Effects of thymectomy and glucocorticoid therapy on peripheral lymphocytes in myasthenia gravis

Clinical manifestations and peripheral blood lymphocyte subset changes were studied in patients with myasthenia gravis (MG) to elucidate the mechanism of clinical improvement following treatment, with thymectomy (Tx) or glucocorticoid (GC) therapy. The changes found were: 1. There was a significant increase in percentages of CD3+, CD29+ CD4+ cells and CD4/CD8 ratio and a significant decrease in percentages of CD8+ and CD16,56+ cells in patients who had never been treated with any immune therapy. 2. After Tx or GC therapy, CD3+ and CD4+, CD29+ cells were decreased, but the number CD19+ and CD16, CD56 cells did not change. 3. Tx had a special effect on CD8+ cells. In most of the patients who showed clinical improvement after Tx, CD8+ cells were increased and CD4/CD8 ratio wad decreased. 4. Anti-acetylcholine receptor (AChRAb) titers were markedly decreased after GC therapy. These results indicate that there were obvious abnormalities in cell-mediated immunity in addition to those in humoral immunity in myasthenia gravis. These abnormalities tended to be normalized after Tx or GC therapy.