المؤلفون: Yesim Parman, Vuslat Yilmaz, Güher Saruhan-Direskeneli, Hacer Durmus, Piraye Oflazer, Fikret Aysal, Erdem Tüzün, Ozlem Gungor-Tuncer, Feza Deymeer

المصدر: Journal of neuroimmunology. 349

مصطلحات موضوعية: 0301 basic medicine, Adult, Male, Adolescent, medicine.medical_treatment, Immunology, CD38, CD19, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Myasthenia Gravis, medicine, Immunology and Allergy, Humans, B-cell activating factor, Child, B cell, Aged, B-Lymphocytes, biology, business.industry, Immunosuppression, Middle Aged, medicine.disease, Myasthenia gravis, Pathophysiology, 030104 developmental biology, medicine.anatomical_structure, Treatment Outcome, Neurology, biology.protein, Female, Neurology (clinical), Antibody, business, 030217 neurology & neurosurgery, Biomarkers, Immunosuppressive Agents

الوصف: B cells play a major role in the pathophysiology of myasthenia gravis (MG) with their ability to produce disease specific, pathogenic antibodies. However, their status during disease development and follow-up stages of the disease in the peripheral blood may need further studies to determine useful markers. In this study, we aimed to detect B cell associated factors concerning immunosuppressive treatment in generalized non-thymomatous MG patients. Although CD19(+) B cell distribution did not vary among disease subgroups, expressions of both CD38 and BAFFR were altered on B cells in MG patients under immunosuppressive therapy. Serum levels of BAFF were elevated in untreated MG patients as compared to treated MG patients and healthy controls. B cell activation factors may show profound alterations due to immunosuppression.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f5ce74a658149bb47de6d62c23141cf3Test
https://pubmed.ncbi.nlm.nih.gov/32977248Test

المؤلفون: Melih Tutuncu, Oner Dogan, Fikret Aysal, Merve Cebi, Arman Çakar, Yesim Parman, Berker Özkan, Mehmet Hocaoglu, Metin Mercan, Vildan Yayla, Onur Akan, Güher Saruhan-Direskeneli, Gizem Engin Gül, Sibel P. Yentür, Hacer Durmus

المساهمون: İÜC, Cerrahpaşa Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü

المصدر: Frontiers in Immunology
Frontiers in Immunology, Vol 11 (2020)

مصطلحات موضوعية: 0301 basic medicine, CD4-Positive T-Lymphocytes, Male, Chemokine, medicine.medical_treatment, Programmed Cell Death 1 Receptor, Chemokine receptor, 0302 clinical medicine, PD-1, IL-21, Immunology and Allergy, Receptors, Cholinergic, Original Research, biology, Chemistry, Interleukin-17, Middle Aged, IL-17, Cytokine, medicine.anatomical_structure, Female, Interleukin 17, Antibody, Immunosuppressive Agents, Signal Transduction, lcsh:Immunologic diseases. Allergy, Adult, Adolescent, T Follicular Helper Cells, T cell, Immunology, Inducible T-Cell Co-Stimulator Protein, 03 medical and health sciences, Young Adult, Myasthenia Gravis, medicine, Humans, Interleukin 4, Aged, Autoantibodies, Immunosuppression Therapy, myasthenia gravis, Interleukins, IL-4, CXCR5, Thymectomy, 030104 developmental biology, ICOS, biology.protein, T follicular helper cells, Interleukin-4, lcsh:RC581-607, 030215 immunology

