Aktuelle Aspekte in der Pathogenese, Diagnostik und Therapie der Myasthenia gravis

Zusammenfassung

In den letzten Jahren ist es bei der Myasthenia gravis zu einer Erweiterung des pathogenetischen Verständnisses und der therapeutischen Möglichkeiten gekommen. Neue klinische und immunologische Befunde legen eine differenzierte Klassifikation der Erkrankung nahe, die wichtige prognostische und therapeutische Implikationen hat. Viele der etablierten Therapien sind trotz unvollständiger Absicherung durch kontrollierte Studien von unbestrittener Wirksamkeit und haben die Prognose der Erkrankung drastisch verbessern können. In der präklinischen Entwicklung haben sich eine Reihe von antigenspezifischen Therapieansätze als wirksam erwiesen und könnten damit zukünftige Alternativen zur derzeit üblichen unspezifischen Immunsuppression darstellen.

Abstract

Recent years have witnessed significant advances in the pathogenetic understanding and therapy of autoimmune myasthenia gravis. New immunological and clinical data suggest a revised classification which has important prognostic and therapeutic implications. Although incompletely tested in controlled trials, immune-directed therapies are of undisputed efficacy and have dramatically improved the prognosis of myasthenic patients. Antigen-specific therapy has proven effective in preclinical animal studies and may offer future alternatives to nonspecific immunosuppression.

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