Immune Profiles in Myasthenia Gravis
Research type
Research Study
Full title
Comparison of lymphocyte subset, cytokine, and complement profiles in myasthenia gravis of different severity, disease time-points, and treatment history
IRAS ID
280091
Contact name
Katherine Dodd
Contact email
Sponsor organisation
University of Manchester
Duration of Study in the UK
2 years, 6 months, 0 days
Research summary
We aim to better describe the immune profile in myasthenia gravis (MG), including lymphocyte subset, cytokine and complement profiles; how they differ between patients of different severity, at times of disease exacerbation, and with different immunosuppressive treatments. Flow cytometry for lymphocyte subset and cytokine analysis will be performed at the University of Manchester, and complement analysis at Cardiff University. We aim to take into account the heterogeneity of MG by taking into account age of onset of MG (early vs late onset) and focussing on acetylcholine receptor antibody (AChR) positive, non-thymomatous MG aged 18-80.
This research project will consist of three work streams:
1. A one-off observational comparison of the immune profile of patients with different MG severity and in comparison to healthy controls. Stable immunosuppressed, stable non-immunosuppressed, and refractory AChR MG patients will be recruited from specialist MG clinics in England. Demographics, medical history, and immune measures will be compared between the groups, along with healthy controls to look for markers of disease severity.
2. A prospective observational study examining changes in lymphocyte subset, cytokine and complement profiles associated with clinical exacerbation of myasthenia gravis. MG patients previously stable at baseline will be reviewed if and when they experience an exacerbation of symptoms, for medical review and repeat immune profile, and again on regain of symptom control to look for markers of disease activity of effective immunosuppression.
3. A prospective cohort study comparing lymphocyte subset, cytokine and complement profile with disease activity following B cell depletion for refractory myasthenia gravis. Participants will be reviewed 4 weeks after rituximab, and at 6 and 12 months following confirmation of B cell depletion.
We hope that these three overlapping projects will build a clearer picture of how the immune profile varies in MG, helping clinicians to optimise an individual’s treatment.REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
21/NW/0188
Date of REC Opinion
23 Jul 2021
REC opinion
Further Information Favourable Opinion