الوصف: WOS:000538882900001 PubMed ID: 32508812 Myasthenia gravis (MG) is an autoimmune disease mediated by autoantibodies predominantly against the acetylcholine receptor (AChR). Specific T cell subsets are required for long-term antibody responses, and cytokines secreted mainly from CD4(+) T cells regulate B cell antibody production. The aim of this study was to assess the differences in the cytokine expressions of CD4(+) T cells in MG patients with AChR antibodies (AChR-MG) and the effect of immunosuppressive (IS) therapy on cytokine activity and to test these findings also in MG patients without detectable antibodies (SN-MG). Clinically diagnosed AChR-MG and SN-MG patients were included. The AChR-MG patients were grouped as IS-positive and -negative and compared with age- and sex-matched healthy controls. Peripheral blood mononuclear cells were used for ex vivo intracellular cytokine production, and subsets of CD4(+) T cells and circulating follicular helper T (cTfh) cells were detected phenotypically by the expression of the chemokine and the costimulatory receptors. Thymocytes obtained from patients who had thymectomy were also analyzed. IL-21, IL-4, IL-10, and IL-17A productions in CD4(+) T cells were increased in AChR-MG compared to those in healthy controls. IS treatment enhanced IL-10 and reduced IFN-gamma production in AChR-MG patients compared to those in IS-negative patients. Increased IL-21 and IL-4 productions were also demonstrated in SN-MG patients. Among CD4(+) T cells, Th17 cells were increased in both disease subgroups. Treatment induced higher proportions of Th2 cells in AChR-MG patients. Both CXCR5(+) and CXCR5(-) CD4(+) T cells expressed higher programmed cell death protein 1 (PD-1) and inducible costimulatory (ICOS) in AChR-MG and SN-MG groups, mostly irrespective of the treatment. Based on chemokine receptors on CXCR5(+)PD-1(+) in CD4(+) T (cTfh) cells, in AChR-MG patients without treatment, the proportions of Tfh17 cells were higher than those in the treated group, whereas the Tfh1 cells were decreased compared with those in the controls. The relevance of CXCR5 and PD-1 in the pathogenesis of AChR-MG was also suggested by the increased presence of these molecules on mature CD4 single-positive thymocytes from the thymic samples. The study provides further evidence for the importance of IL-21, IL-17A, IL-4, and IL-10 in AChR-MG. Disease-related CD4(+)T cells are identified mainly as PD-1(+) or ICOS+ with or without CXCR5, resembling cTfh cells in the circulation or probably in the thymus. AChR-MG and SN-MG seem to have some similar characteristics. IS treatment has distinctive effects on cytokine expression. TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [116S317]; Istanbul University Research FundIstanbul University This study was supported by TUBITAK (116S317) and Istanbul University Research Fund.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::273c967f5cde2dabc6846cda979ed160Test
https://hdl.handle.net/20.500.12511/5437Test

المؤلفون: Güher Saruhan-Direskeneli, Yesim Parman, Feza Deymeer, Hacer Durmus, Berker Özkan, Mehmet Hocaoglu, Sibel P. Yentür, Oner Dogan

المصدر: Journal of neuroimmunology. 323

مصطلحات موضوعية: 0301 basic medicine, Adult, Male, animal structures, Adolescent, Immunology, Thymus Gland, Pathogenesis, 03 medical and health sciences, Young Adult, Co-stimulation, immune system diseases, Myasthenia Gravis, medicine, Immunology and Allergy, Humans, Child, Cells, Cultured, Acetylcholine receptor, Aged, CD86, Aged, 80 and over, B-Lymphocytes, biology, Chemistry, Interleukins, TLR9, hemic and immune systems, Middle Aged, medicine.disease, Myasthenia gravis, nervous system diseases, 030104 developmental biology, Neurology, biology.protein, Female, Neurology (clinical), Antibody, CD80, Immunosuppressive Agents

الوصف: B cells may contribute to the pathogenesis of myasthenia gravis with anti-acetylcholine antibodies (AChR+ MG) by co-stimulation or selection of T cells. In this study, we investigated costimulatory molecules on B cells in the blood and in the thymus as well as by TLR9 and IL-21 stimulations in AChR+ MG patients with or without immunosuppressive treatment and controls. CD80 and CD86 expression on B cells was increased in the peripheral blood and in the thymus of untreated patients. CD86 was further amplified by IL-21. A role for activated B cells, active thymic environment and IL-21 is implicated in MG.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f8cb9b93506b40de9ae05355984900ecTest
https://pubmed.ncbi.nlm.nih.gov/30196831Test

