ACETYLCHOLINE-RECEPTOR ANTIBODY CHARACTERISTICS IN MYASTHENIA-GRAVIS .1. PATIENTS WITH GENERALIZED MYASTHENIA OR DISEASE RESTRICTED TO OCULAR MUSCLES

Abstract

Anti-acetylcholine receptor (AChR) characteristics were investigated in 3 forms of generalized myasthenia gravis, which are distinguishable by their thymic pathology, age of onset, sex incidence and HLA antigen associations, and in restricted ocular myasthenia. Light chain, IgG subclass, avidity for denervated human AChR and reaction with various human and mammalian AChR preparations were examined in 9-12 patients from each group. Characteristics varied between individuals in each group but not significant differences were found in mean values between the 3 groups with generalized myasthenia. When antibody characteristics in ocular myasthenia were compared with those in generalized disease, differences were found particularly in relative reactivity with denervated, normal and ocular human AChR. The nature of the humoral response in ocular myasthenia differs from that in generalized myasthenia. The similarity in the humoral response between the 3 groups of generalized myasthenia suggests that the distinguishing clinical features may reflect differing susceptibilities to diverse precipitating mechanisms.