Treatment of experimental myasthenia with autologous idiotypes linked to muramyl dipeptide.

In order to develop a new treatment of experimental autoimmune myasthenia gravis (EAMG), rabbits were injected with purified acetylcholine receptor (AChR) from Torpedo californica. Polyclonal affinity-purified anti-AChR antibodies (idiotypes, Ids) were coupled covalently to muramyl dipeptide and injected back into the same (i.e. autologous) rabbits from which the Ids were obtained. Treated animals developed anti-Ids that bound to the F(ab')2 fragments of the Ids as demonstrated by ELISA and that also blocked binding of Ids to AChR in a radioimmunoassay. Treated animals showed a protective effect compared to control animals when challenged with a second injection of AChR. Anti-AChR titres in surviving animals achieved a steady-state equilibrium. No apparent toxicity from the treatment was noted.