Alpert, Laurence I., Rule, Allyn, Norio, Matti, Kott, Edna, Kornfeld, Peter, and Osserman, Kermitt E.: Studies in myasthenia gravis: Cellular hypersensitivity to skeletal muscle. Am. J. Clin. Pathol. 58: 647–653, 1972. The direct leukocyte migration inhibition technic was used to investigate cell-mediated immunity to skeletal muscle components in patients with myasthenia gravis. Significant migration inhibition was observed in 14 of the 21 patients studied using crude skeletal muscle as antigen. Myosin-containing muscle fractions demonstrated similar or increased inhibitory activities. A strong positive correlation was found between presence and titer of circulating antiskeletal muscle antibodies (demonstrable by indirect immunofluorescence) and significant leukocyte migration inhibition. These findings indicate that patients with myasthenia gravis may demonstrate both humoral and cellular sensitization to skeletal muscle.