المؤلفون: John Tzartos, Anastasios Tsonis, Kleopas A. Kleopa, Chantal M. E. Tallaksen, Dragana Lavrnic, Ivana Basta, Anthony Behin, Socrates J. Tzartos, Feza Deymeer, Stojan Peric, Mario Losen, C. Casasnovas Pons, Angelina H. Maniaol, Carlo Antozzi, Sonia Berrih-Aknin, Amelia Evoli, M. De Baets, F. Hanisch, E. Matsigkou, Renato Mantegazza, Tassos C. Kyriakides, Francesca Andreetta, Anna Kostera-Pruszczyk, Piotr Szczudlik, Güher Saruhan-Direskeneli, Konstantinos Lazaridis, Tarek Sharshar, Paraskevi Zisimopoulou, M. Jakubíkova, A. Vaknin, Hacer Durmus, Vasiliki Zouvelou, Eleni Zamba-Papanicolaou, Talma Brenner, Pilar Martinez-Martinez, Beata Szyluk, Jiri Pitha

المساهمون: Psychiatrie & Neuropsychologie, RS: MHeNs - R3 - Neuroscience

المصدر: Journal of Neuroimmunology, 284, 10-17. Elsevier
Journal of Neuroimmunology

مصطلحات موضوعية: Adult, Male, International Cooperation, Immunology, Radioimmunoassay, Thymus Gland, Diagnosis, medicine, Immunology and Allergy, Humans, Receptors, Cholinergic, Cell based assay, Myasthenia gravis, LDL-Receptor Related Proteins, Acetylcholine receptor, Aged, MuSK, Autoantibodies, Neuromyelitis optica, biology, business.industry, Multiple sclerosis, Neuromyelitis Optica, Autoantibody, Receptor Protein-Tyrosine Kinases, Hyperplasia, Middle Aged, medicine.disease, Flow Cytometry, 3. Good health, Settore MED/26 - NEUROLOGIA, Neurology, biology.protein, Cell-based assay, Female, Neurology (clinical), Thymus Hyperplasia, Antibody, business

الوصف: Seronegativemyastheniagravis(MG) presents a serious gap in MG diagnosis and understanding. We applied acellbasedassay(CBA) for the detection of muscle specific kinase (MuSK) antibodies undetectable by radioimmunoassay. We tested 633 triple-seronegative MG patients' sera from 13 countries, detecting 13% as positive.MuSKantibodies were found, at significantly lower frequencies, in 1.9% of healthy controls and 5.1% of other neuroimmune disease patients, including multiple sclerosis and neuromyelitis optica. The clinical data of the newly diagnosedMuSK-MG patients are presented. 27% of ocular seronegative patients wereMuSKantibody positive. Moreover, 23% had thymic hyperplasia suggesting that thymic abnormalities are more common than believed.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8c566b9ba7e0928a801e300de6d24f7fTest
https://doi.org/10.1016/j.jneuroim.2015.04.015Test

المؤلفون: A. Vaknin, Dragana Lavrnic, Eleni Zamba-Papanicolaou, Chantal M. E. Tallaksen, M. DeBaets, M. Frenkian Cuvelier, Stojan Peric, Talma Brenner, John Tzartos, Vasiliki Zouvelou, Beata Szyluk, Carlo Antozzi, Hacer Durmus, Piotr Szczudlik, Konstantinos Lazaridis, Francesca Andreetta, Paraskevi Zisimopoulou, T. Stojkovic, Socrates J. Tzartos, Angelina H. Maniaol, Sonia Berrih-Aknin, Renato Mantegazza, Anna Kostera-Pruszczyk, Feza Deymeer, Mario Losen, Pilar Martinez-Martinez, Panagiota Evangelakou, Kleopas A. Kleopa, Tassos C. Kyriakides, Amelia Evoli, Güher Saruhan-Direskeneli, Ivana Basta

