BRAIN and NERVE Shinkei Kenkyu no Shinpo Volume 66, Issue 5 (May 2014)

Myasthenia Gravis and Acetylcholine Toshiki Fujioka 1 1Division of Neurology (Ohashi), Department of Medicine, School of Medicine, Toho University Keyword: アセチルコリン , 神経筋接合部 , 神経筋伝達ブロック , アセチルコリン受容体 , 重症筋無力症 , acetylcholine , neuromuscular junction , neuromuscular block , acetylcholine receptor , myasthenia gravis pp.517-525
Published Date 2014/5/1
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A century has passed since the discovery of the first neurotransmitter, acetylcholine, in 1914. Extensive research on acetylcholine and its function has provided us with important options to treat the formerly intractable neuromuscular disease myasthenia gravis (MG). In the first days of treatment for MG, acetylcholine esterase inhibitors are administered, which is only a symptomatic therapy. After overwhelming developments in immunology, the immunological mechanisms of MG at the molecular or genetic level were recognized. Destruction of the acetylcholine receptors through autoimmune attacks plays a pivotal role in the evolution of MG. Thus, a mainstay of the newly developing treatments for MG are effective immunosuppression or immunomodulation. However, these therapeutic approaches are still "symptomatic", and target immunological rather than specific myasthenic symptoms. Immunomodulation may result in fatal immunodeficiency. From this point of view, although they are somewhat removed from first-line MG treatment (cholinesterase inhibitors), future drug development should focus on the cancellation of autoimmunity in MG patients.

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BRAIN and NERVE-神経研究の進歩
66巻5号 (2014年5月)
電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院