Myasthenia gravis

Abstract

Autoimmune diseases are becoming increasingly important with respect to the quality of life and health in modern societies. Myasthenia gravis (MG) is a prototype autoimmune disease since it has well-studied antigenic targets, pathogenic mechanisms, and experimental animal models of the disease. It is, therefore, well characterized and often serves as a model for other similar disorders. The hallmark of MG is muscle weakness and fatigability, caused by disruption of the neuromuscular junction function. This is effected by autoantibodies, which in the majority of patients are directed against the acetylcholine receptor in the muscle membrane. Accurate diagnosis is crucial in administering treatment, relying on both clinical examination and a combination of electrophysiological, serological, and pharmacological tests. The most common therapy is immunosupression, which can have a number of side effects, due to the long-term treatment regimes required. Thymectomy is recommended in many patients since the thymus seems to be central in the pathogenesis of MG. Other approaches, such as acetylcholinesterase inhibitors, intravenous immunoglobulin, and plasmapheresis, have also proven useful in the management of MG. Nevertheless, there is a pressing need for more sensitive diagnostic tests and more specific therapies with fewer side effects. To this end, efforts are currently being made for an even better understanding of the pathophysiology of MG. Importantly, this will not only aid in the management of MG, but will lead to advances in other autoimmune disorders as well.