What is Myasthenia Gravis? 

Myasthenia gravis (MG) is a long-standing autoimmune disease, which means that the system in charge of protecting the body from foreign organisms mistakenly attacks itself. Patients with MG experience weakness and fatigue of the muscles we can voluntarily control. This is a result of an interrupted communication between nerves and muscles.    

Prevalence of Myasthenia Gravis  

The prevalence of MG in the United States is estimated at "20 per 100,000 individuals. It affects people of any age, both men and women from all ethnic and racial backgrounds. However, it is more common in women under 40 and men over 60.    

Symptoms 

Some of the most common symptoms are:

Common Causes

The pathology of MG lies within the neuromuscular junction, the space between a neuron and the muscle they control. Normally, a neuron releases a messenger molecule called acetylcholine (ACh) to communicate with the muscle. ACh binds to a protein in the muscle called acetylcholine receptor (AChR), which activates the muscle in order to enable muscle contraction. This process can be affected in various ways and for different reasons in patients with MG. 

Antibodies

Antibodies are proteins produced by the immune system. Their normal function is to protect the body from intruders (e.g. bacteria, viruses, etc.). In MG, the body produces abnormal antibodies (also known as pathogenic or problematic antibodies) that bind to receptors in the muscles and block, alter, or destroy the receptor and its function. With fewer receptors available, the muscle receives less signals from the neuron, preventing the muscles from contracting properly. In most cases ("80%), the abnormal antibodies target the AChR. Patients with this type of MG are diagnosed with “antibody positive or seropositive MG”, referring to the presence of anti-AChR antibodies. Fewer cases are presented with abnormal antibodies that target other receptors or proteins in the muscle. For example, the MuSK (Muscle-Specific Kinase) protein, or the LRP4 (lipoprotein receptor-related protein 4) protein.     

Thymus gland 

The thymus gland is part of the immune system. Therefore, it plays an important part in protecting the body from infections throughout childhood. This organ is usually large during infancy and then gets smaller and replaced by fat in healthy adults. However, in some patients with MG, the thymus remains abnormally large and produces antibodies that can target receptors like the AChR and affect the communication between the neuron and the muscle. Some patients with MG develop thymomas (tumors of the thymus gland). Thymomas are usually harmless, but can become cancerous. 

Diagnosis

Several tests can be performed in order to confirm the diagnosis of MG: 

Current treatments

Currently, there are only two FDA-approved therapies for the treatment of MG: Mestinon (an acetylcholinesterase inhibitor) and Soliris (immunosuppressive drug). These medications are effective for only a portion of all patients with MG.  

Other available treatments include: plasmapheresis, immunoadsorption, intravenous immunoglobulin administration, and thymectomy. 

However, there is still a great need for new and efficacious treatment alternatives, especially for those patients that currently have little to no treatments available for their specific condition. Clinical trials with new potential therapies for the treatment of MG are currently available. Feel free to contact us for more information about the possibility to participate in a clinical trial for MG. 

Recommended Resources

Myasthenia Gravis Foundation of America

MG United

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