Anti‐AChR antibodies, thymic histology, and T cell subsets in myasthenia gravis

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Abstract
The relationship between the titers of antibody against acetylcholine receptor (AChR) and T helper/ suppressor balance (assessed by the OKT4/OKT8 ratio) were investigated in 74 patieqts with myasthenia gravis (MG). All patients with elevated AChR antibody titers (> 100 nM) had hyperplastic thymuses, while most patients with low or negative antibody titers (> 1 nM) had involuted thymuses. All patients with thymoma had positive, though not very high, antibody titers. No correlation was found between anti-AChR antibody levels and OKT4/OKT8 ratios except for patients with thymoma. Thus, it appears that AChR antibody titers are more closely related to thymic pathology than to peripheral T cell imbalance. These results are consistent with the hypothesis giving a central role to thymic lymphocytes in the AChR antibody production, either as antibody producer B cells or helper T cells.

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