Clinical Significance Of Interleukin-27 In Anti-acetylcholine Receptor Antibody-postive Myasthenia Gravis

Objective To detect the IL-27 in patients with the myasthenia gravis(MG)whose acetylcholine receptors antibody were positive.The significant of serum IL-27 in MG was analyzed.Methods The study subjects were recruited from Tianjin Medical University General Hospital.The 40 anti-acetylcholine receptor(ACh R)antibody-postive MG patients were from the Neurology Department,during January 2015 to December 2017,The 35 healthy volunteers from the physical examination center of our hospital were enrolled as healthy controls(HC).Quantitative MG(QMG)score was performed to assess the severity of disease.Activities of daily living(ADL)was used to assess the basic living conditions of patients,the clinical state was assessed by assessment of postintervention status made by Myasthenia Gravis Foundation of America(MGFA).The thymus of the patients were scanned with computed tomography or megnetic resonance imaging.The serum ACh R antibody of patients and healthy controls were qualitative detected by cell-based assay(CBA).ELISA was used to measure serum IL-27 levels.The correlation between IL-27 levels and other clinical indicators were analyzed.Results1.The level of IL-27 in the serum of MG patients before treatment was higher than that of HC(205.74±134.40pg/m L,116.60±53.13pg/m L)(P<0.01);The IL-27 level of MG patients in the IV~V subtype classified by MGFA was(288.15±182.11)pg/ml,higher than that of I~III subtype patients(116.60±53.13)pg/ml,(P=0.01).2.After the treatment with steroids or and with high dose immunoglobin G intervenous infusion,at the MM-3 clinical stage(patients who were relieved by oraling small dose of prednisolone and pyridostigmine),(176.12±154.75)pg/ml and(145.55±83.28)pg/ml in the MG IV~V and I~III subgroup.The serum IL-27 level in MG at the MM-3 stage was higher than in the HC,but the difference was not statistically significant(P>0.05).3.The serum IL-27 level dropped down after intenvention with immune therapy,at the MM-3 stage,the IL-27 level,whatever in the total MG subjects,or in their clinical subgroups,were abviously lower than those before the treatment.(P=0.04,P=0.04,P=0.02).4.Whatever in the total MG group,or their subgroup IV~V and I~III,the serum IL-27 level was not significantly correlated with QMG scores before treatment.(r=0.16,P=0.33;r=0.14,P=0.63;r=0.24,P=0.21;r=0.36,P=0.06;r=0.21,P=0.52;r=0.19,P=0.51).5.However in the total MG group,or their subgroup IV~V and I~III,the serum IL-27 level was significantly correlated with ADL scores before treatment(r=-0.38,P=0,02;r=0.59,P=0.03;r=0.64,P<0.01).Conclusions1.The serum IL-27 level in patients with MG and its subgroup who were remained untreated were higher than in HC and those in their MM-3 stage,which prompted IL-27 may be involved in the pathogenesis of MG,and the detection of serum level of IL-27 may help predict disease activity,and it provided the basis for its possible target therapy.2.The serum IL-27 level was significantly correlated with patients ADL scores,and was significantly higher in IV~V patients than I~III patients,which prompted IL-27 was likely to play an important regulating role in MG immune inflammatory process,to some extent could predict the severity of the disease and prognosis.