المساهمون: Psychiatrie & Neuropsychologie, RS: MHeNs - R3 - Neuroscience

المصدر: Journal of Autoimmunity; Vol 52
Journal of Autoimmunity, 52, 139-145. Elsevier Science
Journal of Autoimmunity

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Thymoma, Adolescent, International Cooperation, Immunology, LRP4, Thymus Gland, Autoantibodies Cell based assay, Young Adult, Sex Factors, Epidemiology, Diagnosis, Humans, Immunology and Allergy, Medicine, Receptors, Cholinergic, Serologic Tests, Age of Onset, Child, Myasthenia gravis, LDL-Receptor Related Proteins, Aged, Autoantibodies, Acetylcholine receptor, Hyperplasia, biology, business.industry, Infant, Newborn, Autoantibody, Infant, Receptor Protein-Tyrosine Kinases, Middle Aged, medicine.disease, 3. Good health, HEK293 Cells, Child, Preschool, Immunoglobulin G, Disease Progression, biology.protein, Female, Therapy, Antibody, business, Lipoprotein

الوصف: Double-seronegative myasthenia gravis (dSN-MG, without detectable AChR and MuSK antibodies) presents a serious gap in MG diagnosis and understanding. Recently, autoantibodies against the low-density lipoprotein receptor-related protein 4 (LRP4) have been identified in several dSN-MG sera, but with dramatic frequency variation (similar to 2-50%). We have developed a cell based assay (CBA) based on human LRP4 expressing HEK293 cells, for the reliable and efficient detection of LRP4 antibodies. We have screened about 800 MG patient sera from 10 countries for LRP4 antibodies. The overall frequency of LRP4-MG in the dSN-MG group (635 patients) was 18.7% but with variations among different populations (range 7-32.7%). Interestingly, we also identified double positive sera: 8/107 anti-AChR positive and 10/ 67 anti-MuSK positive sera also had detectable LRP4 antibodies, predominantly originating from only two of the participating groups. No LRP4 antibodies were identified in sera from 56 healthy controls tested, while 4/110 from patients with other neuroimmune diseases were positive. The clinical data, when available, for the LRP4-MG patients were then studied. At disease onset symptoms were mild (81% had MGFA grade I or II), with some identified thymic changes (32% hyperplasia, none with thymoma). On the other hand, double positive patients (AChR/LRP4-MG and MuSK/LRP4-MG) had more severe symptoms at onset compared with any single positive MG subgroup. Contrary to MuSK-MG, 27% of ocular dSN-MG patients were LRP4 antibody positive. Similarly, contrary to MuSK antibodies, which are predominantly of the IgG4 subtype, LRP4 antibodies were predominantly of the IgG1 and IgG2 subtypes. The prevalence was higher in women than in men (female/male ratio 2.5/1), with an average disease onset at ages 33.4 for females and 41.9 for males. Overall, the response of LRP4-MG patients to treatment was similar to published responses of AChR-MG rather than to MuSK-MG patients.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0dc6fee35d6be5e7c6c4359d7e4c028eTest

المؤلفون: Amr H. Sawalha, Adam Adler, Yesim Gulsen-Parman, Mahdi Alahgholi-Hajibehzad, Alexander Marx, Oner Dogan, Feza Deymeer, Fikret Aysal, Piraye Oflazer, Güher Saruhan-Direskeneli, Vuslat Yilmaz, Travis K. Hughes, Mehmet Ali Akalin, Sibel P. Yentür, Hacer Durmus

مصطلحات موضوعية: 0301 basic medicine, Male, Genotype, Turkey, Immunology, Population, Genome-wide association study, Human leukocyte antigen, HLA-C Antigens, Polymorphism, Single Nucleotide, Linkage Disequilibrium, 03 medical and health sciences, Genetic Heterogeneity, 0302 clinical medicine, Gene Frequency, Myasthenia Gravis, Genetic predisposition, medicine, Immunology and Allergy, HLA-DQ beta-Chains, Humans, Genetic Predisposition to Disease, Receptors, Cholinergic, Allele, Age of Onset, education, Alleles, Genetics, education.field_of_study, biology, Genetic heterogeneity, Genome, Human, Receptor Protein-Tyrosine Kinases, medicine.disease, Myasthenia gravis, 030104 developmental biology, HLA-B Antigens, biology.protein, Female, Antibody, 030217 neurology & neurosurgery, Genome-Wide Association Study

