Editorial Material
Clinical Neurology
Steven Karceski
Summary: The study examines the impact of different surgical approaches on thymectomy in Myasthenia Gravis patients, aiming to determine the most effective method with the lowest risk and highest benefit. Modern surgical techniques, including minimally invasive approaches with robotic assistance, have revolutionized treatment options and outcomes for MG patients. The question of which surgical approach is best for MG may seem simple but entails complex considerations and evaluations.
Review
Oncology
Mingbo Tang, Yifeng Shao, Junxue Dong, Xinliang Gao, Shixiong Wei, Jianzun Ma, Yang Hong, Zhiqin Li, Taiyu Bi, Yipeng Yin, Wenyu Zhang, Wei Liu
Summary: This study used a meta-analysis to examine the incidence of postoperative myasthenia gravis (PMG) and risk factors in patients with non-MG thymoma. The results showed that the incidence of PMG in preoperative patients with non-MG thymoma was 8%. Preoperative seropositive acetylcholine receptor antibody, open thymectomy, non-R0 resection, WHO type B, and postoperative inflammation were identified as risk factors for PMG.
FRONTIERS IN ONCOLOGY
(2023)
Article
Oncology
Florit Marcuse, Monique Hochstenbag, Janneke G. J. Hoeijmakers, Myrurgia Abdul Hamid, Jan Damoiseaux, Jos Maessen, Marc De Baets
Summary: Subclinical myasthenia gravis (MG) was found in a proportion of thymoma patients, with the majority of these patients developing clinical MG within six years after thymectomy. Analyzing anti-AChR antibodies in suspected thymoma patients before thymectomy is recommended.
Review
Clinical Neurology
Jakob Rath, Bernhard Moser, Fritz Zimprich
Summary: Thymectomy is an effective treatment option for adult patients with early onset acetylcholine-receptor positive myasthenia gravis, but there is still uncertainty regarding certain patient subgroups.
CURRENT OPINION IN NEUROLOGY
(2023)
Article
Medicine, Research & Experimental
Zhu Haoshuai, Zou Jianyong, Yang Lei, Zeng Bo, Jiefei Xiao, Xin Zhang, Zhenguang Chen, Su Chunhua
Summary: In patients with thymomatous MG undergoing thymectomy, it takes on average 6 months to achieve a 3 point reduction in QMGS and 30 months for another 3 point reduction. Older age (>=42 years) and higher Masaoka-Koga stage (>I) are associated with a lower probability of achieving a reduction in QMGS.
JOURNAL OF TRANSLATIONAL MEDICINE
(2021)
Article
Multidisciplinary Sciences
Patricia Sikorski, Yaoxiang Li, Mehar Cheema, Gil I. Wolfe, Linda L. Kusner, Inmaculada Aban, Henry J. Kaminski
Summary: The study identified that high levels of phospholipids in serum were associated with treatment response in MG patients. It also found a panel of markers including histidine, free fatty acid, gamma-cholestenol, and guanosine that were highly predictive of treatment response. Pathway analysis suggested that xenobiotic metabolism may play a major role in treatment resistance, and individual variation in prednisone metabolism could impact treatment efficacy.
Article
Surgery
Ahmed AL-Bulushi, Issa Al Salmi, Fatma Al Rahbi, AbdulAziz Al Farsi, Suad Hannawi
Summary: This study investigated the epidemiology of patients with myasthenia gravis who underwent thymectomy at the Royal Hospital in Muscat, Oman over the past three decades. The results showed that post-thymectomy, most patients experienced significant clinical improvement, with a small percentage achieving complete clinical remission.
