Current and emerging therapies for the treatment of myasthenia gravis

Renato Mantegazza, Silvia Bonanno, Giorgia Camera, Carlo AntozziDepartment of Neuromuscular Diseases and Neuroimmunology, Fondazione Istituto Neurologico Carlo Besta, Milan, ItalyAbstract: Myasthenia gravis (MG) is an autoimmmune disease in which autoantibodies to different antigens of the neuromusc...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Renato Mantegazza, Silvia Bonanno, Giorgia Camera, et al
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/42d9506f1cd747d1880b6e7e5e5b2e37
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:42d9506f1cd747d1880b6e7e5e5b2e37
record_format	dspace
spelling	oai:doaj.org-article:42d9506f1cd747d1880b6e7e5e5b2e372021-12-02T01:17:37ZCurrent and emerging therapies for the treatment of myasthenia gravis1176-63281178-2021https://doaj.org/article/42d9506f1cd747d1880b6e7e5e5b2e372011-03-01T00:00:00Zhttp://www.dovepress.com/current-and-emerging-therapies-for-the-treatment-of-myasthenia-gravis-a6791https://doaj.org/toc/1176-6328https://doaj.org/toc/1178-2021Renato Mantegazza, Silvia Bonanno, Giorgia Camera, Carlo AntozziDepartment of Neuromuscular Diseases and Neuroimmunology, Fondazione Istituto Neurologico Carlo Besta, Milan, ItalyAbstract: Myasthenia gravis (MG) is an autoimmmune disease in which autoantibodies to different antigens of the neuromuscular junction cause the typical weakness and fatigability. Treatment includes anticholinesterase drugs, immunosuppression, immunomodulation, and thymectomy. The autoimmune response is maintained under control by corticosteroids frequently associated with immunosuppressive drugs, with improvement in the majority of patients. In case of acute exacerbations with bulbar symptoms or repeated relapses, modulation of autoantibody activity by plasmapheresis or intravenous immunoglobulins provides rapid improvement. Recently, techniques removing only circulating immunoglobulins have been developed for the chronic management of treatment-resistant patients. The rationale for thymectomy relies on the central role of the thymus. Despite the lack of controlled studies, thymectomy is recommended as an option to improve the clinical outcome or promote complete remission. New videothoracoscopic techniques have been developed to offer the maximal surgical approach with the minimal invasiveness and hence patient tolerability. The use of biological drugs such as anti-CD20 antibodies is still limited but promising. Studies performed in the animal model of MG demonstrated that several more selective or antigen-specific approaches, ranging from mucosal tolerization to inhibition of complement activity or cellular therapy, might be feasible. Investigation of the transfer of these therapeutic approaches to the human disease will be the challenge for the future.Keywords: myasthenia gravis, therapy, immunosuppression, thymectomy, plasmapheresis Renato MantegazzaSilvia BonannoGiorgia Cameraet alDove Medical PressarticleNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol 2011, Iss Issue 1, Pp 151-160 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Renato Mantegazza Silvia Bonanno Giorgia Camera et al Current and emerging therapies for the treatment of myasthenia gravis
description	Renato Mantegazza, Silvia Bonanno, Giorgia Camera, Carlo AntozziDepartment of Neuromuscular Diseases and Neuroimmunology, Fondazione Istituto Neurologico Carlo Besta, Milan, ItalyAbstract: Myasthenia gravis (MG) is an autoimmmune disease in which autoantibodies to different antigens of the neuromuscular junction cause the typical weakness and fatigability. Treatment includes anticholinesterase drugs, immunosuppression, immunomodulation, and thymectomy. The autoimmune response is maintained under control by corticosteroids frequently associated with immunosuppressive drugs, with improvement in the majority of patients. In case of acute exacerbations with bulbar symptoms or repeated relapses, modulation of autoantibody activity by plasmapheresis or intravenous immunoglobulins provides rapid improvement. Recently, techniques removing only circulating immunoglobulins have been developed for the chronic management of treatment-resistant patients. The rationale for thymectomy relies on the central role of the thymus. Despite the lack of controlled studies, thymectomy is recommended as an option to improve the clinical outcome or promote complete remission. New videothoracoscopic techniques have been developed to offer the maximal surgical approach with the minimal invasiveness and hence patient tolerability. The use of biological drugs such as anti-CD20 antibodies is still limited but promising. Studies performed in the animal model of MG demonstrated that several more selective or antigen-specific approaches, ranging from mucosal tolerization to inhibition of complement activity or cellular therapy, might be feasible. Investigation of the transfer of these therapeutic approaches to the human disease will be the challenge for the future.Keywords: myasthenia gravis, therapy, immunosuppression, thymectomy, plasmapheresis
format	article
author	Renato Mantegazza Silvia Bonanno Giorgia Camera et al
author_facet	Renato Mantegazza Silvia Bonanno Giorgia Camera et al
author_sort	Renato Mantegazza
title	Current and emerging therapies for the treatment of myasthenia gravis
title_short	Current and emerging therapies for the treatment of myasthenia gravis
title_full	Current and emerging therapies for the treatment of myasthenia gravis
title_fullStr	Current and emerging therapies for the treatment of myasthenia gravis
title_full_unstemmed	Current and emerging therapies for the treatment of myasthenia gravis
title_sort	current and emerging therapies for the treatment of myasthenia gravis
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/42d9506f1cd747d1880b6e7e5e5b2e37
work_keys_str_mv	AT renatomantegazza currentandemergingtherapiesforthetreatmentofmyastheniagravis AT silviabonanno currentandemergingtherapiesforthetreatmentofmyastheniagravis AT giorgiacamera currentandemergingtherapiesforthetreatmentofmyastheniagravis AT etal currentandemergingtherapiesforthetreatmentofmyastheniagravis
_version_	1718403136361594880

Current and emerging therapies for the treatment of myasthenia gravis

Ejemplares similares