الوصف: This study aims to investigate genetic susceptibility to early-onset and late-onset anti-acetylcholine receptor antibody positive myasthenia gravis (EOMG and LOMG) and anti-muscle specific kinase antibody positive MG (MuSK-MG) at genome-wide level in a single population. Using a custom-designed array and imputing additional variants and the classical HLA alleles in 398 patients, we detected distinct associations. In EOMG, rs113519545 in the HLA class I region (OR = 5.71 [3.77-8.66], P = 2.24 x 10(-16)), HLA-B*08:01 (OR = 7.04 [3.95-12.52], P = 3.34 x 10(-11)) and HLA-C*07:01 (OR = 2.74 [1.97-3.81], P = 2.07(-9)), in LOMG, rs111256513 in the HLA class II region (OR = 2.22 [1.59-3.09], P = 2.48 x 10(-6)) and in MuSK-MG, an intronic variant within HLA-DQB1 (rs68081734, OR = 5.86, P = 2.25 x 10(-14)) and HIA-DQB1*05:02 (OR = 8.56, P = 6.88 x 10(-13)) revealed the most significant associations for genome-wide significance. Differential genetic susceptibility within the HLA to EOMG, LOMG and MuSK-MG has been established in a population from Turkey. (C) 2016 Elsevier Inc. All rights reserved.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ab41880803428b2e79e732068f87a876Test
https://aperta.ulakbim.gov.tr/record/56575Test

المؤلفون: Jiri Pitha, Güher Saruhan-Direskeneli, F. Hanisch, Eleni Zamba-Papanicolaou, Talma Brenner, Beata Szyluk, Siegfried Labeit, Socrates J. Tzartos, C. Casasnovas Pons, John Tzartos, Dittmar Labeit, Julius Bogomolovas, Nils Erik Gilhus, Pilar Martinez-Martinez, Anna Kostera-Pruszczyk, Christos Stergiou, Ivana Basta, Konstantinos Lazaridis, Anthony Behin, Hacer Durmus, Francesca Andreetta, Angelina H. Maniaol, Sonia Berrih-Aknin, Kleopas A. Kleopa, A. Vaknin, Amelia Evoli, Piotr Szczudlik, Renato Mantegazza, M. De Baets, Tassos C. Kyriakides, Tarek Sharshar, Carlo Antozzi, M. Jakubíkova, Vasiliki Zouvelou, Chantal M. E. Tallaksen, Stojan Peric, Feza Deymeer, Dragana Lavrnic, Mario Losen

المساهمون: RS: MHeNs - R3 - Neuroscience, Psychiatrie & Neuropsychologie

المصدر: Journal of Neuroimmunology
Journal of Neuroimmunology, 292, 108-115. Elsevier

مصطلحات موضوعية: 0301 basic medicine, Seronegative, Male, Radioimmunoprecipitation Assay, animal structures, Titin, International Cooperation, Immunology, Enzyme-Linked Immunosorbent Assay, Serology, 03 medical and health sciences, 0302 clinical medicine, Antigen, Receptors, Diagnosis, Myasthenia Gravis, Autoantibodies, Myasthenia gravis, Radioimmunoprecipitation assay, Connectin, Female, Humans, LDL-Receptor Related Proteins, Receptor Protein-Tyrosine Kinases, Receptors, Cholinergic, Immunology and Allergy, Neurology, Neurology (clinical), Medicine, Myopathy, Cholinergic, Autoimmune disease, biology, business.industry, Autoantibody, musculoskeletal system, medicine.disease, 3. Good health, Settore MED/26 - NEUROLOGIA, 030104 developmental biology, biology.protein, Antibody, medicine.symptom, business, 030217 neurology & neurosurgery

