Abstract
Background and Purpose: Thymectomy is generally accepted as the major option of treatment for myasthenia gravis. To elucidate the biological role of thymectomy in the treatment of myasthenia gravis, the immunologic characteristics of the thymus was studied in association with the postoperative kinetics of the anti-acetylcholine receptor antibody titer. Materials and Methods: Thirty-four patients with nonthymomatous myasthenia gravis who had positive anti-acetylcholine receptor antibody titer and undergoing extended thymectomy were subjected to the study. Reduction of anti-acetylcholine receptor antibody titer was evaluated in terms of the proportion of anti-acetylcholine receptor antibody titer at 1 year after thymectomy to that before the operation. The numbers of B lymphocytes (CD19+ cells) and the germinal center B lymphocytes (CD19+CD38high cells) present in 1 g of the thymic tissue were calculated by flow cytometry. Results: The proportion of anti-acetylcholine receptor antibody titer at 1 year after thymectomy ranged from 27.5% to 150%. The numbers of B lymphocytes and the germinal center B lymphocytes in 1 g of the thymic tissue ranged from 0.19 × 106/g to 162.8 × 106/g and from 0.09 × 106/g to 33.4 × 106/g, respectively. The proportion of anti-acetylcholine receptor antibody titer at 1 year after thymectomy had a significant inverted correlation with the number of B lymphocytes (P = .002) as well as that of the germinal center B lymphocytes (P = .007). Conclusion: Effectiveness of thymectomy was dependent on predominance of B lymphocytes and the germinal center B lymphocytes in the thymus, suggesting that one of the biological roles of thymectomy in the treatment of myasthenia gravis is removing the thymus-associated germinal centers.
| Original language | English |
|---|---|
| Pages (from-to) | 1922-1928 |
| Number of pages | 7 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 126 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Dec 2003 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
Cite this
The immunologic role of thymectomy in the treatment of myasthenia gravis : Implication of thymus-associated B-lymphocyte subset in reduction of the anti-acetylcholine receptor antibody titer. / Okumura, Meinoshin; Ohta, Mitsunori; Takeuchi, Yukiyasu; Shiono, Hiroyuki; Inoue, Masayoshi; Fukuhara, Kenjiro; Kadota, Yoshihisa; Miyoshi, Shinichiro; Fujii, Yoshitaka; Matsuda, Hikaru; Mentzer, Steven J.; Bremner, Ross M.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 126, No. 6, 12.2003, p. 1922-1928.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The immunologic role of thymectomy in the treatment of myasthenia gravis
T2 - Implication of thymus-associated B-lymphocyte subset in reduction of the anti-acetylcholine receptor antibody titer
AU - Okumura, Meinoshin
AU - Ohta, Mitsunori
AU - Takeuchi, Yukiyasu
AU - Shiono, Hiroyuki
AU - Inoue, Masayoshi
AU - Fukuhara, Kenjiro
AU - Kadota, Yoshihisa
AU - Miyoshi, Shinichiro
AU - Fujii, Yoshitaka
AU - Matsuda, Hikaru
AU - Mentzer, Steven J.
AU - Bremner, Ross M.
PY - 2003/12
Y1 - 2003/12
N2 - Background and Purpose: Thymectomy is generally accepted as the major option of treatment for myasthenia gravis. To elucidate the biological role of thymectomy in the treatment of myasthenia gravis, the immunologic characteristics of the thymus was studied in association with the postoperative kinetics of the anti-acetylcholine receptor antibody titer. Materials and Methods: Thirty-four patients with nonthymomatous myasthenia gravis who had positive anti-acetylcholine receptor antibody titer and undergoing extended thymectomy were subjected to the study. Reduction of anti-acetylcholine receptor antibody titer was evaluated in terms of the proportion of anti-acetylcholine receptor antibody titer at 1 year after thymectomy to that before the operation. The numbers of B lymphocytes (CD19+ cells) and the germinal center B lymphocytes (CD19+CD38high cells) present in 1 g of the thymic tissue were calculated by flow cytometry. Results: The proportion of anti-acetylcholine receptor antibody titer at 1 year after thymectomy ranged from 27.5% to 150%. The numbers of B lymphocytes and the germinal center B lymphocytes in 1 g of the thymic tissue ranged from 0.19 × 106/g to 162.8 × 106/g and from 0.09 × 106/g to 33.4 × 106/g, respectively. The proportion of anti-acetylcholine receptor antibody titer at 1 year after thymectomy had a significant inverted correlation with the number of B lymphocytes (P = .002) as well as that of the germinal center B lymphocytes (P = .007). Conclusion: Effectiveness of thymectomy was dependent on predominance of B lymphocytes and the germinal center B lymphocytes in the thymus, suggesting that one of the biological roles of thymectomy in the treatment of myasthenia gravis is removing the thymus-associated germinal centers.
AB - Background and Purpose: Thymectomy is generally accepted as the major option of treatment for myasthenia gravis. To elucidate the biological role of thymectomy in the treatment of myasthenia gravis, the immunologic characteristics of the thymus was studied in association with the postoperative kinetics of the anti-acetylcholine receptor antibody titer. Materials and Methods: Thirty-four patients with nonthymomatous myasthenia gravis who had positive anti-acetylcholine receptor antibody titer and undergoing extended thymectomy were subjected to the study. Reduction of anti-acetylcholine receptor antibody titer was evaluated in terms of the proportion of anti-acetylcholine receptor antibody titer at 1 year after thymectomy to that before the operation. The numbers of B lymphocytes (CD19+ cells) and the germinal center B lymphocytes (CD19+CD38high cells) present in 1 g of the thymic tissue were calculated by flow cytometry. Results: The proportion of anti-acetylcholine receptor antibody titer at 1 year after thymectomy ranged from 27.5% to 150%. The numbers of B lymphocytes and the germinal center B lymphocytes in 1 g of the thymic tissue ranged from 0.19 × 106/g to 162.8 × 106/g and from 0.09 × 106/g to 33.4 × 106/g, respectively. The proportion of anti-acetylcholine receptor antibody titer at 1 year after thymectomy had a significant inverted correlation with the number of B lymphocytes (P = .002) as well as that of the germinal center B lymphocytes (P = .007). Conclusion: Effectiveness of thymectomy was dependent on predominance of B lymphocytes and the germinal center B lymphocytes in the thymus, suggesting that one of the biological roles of thymectomy in the treatment of myasthenia gravis is removing the thymus-associated germinal centers.
UR - http://www.scopus.com/inward/record.url?scp=9144227583&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=9144227583&partnerID=8YFLogxK
U2 - 10.1016/S0022-5223(03)00938-3
DO - 10.1016/S0022-5223(03)00938-3
M3 - Article
C2 - 14688707
AN - SCOPUS:9144227583
VL - 126
SP - 1922
EP - 1928
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 6
ER -