Myasthenogenicity of a human acetylcholine receptor ?-subunit peptide: Morphology and immunology

Breakdown of tolerance to a self-peptide of acetylcholine receptor alpha-subunit induces experimental myasthenia gravis in rats

Experimental autoimmune myasthenia gravis (EAMG), a model for human myasthenia (MG), is routinely induced in susceptible rat strains by a single immunization with Torpedo acetylcholine receptor (TAChR). TAChR immunization induces anti-AChR Abs that cross-react with self AChR, activate the complement cascade, and promote degradation of the postsynaptic membrane of the neuromuscular junction. In parallel, TAChR-specific T cells are induced, and their specific immunodominant epitope has been mapped to the sequence 97-116 of the AChR alpha subunit. A proliferative T cell response against the corresponding rat sequence (R97-116) was also found in TAChR-immunized rats. To test whether the rat (self) sequence can be pathogenic, we immunized Lewis rats with R97-116 or T97-116 peptides and evaluated clinical, neurophysiological, and immunological parameters. Clinical signs of the disease were noted only in R97-116-immunized animals and were confirmed by electrophysiological signs of impaired neuromuscular transmission. All animals produced Abs against the immunizing peptide, but anti-rat AChR Abs were observed only in animals immunized with the rat peptide. These findings suggested that EAMG in rats can be induced by a single peptide of the self AChR, that this sequence is recognized by T cells and Abs, and that breakdown of tolerance to a self epitope might be an initiating event in the pathogenesis of rat EAMG and MG.

FK506 prevents induction of rat experimental autoimmune myasthenia gravis

Myasthenia gravis (MG) is an organ-specific autoimmune disease attacking nicotinic acetylcholine receptors (AChR) of the neuromuscular junction. Autoantibody production is regulated by autoimmune helper T cells that are specific to AChR. Therefore the suppression of autoimmune T cell activity could reduce myasthenic symptoms. Amongst immunomodulatory therapies aimed at T cells, we studied the therapeutic effect of FK506 as a T cell-specific immunosuppressive agent. Rats in which experimental autoimmune myasthenia gravis (EAMG) was induced by immunization with synthetic peptide of human AChR alpha-subunit residues 125-147 (H alpha 125-147) were treated daily with FK506 (1 mg/kg). FK506 prevented the reduction in amplitude of miniature endplate potential (MEPP) which was induced by H alpha 125-147 immunization. FK506 also suppressed anti-H alpha 125-147 and anti-rat AChR antibody production accompanied by a decrease in the antigen-specific T cell response against H alpha 125-147. These findings indicate that FK506 prevents induction of rat EAMG evoked by immunizing T cells against H alpha 125-147.

Response to human acetylcholine receptor alpha 138-199: determinant spreading initiates autoimmunity to self-antigen in rabbits

NZW rabbits immunised with a mixture of synthetic peptides representing alpha 138-199 of the human acetylcholine receptor (AChR) alpha-subunit exhibited clinical, biochemical and electrophysiological signs of experimental autoimmune myasthenia gravis (EAMG), with raised levels of anti-rabbit AChR antibodies. Surprisingly, these were partly directed at the main immunogenic region (MIR, thought to be alpha 67-76) and alpha-Bungarotoxin binding sites on rabbit AChR, and reacted less well with human AChR. Moreover, they could be separated from the anti-peptide antibodies by fractionation on immobilised peptide. We conclude that immunisation with these peptides led, by 'determinant spreading', to a response directed at self-AChR. Similar phenomena may have been overlooked in previous studies of responses to synthetic or recombinant AChR sequences. These findings suggest that autoimmunity could be induced by low-affinity, cross-reacting epitopes even when the observed serum response is highly specific for the autoantigen.