ASIAN JOURNAL OF SURGERY
(2021)
Article
Clinical Neurology
Jakob Rath, Manuela Taborsky, Bernhard Moser, Gudrun Zulehner, Rosa Weng, Martin Krenn, Hakan Cetin, Jose Ramon Matilla, Leonhard Muellauer, Fritz Zimprich
Summary: This study investigated the short- and long-term outcomes of thymectomy in patients with acetylcholine receptor antibody-positive myasthenia gravis (MG). The results showed that the sustained long-term clinical response after thymectomy is lower than the initial response rates would suggest. None of the evaluated clinical factors predicted a worse outcome, supporting the current clinical practice of patient selection for thymectomy. The relative decline of AChR-Abs after surgery appears to be a promising prognostic marker.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Review
Clinical Neurology
Pushpa Narayanaswami, Donald B. Sanders, Gil Wolfe, Michael Benatar, Gabriel Cea, Amelia Evoli, Nils Erik Gilhus, Isabel Illa, Nancy L. Kuntz, Janice Massey, Arthur Melms, Hiroyuki Murai, Michael Nicolle, Jacqueline Palace, David Richman, Jan Verschuuren
Summary: This study updated the 2016 formal consensus-based guidance for the management of myasthenia gravis, with updated recommendations on thymectomy and new recommendations on the use of rituximab, eculizumab, and methotrexate. The consensus guidance developed by international MG experts based on new evidence can provide direction for clinicians caring for MG patients worldwide.
Article
Clinical Neurology
Deepak Menon, Hans Katzberg, Carolina Barnett, Prodipto Pal, Andrea Bezjak, Shaf Keshavjee, Vera Bril
Summary: The World Health Organization pathological subtype of thymoma did not correlate with Myasthenia Gravis outcomes. However, positive acetylcholine antibody serology, presence of TFH, and non-recurrence of thymoma predict a favorable outcome.
Review
Immunology
Kangzhi Chen, Yi Li, Huan Yang
Summary: Myasthenia gravis (MG) is a group of diverse but treatable autoimmune diseases. Thymectomy, as an important treatment approach, can lead to favorable outcomes in certain cases, but there are also risks of poor results. The response to thymectomy may be influenced by patient characteristics, disease conditions, antibody profiles, surgical factors, and abnormal immune reactions. Pathological remnants and abnormal immune responses are potential mechanisms behind poor outcomes.
JOURNAL OF AUTOIMMUNITY
(2022)
Article
Clinical Neurology
Hye Yoon Chung, Ha Young Shin, Young-Chul Choi, Hyung Jun Park, Jin Gu Lee, Chang Young Lee, Byung Jo Park, Gi Jeong Kim, Seung Woo Kim
Summary: This study found that the presence of germinal centers in thymic tissues could be a significant risk factor for the development of myasthenia gravis (MG) after thymoma resection. Even in patients without clinical symptoms of MG, postthymectomy MG should be considered, especially if thymic germinal centers are observed.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Multidisciplinary Sciences
Yoshiaki Yasumizu, Naganari Ohkura, Hisashi Murata, Makoto Kinoshita, Soichiro Funaki, Satoshi Nojima, Kansuke Kido, Masaharu Kohara, Daisuke Motooka, Daisuke Okuzaki, Shuji Suganami, Eriko Takeuchi, Yamami Nakamura, Yusuke Takeshima, Masaya Arai, Satoru Tada, Meinoshin Okumura, Eiichi Morii, Yasushi Shintani, Shimon Sakaguchi, Tatsusada Okuno, Hideki Mochizuki
Summary: This study reveals the ectopic expression of neuromuscular molecules in MG-type thymoma, specifically in a distinct subpopulation of medullary thymic epithelial cells (nmTECs). MG-thymoma exhibits microenvironments dedicated to autoantibody production and cell-cell interactions between nmTECs and T/B cells. The findings suggest that nmTECs play a significant role in the pathogenesis of MG through ectopic expression of neuromuscular molecules.
NATURE COMMUNICATIONS
(2022)
Article
Oncology
Zhengcheng Liu, Louqian Zhang, Weifeng Tang, Rusong Yang
Summary: Patients undergoing non-intubated uniportal subxiphoid thoracoscopic extended thymectomy had successful outcomes without the need for intubation or thoracotomy. The procedure had short operative time, chest tube duration, and hospital stay. Histologic examination showed early-stage thymomas and there were rare side effects.
