Myasthenia Gravis: etiology, pathophysiological & therapeutic approaches
Myasthenia gravis is an autoimmune diseases; diseases that affect more than 5% of the population. These are multifactorial diseases involving genetic predispositions, hormonal implication, dysfunctions of the immune system, and are triggered by unidentified factors. Myasthenia gravis is due to autoantibodies directed against components of the neuromuscular junction, mainly the acetylcholine receptor (AChR, 85% of cases) but sometimes also against the muscle-specific tyrosine kinase receptor (MuSK) or the LRP4 protein interacting with agrin. These autoantibodies reduce the efficiency of neuromuscular transmission and lead to abnormal muscle fatigability.
The thymus is most likely the site of initiation of myasthenia gravis with anti-AChR antibodies. Histological abnormalities of the thymus are very common: 50-60% of the patients present follicular hyperplasia with ectopic germinal centers, and 10-15% of the patient present a tumor of the thymus (Thymoma). Thymectomy is one of the treatments proposed to these patients.
The research projects developed by the team aim to understand the etiological and pathophysiological mechanisms involved in myasthenia gravis and to propose new therapeutic approaches. More specifically, our objectives are to:
- Elucidate the etiological mechanisms involved in autoimmunity by analyzing the impact of sex hormones and endocrine disruptors in central tolerance processes.
- Understand the cellular and molecular mechanisms at the origin of thymus inflammation and remodeling observed in patients.
- Study the immunoregulatory defects in myasthenia gravis patients by studying the functional phenotype of peripheral and thymic cells by mass cytometry (CyTOF).
- Develop new therapeutic approaches. In this context, we are studying the immunomodulatory and therapeutic potential of mesenchymal stem cells, and the potential of molecules interfering with inflammatory pathways.
- Search for circulating biomarkers to follow the evolution of the disease and the response to treatments.
| Name | Position | ORCID |
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- Cyprien Denoeud, Guotian Luo, Joseph Paquet, Julie Boisselier, Pauline Wosinski, et al.. Enzyme-controlled, nutritive hydrogel for mesenchymal stromal cell survival and paracrine functions. Communications Biology, 2023, 6 (1), pp.1266. ⟨10.1038/s42003-023-05643-y⟩. ⟨hal-04442110⟩
- José A Villegas, Jérôme van Wassenhove, Judith Merrheim, Karen Matta, Samy Hamadache, et al.. Blocking interleukin-23 ameliorates neuromuscular and thymic defects in myasthenia gravis. Journal of Neuroinflammation, 2023, 20 (1), pp.9. ⟨10.1186/s12974-023-02691-3⟩. ⟨hal-03972909⟩
- V. Decostre, C. Chikhaoui, C. Vigouroux, A. Behin, G. Bassez, et al.. VP429 Impaired skeletal muscle strength in adult patients with laminopathies. 28th International Annual Congress of the World Muscle Society, Oct 2023, Charleston SC, United States. pp.S159-S160, ⟨10.1016/j.nmd.2023.07.370⟩. ⟨hal-04280272⟩
- A. Merlet, E. Lacène, I. Nelson, G. Brochier, C. Labasse, et al.. P338 Clinical, morphological, and proteomic features of patients suspected of X-linked myopathy with excessive autophagy (XMEA). 28th International Annual Congress of the World Muscle Society, Oct 2023, Charleston SC, United States. pp.S99, ⟨10.1016/j.nmd.2023.07.136⟩. ⟨hal-04280238⟩
- Cloé Payet, Axel You, Odessa-Maud Fayet, Edouard Hemery, Frederique Truffault, et al.. Central role of macrophages and nucleic acid release in Myasthenia Gravis thymus. Annals of Neurology, 2023, 93 (4), pp.643-654. ⟨10.1002/ana.26590⟩. ⟨pasteur-03927224⟩
- Lidia Almenara-Fuentes, Silvia Rodriguez-Fernandez, Estela Rosell-Mases, Katerina Kachler, Axel You, et al.. A new platform for autoimmune diseases. Inducing tolerance with liposomes encapsulating autoantigens. Nanomedicine: Nanotechnology, Biology and Medicine, 2023, pp.102635. ⟨10.1016/j.nano.2022.102635⟩. ⟨hal-03885962⟩
- Julien Verdier, Odessa-Maud Fayet, Edouard Hemery, Frédérique Truffault, Natalia Pinzón, et al.. Single-cell mass cytometry on peripheral cells in Myasthenia Gravis identifies dysregulation of innate immune cells. Frontiers in Immunology, 2023, 14, ⟨10.3389/fimmu.2023.1083218⟩. ⟨hal-03972888⟩
- Tanya Stojkovic, Marion Masingue, Helène Turmel, Marianne Hezode-Arzel, Anthony Béhin, et al.. Diagnostic yield of a practical electrodiagnostic protocol discriminating between different congenital myasthenic syndromes. Neuromuscular Disorders, 2022, 32 (11-12), pp.870-878. ⟨10.1016/j.nmd.2022.10.001⟩. ⟨hal-04074000⟩
- Alexandra Bayer Wildberger, Jean-Thomas Vilquin. Les cellules CAR-T. Des nouvelles armes dans la lutte contre la fibrose musculaire ?. 2022, pp.40-41. ⟨10.1051/medsci/2022179⟩. ⟨hal-03957222⟩
- Alexandra Bayer Wildberger, Cinthia Bergman, Natalia Pinzon, Axel You, Frédérique Truffault, et al.. Immunomodulation capacities of conditioned mesenchymal stromal cells: benefits and mechanisms in an experimental cell therapy approach for Myasthenia gravis. 7th International Myology Congress, Sep 2022, Nice, France. ⟨hal-03824304⟩
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