JOURNAL OF THE CZECH PHARMACEUTICAL SOCIETY AND THE SLOVAK PHARMACEUTICAL SOCIETY

Čes. slov. farm. 2011, 60(2):47-53

Myasthenia gravis - current treatment standards and emerging drugs

Markéta Komlóová1, Kamil Musílek2,4,*, Kamil Kuča3,4
1 Univerzita Karlova v Praze, Farmaceutická fakulta Hradec Králové, Katedra farmaceutické chemie a kontroly léčiv
2 Univerzita obrany Hradec Králové, Fakulta vojenského zdravotnictví, Katedra toxikologie
3 Univerzita obrany Hradec Králové, Fakulta vojenského zdravotnictví, Centrum pokročilých studií
4 Fakultní nemocnice Hradec Králové

Myasthenia gravis is very rare autoimmune disease of neuromuscular junction, which presents as a weakness and increased fatiquability of striated muscles. Formerly, myasthenia was largely constraining disease and often ended by death. Recently, advanced diagnostic methods and variety of therapeutic options allow the full compensation of the disease and the quality of patient life is restored. In this review, the methods used during the myasthenia treatment along with the description of the disease itself were detailed.

Keywords: myasthenia gravis; review; diagnostics; treatment; emerging drugs
Grants and funding:

Autoři práce děkují za finanční podporu Grantové agentuře České republiky (203/09/P130), Grantové agentuře Univerzity Karlovy v Praze (117909/2009/B-CH/FaF) a Ministerstvu zdravotnictví České republiky (MZO00179906).

Received: January 17, 2011; Accepted: January 24, 2011; Published: February 1, 2011  Show citation

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Komlóová M, Musílek K, Kuča K. Myasthenia gravis - current treatment standards and emerging drugs. Čes. slov. farm. 2011;60(2):47-53.
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    References

