The Expression Of IL-17in Serum From Myasthenia Gravis Crisis

ObjectiveTo investigate the clinical characteristics of patients with myasthenia gravis crisis and investigate the effect of IL-17, IL-23, IL-6in myasthenia gravis by detecting the serum concentration of IL-17, IL-23, IL-6in patients with myasthenia gravis crisis, analyzing the concentration change during different periods and the relationship with AChR-Ab level, so as to find some sensitive clinical indicators and offer a theoretical basis of the targeted therapy.MethodsThe clinical data of24cases of crisis were collected, analyzed the age of onset, Osserman typing before crisis, potential incentives, hospitalization time, thymectomy;24cases of patients with crisis and10cases of ocular MG and10cases fo healthy controls were investigated. The serum concentrations of IL-17, IL-23, IL-6and the level of anti-AChR-Ab were tested through ELISA. The concentration between different groups and concentration changes during different periods were analyzed by statistical software.Result1.24patients experienced myasthenic crisis. Male were predominance. Average age of onset was43.71±16.04years,54.17%MG patients appeared crisis within2years of disease onset.21cases in the crisis experienced ball paralysis before the emergence of crisis. The hospitalization time was12-90days, Infection was the most common precipitating factor (58.33%).2. The anti AChR-Ab positive rate was91.67%in serum of patients with crisis, while60%in serum of ocular MG.3The anti AChR-Ab concentration in serum of patients with crisis was higher than in ocular MG(P<0.01).4. The anti AChR-Ab concentration in serum of patients with crisis was reduced after obtaining some alleviate, without significant difference (P=0.463,>0.05).5. The IL-17, IL-23, IL-6level in serum of MG were higher than the normal individuals (P<0.01); The IL-17, IL-23, IL-6level in serum of patients with crisis were significantly higher than ocular MG (P<0.01).6. The IL-17, IL-23, IL-6concentration in serum of patients with crisis were reduced after obtaining some alleviate. But only the IL-17level was decreased significant(P<0.01).7. The level of IL-17, IL-23were positive correlated with the anti AChR-Ab level in serum of patients with crisis(P<0.01).8. The concentrations of IL-23, IL-6were positive correlated with the IL-17level in serum of patients with crisis(P<0.01).Conclusion1. Crisis mostly occurred in the first two years, accompanies the ball paralysis. The infection work as the main suggestion factor. The blood plasma exchangement and the gamma globulin may ameliorate symptoms quickly.2. The level of IL-17in serum of MG patients are significantly higher than the normal person, correlated with the concentration of AChR-Ab, indicated that it may be the index of monitoring of myasthenia gravis.3. The level of IL-17and IL-23, IL-6in serum of MG patients are significantly higher than the normal individuals, correlated with the concentration of AChR-Ab, suggesting that IL-17/IL-23pathway plays an important role in the pathogenesis of MG.