gravis.
title_full_unstemmed Scenarios for autoimmunization of T and B cells in myasthenia gravis.
title_short Scenarios for autoimmunization of T and B cells in myasthenia gravis.
title_sort scenarios for autoimmunization of t and b cells in myasthenia gravis
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