重症筋無力症の予防

抄録

Myasthenia gravis (MG) is an autoimmune disorder induced by antibodies against molecules on the postsynaptic membrane. The primary targets are the acetylcholine receptor (AChR) and muscle–specific tyrosine kinase (MuSK). The reason why patients produce such autoantibodies remains unknown. The therapy for MG improved its efficacy and safety in recent years. We admit non–specific immunosuppressive therapy and thymectomy are adequate for treatments of MG. According to the National Epidemiological Surveillance in Japan, the prevalence of MG almost doubled in 2018 compared to that of 2005. Lerner (2016) reported that autoimmune diseases are increasing over countries. As a regional specificity, the northwest area has a high prevalence than the southeast region. Generally, the factors that influence the disease are genetics, living environment, working environment, food, exercise habit, lifestyle, and mental health. There might be some risks in the westernized lifestyle for the onset of autoimmune diseases that we do not realize yet. Westerberg (2018) studied the lifestyle of MG patients in Sweden. They reported patients with MG tended to be obesity, eat less fish, smoke frequently, have a problem in mental health, and less physical activities. Iwasa (2018) reported that titers of anti–AChR antibody in MG patients related to the incidence of Mycoplasma pneumonia and influenza virus infections. These two reports are precious to connect the etiology of MG and environmental factors. In a further study of the prevention of MG, we should go straight forward to integrated research of epidemiology, genomics, transcriptomics, proteomics, metabolomics, and microbiomics. As well, we need to cooperate with researchers in the field of other autoimmune diseases.