WORLD JOURNAL OF SURGICAL ONCOLOGY
(2021)
Article
Clinical Neurology
Jinwei Zhang, Peng Zhang, Hui Zhang, Yuantao Cui, Yuan Chen, Peng Lv, Xin Li
Summary: This study retrospectively analyzed the postthymectomy outcomes and factors affecting the prognosis of thymomatous generalized myasthenia gravis (TGMG) in 86 patients. The results showed that male sex and disease duration < 11.5 weeks were independent predictors of complete stable remission (CSR) in TGMG postthymectomy. Patients with onset age < 52.8 years and symptoms of ocular and limb muscle weakness had a higher probability of achieving CSR compared to those with onset age > 52.8 years and symptoms of bulbar muscle weakness. Female sex was an independent predictor of MG symptom exacerbation in TGMG postthymectomy.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Immunology
Yingkai Li, Jeffrey T. Guptill, Melissa A. Russo, James F. Howard, Janice M. Massey, Vern C. Juel, Lisa D. Hobson-Webb, Doug Emmett, Manisha Chopra, Shruti Raja, Weibin Liu, John S. Yi
JOURNAL OF NEUROIMMUNOLOGY
(2020)
Review
Clinical Neurology
Yaru Lu, Hao Ran, Wenhao Yang, Qian Ma, Li Qiu, Changyi Ou, Pei Chen, Zhongqiang Lin, Weibin Liu
NEUROMUSCULAR DISORDERS
(2020)
Article
Clinical Neurology
Jiaxin Chen, Wenjin Shang, Yin Chen, Yan Li, Xin Huang, Chunhua Su, Kai Zhu, Jieni Zhang, Weibin Liu, Huiyu Feng
Summary: Thymomatous myasthenia gravis (T-MG) differs clinically from non-thymomatous myasthenia gravis (NT-MG), with thymoma considered a risk factor for MG. Preoperative use of anticholinesterase drugs is a protective factor for the long-term prognosis of T-MG. Understanding the characteristics of T-MG may help improve its prognosis.
ACTA NEUROLOGICA SCANDINAVICA
(2021)
Article
Immunology
Xiaoxi Liu, Qian Ma, Li Qiu, Changyi Ou, Zhongqiang Lin, Yaru Lu, Huan Huang, Pei Chen, Zhidong Huang, Weibin Liu
CLINICAL IMMUNOLOGY
(2020)
Article
Biochemistry & Molecular Biology
Hao Ran, Weibin Liu, Xin Pan, Chuanbin Wu, Guilan Quan, Ying Huang, Yingtong Cui
Summary: This study presents a multifunctional approach for pharmaceutical management, utilizing the ANIAE technique to assemble nanospheres in one step using polyprotein microspheres. The results demonstrate a versatile and universal solution for insoluble active ingredients.
CURRENT PHARMACEUTICAL BIOTECHNOLOGY
(2021)
Article
Immunology
Qian Ma, Hao Ran, Yingkai Li, Yaru Lu, Xiaoxi Liu, Huan Huang, Wenhao Yang, Lu Yu, Pei Chen, Xin Huang, Li Qiu, Zhongqiang Lin, Changyi Ou, Weibin Liu
CLINICAL IMMUNOLOGY
(2020)
Review
Clinical Neurology
Jieni Zhang, Yin Chen, Jiaxin Chen, Xin Huang, Haiyan Wang, Yan Li, Weibin Liu, Huiyu Feng
Summary: The study found that DSP-MG in southern China has more severe symptoms and poor prognosis compared to AChR-MG, with no significant differences compared to MuSK-MG. The researchers speculated that DSP-MG may be a subtype of MuSK-MG.
NEUROLOGICAL SCIENCES
(2021)
Article
Immunology
Huan Huang, Hao Ran, Xiaoxi Liu, Lu Yu, Li Qiu, Zhongqiang Lin, Changyi Ou, Yaru Lu, Wenhao Yang, Weibin Liu
Summary: The study found that leflunomide can alleviate the severity of EAMG by regulating humoral immune responses and balancing Th cell subsets, potentially by inhibiting Tfh cells and reducing antibody secretion.