    1. Willis, T.: De anima brutorum. Oxford, UK: Theatro Sheldoniano 1672; 404-406.
    2. Schmidt, J. E.: Medical Discoveries, Who and When, Springfield, Illinois. USA: Thomas 1959.
    3. Barohn, R. J.: Treatment and clinical research in myasthenia gravis. Ann. NY Acad. Sci. 2008; 1132, 225-232. Go to original source... Go to PubMed...
    4. Carr, A. S., Cardwell, C. R., McCarron, P. O., McConville, J.: A systematic review of population based epidemiological studies in myasthenia gravis. BMC Neurol. 2010; 10(1), 46. Go to original source... Go to PubMed...
    5. Phillips, L. H., Torner, J. C.: Epidemiologic evidence for changing natural history of myasthenia gravis. Neurology 1996; 47, 1233-1238. Go to original source... Go to PubMed...
    6. Špalek, P.: Myasténia gravis. Cesk. Slov. Neurol. 2008; 71, 7-24.
    7. Toyka, K. V., Drachman, D. B., Griffin, D. E.: Myasthenia gravis: study of humoral immune mechanisms by passive transfer to mice. N. Engl. J. Med. 1977; 296, 125-131. Go to original source... Go to PubMed...
    8. Santa, T., Engel, A. G., Lambert, E. H.: Histomeric study of neuromuscular junction ultrastructure I. Myasthenia gravis. Neurology 1972; 22, 71-82. Go to original source... Go to PubMed...
    9. Lennon, V. A.: Serological diagnosis of myasthenia gravis and Lambert-Eaton myasthenic syndrome. Handbook of myasthenia gravis and myasthenic syndromes. New York: Marcel-Dekker 1994; 149-164.
    10. Hoch, W., McConville, J., Helms, S.: Auto-antibodies to the receptor tyrosine kinase MuSK in patients with myasthenia gravis without acetylcholine receptor antibodies. Nature Med. 2001; 7, 365-368. Go to original source... Go to PubMed...
    11. Thanvi, B. R., Lo, T. C. N.: Update on myasthenia gravis. Postgrad. Med. J. 2004; 80, 690-700. Go to original source... Go to PubMed...
    12. Warrell, D. A., Cox, T. M., Firth, J. D., Weatherall, D.: Oxford Texbook of Medicine. 4. vyd. Oxford: Oxford University Press 2003.
    13. Pen, A. S., Low, B. W,, Jaffe, J. L.: Drug-induced autoimmune myastenia gravis. Ann. N Y Acad. Sci. 1998; 841, 433-449. Go to original source... Go to PubMed...
    14. Juel, V. C., Massey, J. M.: Myasthenia gravis. Orphanet J. Rare Dis. 2007; 2, 44. Go to original source... Go to PubMed...
    15. Bedlack, R. S., Sanders, D. B.: How to handle myasthenic crisis. Essential steps in patient care. Postgrad. Med. 2000; 107, 211-222. Go to original source... Go to PubMed...
    16. Jablecki, A. 3rd, Barohn, R. J., Ernstoff, R. M.: Myasthenia gravis: recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America. Neurology 2000; 55, 16-23. Go to original source... Go to PubMed...
    17. Oh, S. J., Kim, D. E., Kuruoglu, R.: Diagnostic sensitivity of the laboratory tests in myasthenia gravis. Muscle Nerve. 1992; 15, 720-724. Go to original source... Go to PubMed...
    18. Lindstrom, J. M., Seybold, M. E., Lennon, V. A.: Antibody to acetylcholine receptor in myasthenia gravis. Prevalence, clinical correlates, and diagnostic value. Neurology 1976; 26, 1054-1059. Go to original source... Go to PubMed...
    19. Lindstrom, J.: An assay for antibodies to human acetylcholine receptor in serum from patients with myasthenia gravis. Clin. Immunol. Immunopathol. 1977; 7, 36-43. Go to original source... Go to PubMed...
    20. Vincent, A., Newsom-Davis, J.: Acetylcholine receptor antibody as a diagnostic test for myasthenia gravis: results in 153 validated cases and 2967 diagnostic assays. J. Neurol. Neurosurg. Psychiatry 1985; 48, 1246-1252. Go to original source... Go to PubMed...
    21. Keesey, J. C.: Contemporary Opinions about Mary Walker. A shy pioneer of therapeutic neurology. Neurology 1998; 51, 1433-1439. Go to original source... Go to PubMed...
    22. Hodge, A. S., Humphrey, D. R., Rosenberry, T. L.: Ambenonium is a rapidly reversible noncovalent inhibitor of acetylcholinesterase, with one of the highest known affinities. Mol. Pharmacol. 1992; 41, 937-942. Go to original source...
    23. Komloova, M., Musilek, K., Dolezal, M., Gunn-Moore, F., Kuca, K.: Structure-activity relationship of quaternary acetylcholinesterase inhibitors - Outlook for early myasthenia gravis treatment. Curr. Med. Chem. 2010; 17, 1810-1824. Go to original source... Go to PubMed...
    24. Musilek, K., Komloova, M., Zavadova, V., Holas, O., Hrabinova, M., Pohanka, M.: Preparation and in vitro screening of symmetrical bispyridinium cholinesterase inhibitors bearing different connecting linkage - initial study for myasthenia gravis implications. Bioorg. Med. Chem. Lett. 2010; 20, 1763-1766. Go to original source... Go to PubMed...
    25. Musilek, K., Komloova, M., Holas, O., Hra-binova, M., Pohanka, M., Dohnal, V., Kuca, K.: Preparation and in vitro screening of symmetrical bis-isoquinolinium cholinesterase inhibitors bearing various connecting linkage - implications for early Myasthenia gravis treatment. Eur. J. Med. Chem. 2011; 46, 811-818. Go to original source... Go to PubMed...
