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Myasthenia Gravis

Anti-bodies

01/07/2009

Question:

In a previous answer you mention 4 different kind of anti-bodies: binding AChR, blocking AChR, modulating AChR, and the MUSK antibody. I have only heard about 2 kind of anti-bodies before. AChR-antibody and MUSK. Could you please tell a little bit more about the different kind of antibodies or refer to a website where I can read more about it.

Answer:

There are three main subtypes of the Acetylcholine receptor antibodies. The binding, blocking, and modulating subtypes are all considered acetylcholine receptor antibodies, but just act at different sites to affect the neuromuscular junction. Modulating antibodies are theorized to cause the cell to "swallow" the receptor from its cell surface, so there is less receptor available. Blocking might decrease the availability of the binding site for the acetylcholine chemical. And the binding antibody might just make the receptor more vulnerable to breakdown by the inflammatory response. The point is important in that most labs really only test for the binding antibody. Sometimes a physician needs to clarify if the modulating and blocking antibodies were tested for.

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Response by:

Robert W Neel, IV, MD Robert W Neel, IV, MD
Assistant Professor of Neurology
College of Medicine
University of Cincinnati