INTERNATIONAL IMMUNOPHARMACOLOGY
(2021)
Article
Clinical Neurology
Ran Zhou, Qiuming Zeng, Huan Yang, Yan Xu, Guojun Tan, Hongbo Liu, Lihua Wang, Hongyu Zhou, Meini Zhang, Jinzhou Feng, Tao Jin, Xinghu Zhang, Jiawei Wang, Xu Zhang, Feng Gao, Chunsheng Yang, Bitao Bu, Chunyang Li, Min Zhang, Huiqing Dong, Aiyu Lin, Weibin Liu, Lei Wu, Manxia Wang, Yulan Tang, Honghao Wang, Youming Long, Zhe Wang, Weihong Zheng
Summary: The study found that highly educated patients with frequent relapses were more willing to receive treatment, while patients with more understanding of the disease opted to be treated. Younger patients, those with severe disease course, and those with more symptoms were more likely to choose treatment. A higher proportion of women chose to be treated with DMTs than with other immunotherapies.
FRONTIERS IN NEUROLOGY
(2021)
Article
Clinical Neurology
Xin Huang, Li Qiu, Yaru Lu, Jiaxin Chen, Wenhao Yang, Changyi Ou, Hao Ran, Weibin Liu
Summary: The combination therapy of leflunomide and low-dose prednisone has been shown to be clinically effective in treating myasthenia gravis (MG), improving patients' clinical symptoms and having a promising treatment effect, especially for generalized MG.
ACTA NEUROLOGICA BELGICA
(2023)
Review
Clinical Neurology
Qian Ma, Hao Ran, Changyi Ou, Xiaoxi Liu, Yaru Lu, Huan Huang, Wenhao Yang, Lu Yu, Pei Chen, Xin Huang, Li Qiu, Zhongqiang Lin, Zhidong Huang, Weibin Liu
Summary: Based on clinical data and literature review, it was found that under proper management, patients with myasthenia gravis (MG) can safely and successfully use botulinum toxin (BTX) for comorbidities.
JOURNAL OF CLINICAL NEUROSCIENCE
(2022)
Article
Geriatrics & Gerontology
Yan Li, Pei Chen, Hao Huang, Huiyu Feng, Hao Ran, Weibin Liu
Summary: This study found that all common DC subsets are present in the human thymus of various ages, with the density of pDCs gradually increasing with age, suggesting an additional role of pDCs in the thymus beyond central tolerance. The ratio of medulla to cortex area in the human thymus increases with age, while the densities of different DC subsets also show changes.
Article
Psychiatry
Lu Yu, Li Qiu, Hao Ran, Qian Ma, Ya-Ru Lu, Wei-Bin Liu
Summary: Late-onset myasthenia gravis (MG) patients, especially women, are more likely to experience anxiety and depression, with higher MG-QOL-15 scores correlating with increased incidence.
WORLD JOURNAL OF PSYCHIATRY
(2022)
Article
Clinical Neurology
Xin Huang, Hao Ran, Yingkia Li, Qian Ma, Changyi Ou, Li Qiu, Huiyu Feng, Weibin Liu
Summary: The combination of leflunomide and low-dose prednisone can significantly reduce the frequency of Th1 and Th17 cells, as well as the secretion of pro-inflammatory cytokines IL-17 and IL-9, thereby improving the clinical symptoms of myasthenia gravis (MG).
FRONTIERS IN NEUROLOGY
(2022)
Article
Neurosciences
Chao Zhang, Bitao Bu, Huan Yang, Lihua Wang, Weibin Liu, Rui-Sheng Duan, Meini Zhang, Pei Zeng, Chen Du, Li Yang, Fu-Dong Shi
CNS NEUROSCIENCE & THERAPEUTICS
(2020)