    26. Seybold, M. E., Drachman, D. B.: Gradually increasing doses of prednisone in myasthenia gravis: reducing the hazards of treatment. N. Engl. J. Med. 1974; 290, 81-84. Go to original source... Go to PubMed...
    27. Sghirlanzoni, A., Peluchetti, D., Mantegazza, R., Fiacchino, F., Cornelio, F.: Myasthenia gravis: prolonged treatment with steroids. Neurology 1984; 34, 170-174. Go to original source... Go to PubMed...
    28. Pascuzzi, R. M., Coslett, H. B., Johns, T. R.: Long-term corticosteroid treatment of myasthenia gravis: Report of 116 patients. Ann. Neurol. 1984; 15, 291-298. Go to original source... Go to PubMed...
    29. Johns, T. R.: Long-term corticosteroid treatment of myasthenia gravis. Ann. NY Acad. Sci. 1987; 505, 568-583. Go to original source... Go to PubMed...
    30. Kokontis, L., Gutmann, L.: Current treatment of neuromuscular diseases. Arch. Neurol. 2000; 57, 939-943. Go to original source... Go to PubMed...
    31. Schwendimann, R. N., Burton, E., Minagar, A.: Management of myasthenia gravis. Am. J. Ther. 2005; 12, 262-268.
    32. Herrlinger, U., Weller, M., Dichgans, J., Melms, A.: Association of primary central nervous system lymphoma with long-term azathioprine therapy for myasthenia gravis. Ann. Neurol. 2000; 47, 682-683. Go to original source...
    33. De Feo, L. G., Schottlender, J., Martelli, N. A., Molfino, N. A.: Use of intravenous pulsed cyclophosphamide in severe, generalized myasthenia gravis. Muscle Nerve 2002; 26, 31-36. Go to original source... Go to PubMed...
    34. Ciafaloni, E., Sanders, D. B.: Advances in myasthenia gravis. Curr. Neurol. Neurosci. Rep. 2002; 2, 89-95. Go to original source... Go to PubMed...
    35. Chaudhry, V., Cornblath, D. R., Griffin, J. W., O'Brien, R., Drachman, D. B.: Mycophenolate mofetil: a safe and promising immunosupressant in neuro-muscular diseases. Neurology 2001; 56, 94-96. Go to original source... Go to PubMed...
    36. Konishi, T., Yoshiyama, Y., Takamori, M., Saida, T.: Long-term treatment of generalized myasthenia gravis with FK506 (tacrolimus). J. Neurol. Neurosurg. Psychiatry 2005; 76, 448-450. Go to original source... Go to PubMed...
    37. Cwiertka, K., Trojanec, R., Špačková, K., Hajdúch, M.: Terapeutické monoklonální protilátky v onkologii. Klin. Farmakol. Farm. 2004; 18, 165-170.
    38. Du, J., Yang, H., Zhang, D., Wang, J., Guo, H., Peng, B.: Structural basis for the blockage of IL-2 signaling by therapeutic antibody basiliximab. J. Immunol. 2010; 184, 1361-1368. Go to original source... Go to PubMed...
    39. Sobotková, M., Bartůňková, J.: Monoklonální protilátky a další biologická léčiva užívaná v imunosupresivní léčbě. Remedia. 2008; 5, 18.
    40. Kakoulidou, M., Pirskanen-Matell, R., Lefvert, A. K.: Treatment of a patient with myasthenia gravis using antibodies against CD25. Acta Neurol. Scand. 2008; 117, 211-216. Go to original source... Go to PubMed...
    41. Madhusudan, S., Muthuramalingam, S. R., Braybrooke, J. P.: Study of etanercept, a tumor necrosis factor-alpha inhibitor, in recurrent ovarian cancer. J. Clin. Oncol. 2005; 23, 5950-5959. Go to original source... Go to PubMed...
    42. Bongioanni, P., Ricciardi, R., Pellegrino, D., Romano, M. R.: T-cell tumor necrosis factor-alpha receptor binding in myasthenic crisis. J. Neuroimmunol. 1999; 93, 203-207. Go to original source... Go to PubMed...
    43. Rowin, J., Meriggioli, M. N., Tüzün, E., Leurgans, S., Christadoss, P.: Etanercept treatment in corticosteroid-dependent myasthenia gravis. Neurology. 2004; 63, 2390-2932. Go to original source... Go to PubMed...
    44. Soreq, H., Saidman, S., Saidman, J., Evron, T.: Antisense oligonucleotide against human acetyl-cholinesterase (AChE) and uses thereof. US patent 2006, US7074915.
    45. Sussman, J.D., Argov, Z., McKee, D., Hazum, E., Brawer, S., Soreq, H.: Antisense treatment for myasthenia gravis: experience with monarsen, Ann. N Y Acad. Sci. 2008; 1132, 283-290. Go to original source... Go to PubMed...
    46. Brenner, T., Hamra-Amitay, Y., Evron, T., Boneva, N.: The role of readthrough acetylcholinesterase in the pathophysiology of myasthenia gravis. FASEB J. 2003; 17, 214-222. Go to original source... Go to PubMed...
    47. Legay, C. S., Bon, P., Vernier, F.: Cloning and expansion of a rat acetylcholinesterase subunit: generation of a Torpedo collagenic subunit. J. Neurochem. 1993; 60, 337-346. Go to original source... Go to PubMed...
    48. Kaufer, D., Friedman, A., Seidman, S.: Acute stress facilitates long-lasting changes in cholinergic gene expression. Nature 1998; 393, 373-377. Go to original source... Go to PubMed...
    49. NIH Consensus Conference: The utility of therapeutic plasmapheresis for neurological disorders. JAMA 1986; 256, 1333-1337.
    50. Evoli, A., Batcchi, A. P., Provenzano, C.: Thymectomy in the treatment of myasthenia gravis: report of 247 patients. J. Neurol. 1988; 235, 272-276. Go to original source... Go to PubMed...

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