综上所述，在采取特异治疗时需注意MG的某些特征：①AChR的丢失是抗体介导的，有效的治疗必需抑制抗AChR抗体；②抗AChR抗体的产生依赖于T细胞，针对T细胞的疗法是重要的措施；③AChR是高度免疫原抗原，用AChR免疫可产生多种对AChR反应的B、T细胞；④对AChR的免疫反应具有高度异质性。总之，近年来重症肌无力分子免疫学研究已取得了很大进展，不仅为认识疾病病因和免疫发病提供了依据，而且为用特异免疫疗法进行治疗打下基础。
作者单位：北京医科大学第一附属医院神经内科(100034)
参考文献
1 McIntosh KR,Roehm PC,Drachman DB.Tolerance to AChR induced by AChR-coupled syngeneic cells:clonal anergy?Ann N Y Acad Sci,1993, (681):306.
2 Storb U.Steps in the generation of autoantibodies.Ann NY Acad sci,1993,681:29
3 Aime-Sempe C,Cohen-Kaminsky S,Bruand C,et al.In vivo preferential usage of tCR V β 8 in Torpedo acetylcholine receptor immune response in the murine experimental model of myasthenia gravis.J Neuroimmunol,1995,58(2):191
4 Schonrich G,Kalinke U,Momburg F,et al.Down regulation of T cell receptors on self-reactive T cells as a novel mechanism for extra-thymic tolerance induction. cell,1991,65(2):293
5 Bacha P,Williams DB, Waters C,et al.Interleukin-2 receptor targeted cytotoxicity:interleukin-2 receptormediated action of a diph-theria toxin-related interleukin-2 fusion protein.J Exp Med,1988,167(2):612
6 Thompson PA,McAtee R,Infante AJ, et al.V β-specific immu-notoxin selectively kills acetylcholine receptor reactive T lymphocyts from mice with experimental autoimmune myasthenia gravis.Intern Immunol,1994,6(12):1807
7 Ahlberg R,Yi Q,Pirskanen R,et al.Treatment of myasthenia gravis with anti-CD4 antibody:improvement correlates to decreased T-cell autoreactivity.Neurology,1994,44(9):1732
上一页 1 2 3 [4] 5 下一页
