Interleukin-6 overproduction by cultured thymic epithelial cells from patients with myasthenia gravis is potentially involved in thymic hyperplasia.

Most patients with Myasthenia Gravis (MG) present a thymic hyperplasia characterized by the presence of lymphoid follicles. The acetylcholine receptor autoantigen, as well as autoantigen specific activated T and B cells found in the thymus, strongly suggest that auto-sensitization could take place in this organ. Since IL-6 is involved in T and B cell growth and differentiation, we thought that abnormal IL-6 expression by thymic epithelial cells (TEC) could be related to thymic hyperplasia in MG. In this paper, IL-6 protein and gene expression by cultured TEC from patients with MG were examined. TEC from patients presented a dramatic IL-6 hyperproduction phenotype as compared to controls when stimulated by exogenous signals such as LPS and cytokines (IL-1 beta, TNF-alpha) alone or in combination. Moreover, we observed a similar effect with a physiological signal such as the syngeneic lympho-epithelial cell contact. Autologous thymocytes stimulated normal and MG TEC IL-6 production in a time- and dose- dependent way, and with a higher magnitude in MG TEC compared to controls. In all stimulation conditions, induction of IL-6 production required protein synthesis and was associated with increased IL-6 mRNA level expression as assessed by computer-aided quantification after in situ mRNA hybridization. In addition, recombinant IL-6 induced in vitro growth of TEC, demonstrating that IL-6 is a possible autocrine growth factor for these cells. This deregulated IL-6 production as well as the ability of TEC to use it as a growth factor may be of pathophysiological relevance in MG. It provides an explanation for morphological changes of the thymus and may have a key role in initiation, exacerbation and ongoing of the autoimmune response in MG. Therefore this study extends our current understanding of the molecular pathophysiology of MG.