الوصف: Myasthenia gravis (MG) is an autoimmune disease caused by antibodies targeting the neuromuscular junction of skeletal muscles. Triple-seronegative MG (tSN-MG, without detectable AChR, MuSK and LRP4 antibodies), which accounts for similar to 10% of MG patients, presents a serious gap in MG diagnosis and complicates differential diagnosis of similar disorders. Several AChR antibody positive patients (AChR-MG) also have antibodies against titin, usually detected by ELISA. We have developed a very sensitive radioimmunoprecipitation assay (RIPA) for titin antibodies, by which many previously negative samples were found positive, including several from tSN-MG patients. The validity of the RIPA results was confirmed by western blots. Using this RIPA we screened 667 MG sera from 13 countries; as expected, AChR-MG patients had the highest frequency of titin antibodies (40.9%), while MuSK-MG and LRP4-MG patients were positive in 14.6% and 16.4% respectively. Most importantly, 13.4% (50/372) of the tSN-MG patients were also titin antibody positive. None of the 121 healthy controls or the 90 myopathy patients, and only 3.6% (7/193) of other neurological disease patients were positive. We thus propose that the present titin antibody RIPA is a useful tool for serological MG diagnosis of tSN patients.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3246f6c7af141f9bf43c1530ed6c7536Test
https://pubmed.ncbi.nlm.nih.gov/26943968Test

المؤلفون: Feza Deymeer, Kostas Poulas, Yesim Gulsen-Parman, Piraye Oflazer, Hacer Durmus, Erdem Tüzün, Fikret Aysal, Alexander Marx, Vuslat Yilmaz, Güher Saruhan-Direskeneli, Sibel P. Yentür, Socrates J. Tzartos

المصدر: PLoS ONE
PLoS ONE, Vol 10, Iss 4, p e0123546 (2015)

مصطلحات موضوعية: Adult, CD4-Positive T-Lymphocytes, Male, medicine.medical_specialty, CD3 Complex, Science, medicine.medical_treatment, CD40 Ligand, Neuromuscular transmission, Cell Separation, Peripheral blood mononuclear cell, 03 medical and health sciences, 0302 clinical medicine, Immune system, Internal medicine, Myasthenia Gravis, medicine, Humans, Receptors, Cholinergic, RNA, Messenger, Receptor, Autoantibodies, Demography, Immunosuppression Therapy, Multidisciplinary, CD40, biology, Interleukin-12 Subunit p40, Receptor Protein-Tyrosine Kinases, medicine.disease, Myasthenia gravis, 3. Good health, Endocrinology, Cytokine, Immunology, biology.protein, Leukocytes, Mononuclear, Medicine, Cytokines, Female, Antibody, 030217 neurology & neurosurgery, 030215 immunology, Research Article

الوصف: Neuromuscular transmission failure in myasthenia gravis (MG) is most commonly elicited by autoantibodies (ab) to the acetylcholine receptor or the muscle-specific kinase, constituting AChR-MG and MuSK-MG. It is controversial whether these MG subtypes arise through different T helper (Th) 1, Th2 or Th17 polarized immune reactions and how these reactions are blunted by immunosuppression. To address these questions, plasma levels of cytokines related to various Th subtypes were determined in patients with AChR-MG, MuSK-MG and healthy controls (CON). Peripheral blood mononuclear cells (PBMC) were activated in vitro by anti-CD3, and cytokines were quantified in supernatants. In purified blood CD4(+) T cells, RNA of various cytokines, Th subtype specific transcription factors and the co-stimulatory molecule, CD40L, were quantified by qRT-PCR. Plasma levels of Th1, Th2 and Th17 related cytokines were overall not significantly different between MG subtypes and CON. By contrast, in vitro stimulated PBMC from MuSK-MG but not AChR-MG patients showed significantly increased secretion of the Th1, Th17 and T follicular helper cell related cytokines, IFN-gamma, IL-17A and IL-21. Stimulated expression of IL-4, IL-6, IL-10 and IL-13 was not significantly different. At the RNA level, expression of CD40L by CD4+ T cells was reduced in both AChR-MG and MuSK-MG patients while expression of Th subset related cytokines and transcription factors were normal. Immunosuppression treatment had two effects: First, it reduced levels of IL12p40 in the plasma of AChR-MG and MuSK-MG patients, leaving other cytokine levels unchanged; second, it reduced spontaneous secretion of IFN-. and increased secretion of IL-6 and IL-10 by cultured PBMC from AChR-MG, but not MuSK-MG patients. We conclude that Th1 and Th17 immune reactions play a role in MuSK-MG. Immunosuppression attenuates the Th1 response in AChR-MG and MuSK-MG, but otherwise modulates immune responses in AChR-MG and MuSK-MG patients differentially.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f1875a70e7cb11c750cc4c1b6337a0a7Test
http://europepmc.org/articles/PMC4403992Test

