Saif Huda1, Mark R Woodhall1, Angela Vincent1, Jeannine M Heckmann2. 1. Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK. 2. Division of Neurology, E8-74, Department of Medicine, University of Cape Town, South Africa.
Abstract
INTRODUCTION: In this study we determined the frequencies of antibodies (Abs) directed against muscle-specific kinase (MuSK) and lipoprotein receptor-related protein 4 (LRP4) in the sera of a South African cohort with acetylcholine receptor (AChR)-antibody-negative generalized MG and determined outcomes to therapies. METHODS: Sera negative by commercial AChR radioimmunoassay (RIA) were tested by MuSK RIA (n = 30; 2006-2012) and AChR, MuSK, and LRP4 RIA with or without cell-based assays (CBA) (n = 53; 2012-2015). RESULTS: AChR-Abs were detected in 4 of 53 and MuSK-Abs in 20 of 83 (24%) cases. Thirty-six of 53 (68%) were triple seronegative (triple-SNMG) for MuSK, AChR, and LRP4-Abs. When compared with triple-SNMG, individuals with MuSK-MG had a younger onset age (P = 0.008), a greater likelihood of African genetic ancestry (P = 0.008), and 4-fold higher odds of reaching MGFA grade IVB/V (P = 0.018), but were also 9-fold more likely to reach at least minimal manifestations status after ≥12 months of therapy (P = 0.003). CONCLUSIONS: Individuals with African genetic ancestry and severe bulbar/respiratory AChR-Ab-negative MG are likely to have MuSK-MG, but most respond favorably to maintenance immunotherapies. Muscle Nerve 54: 1023-1029, 2016.
INTRODUCTION: In this study we determined the frequencies of antibodies (Abs) directed against muscle-specific kinase (MuSK) and lipoprotein receptor-related protein 4 (LRP4) in the sera of a South African cohort with acetylcholine receptor (AChR)-antibody-negative generalized MG and determined outcomes to therapies. METHODS: Sera negative by commercial AChR radioimmunoassay (RIA) were tested by MuSK RIA (n = 30; 2006-2012) and AChR, MuSK, and LRP4 RIA with or without cell-based assays (CBA) (n = 53; 2012-2015). RESULTS: AChR-Abs were detected in 4 of 53 and MuSK-Abs in 20 of 83 (24%) cases. Thirty-six of 53 (68%) were triple seronegative (triple-SNMG) for MuSK, AChR, and LRP4-Abs. When compared with triple-SNMG, individuals with MuSK-MG had a younger onset age (P = 0.008), a greater likelihood of African genetic ancestry (P = 0.008), and 4-fold higher odds of reaching MGFA grade IVB/V (P = 0.018), but were also 9-fold more likely to reach at least minimal manifestations status after ≥12 months of therapy (P = 0.003). CONCLUSIONS: Individuals with African genetic ancestry and severe bulbar/respiratory AChR-Ab-negative MG are likely to have MuSK-MG, but most respond favorably to maintenance immunotherapies. Muscle Nerve 54: 1023-1029, 2016.
Authors: Djingri Labodi Lompo; Nagaonlé Éric Some; Adja Mariam Ouedraogo; Rodrigue P Yonli; Ousséini Diallo; Christian Napon; Athanase Millogo; Jean Kabore Journal: Med Trop Sante Int Date: 2021-11-11
Authors: Alvin Pumelele Ndondo; Brian Eley; Jo Madeleine Wilmshurst; Angelina Kakooza-Mwesige; Maria Pia Giannoccaro; Hugh J Willison; Pedro M Rodríguez Cruz; Jeannine M Heckmann; Kathleen Bateman; Angela Vincent Journal: Front Immunol Date: 2022-03-09 Impact factor: 7.561