Tacrolimus inhibits Th1 and Th17 responses in MuSK-antibody positive myasthenia gravis patients.

Journal Article (Journal Article)

Muscle specific tyrosine kinase antibody positive myasthenia gravis (MuSK- MG) is characterized by autoantibodies against the MuSK protein of the neuromuscular junction resulting in weakness of bulbar and proximal muscles. We previously demonstrated that patients with MuSK-MG have increased pro-inflammatory Th1 and Th17 responses. Tacrolimus, an immunosuppressant used in AChR-MG and transplantation patients, inhibits T cell responses through interference with IL-2 transcription. The therapeutic efficacy and immunological effect of tacrolimus in MuSK-MG is unclear. In the current study we examined the proliferation, phenotype and cytokine production of CD4+ and CD8+ T cells in peripheral blood mononuclear cells of MuSK-MG following a 3-day in vitro culture with or without tacrolimus. We determined that tacrolimus profoundly suppressed CD4 and CD8 T cell proliferation and significantly suppressed Th1 and Th17 responses, as demonstrated by a reduced frequency of IFN-γ, IL-2, and IL-17 producing CD4 T cells and reduced frequencies of IFN-γ and IL-2 producing CD8 T cells. Tacrolimus also inhibits pathogenic Th17 cells coproducing IL-17 and IFN-γ. In addition, tacrolimus suppressed follicular T helper cell (Tfh) and regulatory T helper cell (Treg) subsets. These findings provide preliminary support for tacrolimus as a potential alternative immunosuppressive therapy for MuSK-MG.

Full Text

Duke Authors

Cited Authors

  • Li, Y; Guptill, JT; Russo, MA; Massey, JM; Juel, VC; Hobson-Webb, LD; Howard, JF; Chopra, M; Liu, W; Yi, JS

Published Date

  • February 2019

Published In

Volume / Issue

  • 312 /

Start / End Page

  • 43 - 50

PubMed ID

  • 30472069

Pubmed Central ID

  • PMC6390960

Electronic International Standard Serial Number (EISSN)

  • 1090-2430

Digital Object Identifier (DOI)

  • 10.1016/j.expneurol.2018.11.006


  • eng

Conference Location

  • United States