المؤلفون: Hacer Durmus, Fikret Aysal, Feza Deymeer, Erdem Tüzün, Güher Saruhan-Direskeneli, Piraye Oflazer, Kostas Poulos, Yesim Parman, Vuslat Yilmaz

المصدر: Journal of Neuroimmunology. 275:212-213

مصطلحات موضوعية: biology, business.industry, medicine.medical_treatment, Immunology, medicine.disease, Myasthenia gravis, Cytokine, Neurology, medicine, biology.protein, Immunology and Allergy, Neurology (clinical), Antibody, business, Acetylcholine receptor

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::8bed8deda75835555a7481ea3c06c50dTest
https://doi.org/10.1016/j.jneuroim.2014.08.571Test

المؤلفون: Yesim Parman, Güher Saruhan-Direskeneli, M. Hajibehzad, Vuslat Yilmaz, F. Deyemeer, S. Yildiz-Celik, Piraye Oflazer-Serdaroglu, Hacer Durmus

المصدر: Neuromuscular Disorders. 24:842

مصطلحات موضوعية: medicine.medical_specialty, Weakness, biology, business.industry, Azathioprine, Disease, medicine.disease, Gastroenterology, Myasthenia gravis, Surgery, Neurology, Internal medicine, Pediatrics, Perinatology and Child Health, Epidemiology, medicine, biology.protein, Prednisolone, Outpatient clinic, Neurology (clinical), Antibody, medicine.symptom, business, Genetics (clinical), medicine.drug

الوصف: Findings in recent epidemiological studies have implied that the frequency of myasthenia gravis (MG) may be increasing in the elderly population. Published studies of late-onset MG have disclosed some of its characteristics: males are more frequently affected, the thymus is more likely to be involuted, there is a different HLA profile and anti-striatal muscle antibodies against titin/ryanodine receptors may be present. In our MG database, there were 95 generalized non-thymomatous MG patients with disease onset ⩾50 years who first presented to our outpatient clinic during the 10 years between 2001 and 2010 and who were followed for at least 3 years. All patients were contacted by phone calls or letters. There was a marked male preponderance with male to female ratio of 1.7:1. Onset was with predominantly ocular symptoms (62%), followed by bulbar symptoms (23%) and weakness in the extremities (11%); two patients had neck weakness and 4 had mixed onset symptoms. Anti-acetylcholine receptor antibodies (AChR Ab) were present in 84%, 5% were anti-MuSK Ab positive and 11 % were double negative. Sixty-two percent had anti-titin antibodies. The disease was mild (MGFA 2) in approximately half of the patients (47%) while 6% were intubated. Fifty-seven percent (including all of the patients with MuSK MG) had MGFA postintervention status of complete stable remission/pharmacological remission/minimal manifestations at the last visit. A further 28 % were improved. The combination of prednisolone and azathioprine appeared to be superior to these agents used alone. In 15 mildly affected patients in whom azathioprine was combined with low dose prednisolone (

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::d913fb3c01ca453cc315227e4910fb82Test
https://doi.org/10.1016/j.nmd.2014.06.168Test