上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2018, Vol. 38 ›› Issue (10): 1252-.doi: 10.3969/j.issn.1674-8115.2018.10.021

• 综述 • 上一篇    下一篇

重症肌无力相关自身抗体及其检测方法的研究进展

黄欣欣 1，朱德生 2，徐见容 3，管阳太 1, 2   

  1. 1. 第二军医大学附属长海医院神经内科，上海 200433；2.上海交通大学医学院附属仁济医院神经内科，上海 200127；3.上海交通大学基础医学院药理学与化学生物学系，上海 200025
  • 出版日期:2018-10-28 发布日期:2018-11-18
  • 通讯作者: 管阳太，电子信箱：yangtaiguan@sina.com。
  • 作者简介:黄欣欣（1994—），女，硕士生；电子信箱： 15821693736@163.com。
  • 基金资助:
    国家自然科学基金（ 81471219）；上海交通大学医学院转化医学协同创新合作研究项目（ TM201508, TM201706）

Research progress on myasthenia gravis related autoantibody and detection approaches

HUANG Xin-xin1, ZHU De-sheng2, XU Jian-rong3, GUAN Yang-tai1, 2   

  1. 1. Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China; 2. Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 3. Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University College of Medical Sciences, Shanghai 200025, China
  • Online:2018-10-28 Published:2018-11-18
  • Supported by:
    National Natural Science Foundation of China, 81471219; Translational Medicine Collaborative Innovation Cooperation Research Project of Shanghai Jiao Tong University School of Medicine, TM201508, TM201706

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摘要： 重症肌无力（ myasthenia gravis，MG）是一种以体液免疫介导为主的自身免疫性疾病，其临床特点为骨骼肌无力和易疲劳。其发病机制与体内产生针对神经 -肌肉接头（ neuromuscular junction，NMJ）突触后膜组分的自身抗体密切相关，包括乙酰胆碱受体（acetylcholine receptor，AChR）抗体、肌肉特异性酪氨酸激酶（ muscle-specific receptor tyrosine kinase，MuSK）抗体、低密度脂蛋白受体相关蛋白 4（low-density lipoprotein receptor-related protein 4，LRP4）抗体等；近年来发现还存在针对集聚蛋白、乙酰胆碱酯酶相关胶原蛋白胶原链、皮层蛋白等抗原的自身抗体。 MG基于血清抗体特征可分为 AChR-MG、MuSK-MG、LRP4-MG及血清抗体阴性 MG等亚型。 MG自身抗体的检测对其分型诊断、治疗及预后判断非常重要。随着医疗技术的发展，抗体检测方法得到不断改进，为各类型 MG的精准诊疗提供新的契机。该文对 MG相关自身抗体分类及抗体检测方法的最新进展进行综述。

关键词: 重症肌无力, 自身抗体, 检测方法, 疾病分型

Abstract:

Myasthenia gravis (MG) is an autoimmue disease mediated mainlyhumoral immunity, which is characterisedskeletal muscle weakness and fatigue. Its pathogensis is closely related to the autoantibodies against the postsynaptic membrane components at neuromuscular junction (NMJ), including acetylcholine receptor (AChR) antibody, muscle-specific receptor tyrosine kinase (MuSK) antibody, and low-density lipoprotein receptor-related protein 4 (LRP4) antibody. In recent years, autoantibodies against antigens such as agrin, collagen Q, and cortactin have been identified. Based on serum antibody patterns, MG can be divided into different subgroups: AChR-MG, MuSK-MG, LRP4-MG and seronegative MG. The detection of autoantibody is vital in clinical for subgroup diagnosis, treatment and prognosis. With the development of medical techniques, the antibody detection approaches were improved, providing new opportunities for precise diagnosis and treatment of different subgroups. Thus, this paper reviewed the latest progress of MG autoantibody classification and the antibody detection approaches.

Key words: myasthenia gravis, autoantibody, detection approach, disease subgroup

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