Lymphoplasma Exchange Improves Myasthenia Gravis Exacerbations: A Retrospective Study in a Chinese Center

Song Ouyang; Weifan Yin; Qiuming Zeng; Bijuan Li; Jian Zhang; Weiwei Duan; Yi Li; Yong Liang; Jiaqi Wang; Hong Tan; Huan Yang

doi:10.3389/fimmu.2022.757841

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Lymphoplasma Exchange Improves Myasthenia Gravis Exacerbations: A Retrospective Study in a Chinese Center

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Lymphoplasma Exchange Improves Myasthenia Gravis Exacerbations: A Retrospective Study in a Chinese Center

Song Ouyang, Weifan Yin, Qiuming Zeng, Bijuan Li, Jian Zhang, Weiwei Duan, Yi Li, Yong Liang, Jiaqi Wang, Hong Tan, …

Frontiers in immunology, Vol.13, 757841

04/01/2022

DOI: 10.3389/fimmu.2022.757841

PMCID: PMC9063637

PMID: 35514988

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Abstract

BackgroundLymphoplasma exchange (LPE), a technique combining plasma exchange with leukapheresis, is emerging as promising treatment for autoimmune diseases. Data on the efficacy and safety of LPE in myasthenia gravis (MG) therapy are scarce. In this study, we aimed to comprehensively review the clinical efficacy, safety, and immunological characteristics of LPE therapy in MG patients.Study Design and MethodsA Chinese cohort of 276 generalized MG patients in state of exacerbation, including impeding crisis, myasthenia crisis, and preparation for thoracic exsection between January 2014 and December 2020, were evaluated in this study.ResultsA total of 276 patients with a median age of 45.5 ± 16.7 years underwent a total of 635 LPE sessions. Clinical scales of Quantitative Myasthenia Gravis (QMG) scores, Myasthenia Gravis Specific Manual Muscle Testing (MMT) scores, activities of daily living (ADL) scores, and quality of life (QOL) scores were improved during 4 weeks’ follow-up. Adverse effects occurred in 20 out of 276 patients, with 14 patients having one adverse event each. Independent predictive factors for good response to LPE therapy were symptom onset before LPE therapy ≤3 days and age on LPE therapy <50 years of age. LPE decreased the serum levels of antibodies, immunoglobulins, and complements 4 weeks after the first replacement, with decreased levels of interleukin (IL)-17A and interferon (IFN)-γ and increased level of IL-10.ConclusionLPE is an effective treatment for MG patients in state of exacerbation and preparation for thymectomy. Early use of LPE on early-onset MG may have good therapeutic effects. The potential mechanism for LPE is the polarization of cytokines from IL-17A, IFN-γ, into IL-10.

autoimmune diseases

lymphoplasma exchange (LPE)

myasthenia gravis (MG)

plasma exchange (PE)

quantitative myasthenia gravis (QMG)

Details

Title: Subtitle: Lymphoplasma Exchange Improves Myasthenia Gravis Exacerbations: A Retrospective Study in a Chinese Center
Creators: Song Ouyang - Xiangya Hospital Central South University
Weifan Yin - Xiangya Hospital Central South University
Qiuming Zeng - Xiangya Hospital Central South University
Bijuan Li - Xiangya Hospital Central South University
Jian Zhang - University of Iowa
Weiwei Duan - Xiangya Hospital Central South University
Yi Li - Xiangya Hospital Central South University
Yong Liang - The First Hospital of Changsha
Jiaqi Wang - The First Hospital of Changsha
Hong Tan - The First Hospital of Changsha
Huan Yang - Xiangya Hospital Central South University
Resource Type: Journal article
Publication Details: Frontiers in immunology, Vol.13, 757841
DOI: 10.3389/fimmu.2022.757841
PMID: 35514988
PMCID: PMC9063637
NLM abbreviation: Front Immunol
eISSN: 1664-3224
Publisher: Frontiers Media S.A
Language: English
Date published: 04/01/2022
Academic Unit: Pathology
Record Identifier: 9984244595002771

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