Professional Documents
Culture Documents
None
All the research results are obtained after National (Greek) and European Union Gr
SPECIAL THANKS
KPJ Healthcare
Dr Mohd Harris Lu, Medical Director of Sentosa Medical Centre
Dr K V Anitha, KPJ Healthcare
Sarah Joseph, KPJ Healthcare
Special Mention: Datin Jasmin Tan
Aristoteles
Socrates
Platon
No. of patients
200
150
100
50
0
0-9
10-19
20-29
30-39
40-49
Age of onset
50-59
60-69
>70
Prevalence rate
250
200
150
100
50
0
0-9
10-19
20-29
30-39
40-49
Age group
50-59
60-69
>70
Clinical Features
Cardinal feature: Weakness and fatigability of muscles. The weakness increases during
the course of MG, and diplopia and ptosis are common initial complaints. Weakness in
chewing is most noticeable after prolonged effort, as in chewing meat.
Speech may have a nasal timbre. Difficulty in swallowing may occur
In many patients, the weakness becomes generalized, affecting the limb muscles as well. If
weakness of respiration becomes so severe as to require respiratory assistance, the patient is
said to be in crisis.
Snail AChBP
Extracellular
domain (ECD)
70
Cytoplasmic
domain
Extra-cellula
domain
(ECD)
Cyto-plasmic
domain
Unwin, 2005
NEUROMUSCULAR JUNCTION
Normal
Vesicles
with ACh
Nerve
Terminal
Muscle
Myasthenia gravis
Complement
Ach binding
site
Complement-mediated
membrane lysis
Accelerated internalization and
degradation of AChRs
Thymus
hyperplasia
thymoma
thymectomy
myoid cells - AChR
CURRENT THERAPIES OF MG
APC
Thymectomy
Immunosupressives
B7
MHC
TCR
CD28
Regulatory T cell
Resting T
cell
(Prednizone, Azathioprine,
Cyclophosphamide,
Cyclosporine A,
mycophenolate mofetil)
Activated T cell
IVIg
B cell
Plasmapheresis
Ab to
AChR
Inhibitors of
Ach-esterase
AChR
Muscle
AUTOANTIGENS IN MYASTHENIA
Autoantigen
Generalized MG
Ocular MG
80-85%
50%
AChR
(1973-76)
MuSK
(2001)
~5%
~0%
LRP4
(2011)
~~2%
~~10%
grin, ColQ
(2012)
LRP-4
LRP-4
AChR
MuSK
radioactive
AChR
+ serum
of patient
+ anti-serum
radioactive precipitant
MYASTHENIA GRAVIS
GENOMIC MEDICINE AND PERSONALIZED
HEALTH
Konstantinos Poulas
Associate Professor,
Laboratory of Mol. Biology and Immunology
Department of Pharmacy, University of Patras
GREECE
Email: kpoulas@upatras.gr
KPJ Conference 2014
Whole
serum
Anti-AChR
antibodies
MG1 (anti-)
+++
+++
MG2 (anti-)
++
+++
MG3 (anti-)
MG4 (anti-)
THANK YOU KL
:PLOS ONE Decision: Accept [PONE-D-14-20638R1] - [EMID:915a8a9090c8d3d7]
:2014-08-21 15:04
:"PLOS ONE" <em@editorialmanager.com>
:"George Lagoumintzis" <glagoum@upatras.gr>
:"PLOS ONE" <plosone@plos.org>
PONE-D-14-20638R1
Direct proof of the in vivo pathogenic role of the AChR autoantibodies from myasthenia gravis patients
PLOS ONE
Dear Dr Lagoumintzis,
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PLOS ONE
Better diagnosis
Is there any genetic base?
Pharmacogenomics
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Thank you!!!!!
Email: kpoulas@upatras.gr
Patras