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ID 116884
Title Alternative
疾患活動性の高い重症筋無力症患者の胸腺ではプラズマブラストが増加している
Author
Yamamoto, Yohei Tokushima University
Uzawa, Akiyuki Chiba University
Ozawa, Yukiko Chiba University
Kanai, Tetsuya Chiba University
Oda, Fumiko Chiba University
Kuwabara, Satoshi Chiba University
Yamamura, Takashi National Center of Neurology and Psychiatry (NCNP)
Keywords
Myasthenia Gravis
Thymectomy
Plasmablast
B cell
Tfh cell
Content Type
Thesis or Dissertation
Description
Background and Objectives
To investigate intrathymic B lymphopoiesis in patients with myasthenia gravis (MG) and explore thymus pathology associated with clinical impact.
Methods
Thymic lymphocytes from 15 young patients without MG, 22 adult patients without MG, 14 patients with MG without thymoma, and 11 patients with MG with thymoma were subjected to flow cytometry analysis of T follicular helper (Tfh), naive B, memory B, plasmablasts, CD19+B220high thymic B cells, B-cell activating factor receptor, and C-X-C chemokine receptor 5 (CXCR5). Peripheral blood mononuclear cells of 16 healthy subjects and 21 untreated patients with MG were also analyzed. Immunologic values were compared, and correlations between relevant values and clinical parameters were evaluated.
Results
The frequencies of circulating and intrathymic plasmablasts were significantly higher in patients with MG than controls. On the other hand, the frequency of CD19+B220high thymic B cells was not increased in MG thymus. We observed a significant increase in CXCR5 expression on plasmablasts in MG thymus and an increased frequency of intrathymic plasmablasts that was correlated with preoperative disease activity. The frequency of intrathymic Tfh cells was significantly lower in patients who received immunosuppressive (IS) therapy than those without IS therapy. However, there was no significant difference in the frequency of intrathymic plasmablasts irrespective of IS therapy.
Discussion
Our findings confirmed a correlation between increased frequency of intrathymic plasmablasts and disease activity before thymectomy. We postulate that activated intrathymic plasmablasts endow pathogenic capacity in MG.
Journal Title
Neurology : Neuroimmunology & Neuroinflammation
ISSN
23327812
NCID
AA12724386
Publisher
Wolters Kluwer|American Academy of Neurology
Volume
8
Issue
6
Start Page
e1087
Published Date
2021-09-24
Remark
内容要旨・審査要旨・論文本文の公開
本論文は,著者Yohei Yamamotoの学位論文として提出され,学位審査・授与の対象となっている。
Rights
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ). The work cannot be changed in any way or used commercially without permission from the journal.
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
ETD
MEXT report number
甲第3581号
Diploma Number
甲医第1526号
Granted Date
2022-03-04
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
University Hospital
Medical Sciences
Institute of Advanced Medical Sciences